TCM Diagnosis of Uremia

Many Chinese medicine practitioners choose to use a dialectical viewpoint when treating uremia. However, when treating uremia, if only Chinese medicine methods are used, the disease cannot be cured. When necessary, some imported drugs are still needed, and dialysis can also be performed on the patient. Although the dialysis process is painful and expensive, the effect is still very good. So what is the dialectical theory of Chinese medicine for uremia?

To sum up, it can be seen that chronic nephritis and uremia are mostly symptoms of spleen and kidney yang deficiency, which is the main pathogenesis. Yang deficiency of the spleen and kidneys leads to poor distribution of qi and fluid, the clear yang fails to rise, the turbid yin fails to descend, dampness and turbidity accumulate inside the body, the meridians are blocked, causing nausea and vomiting, and oligouria or urinary retention.

In addition, clinically, other symptoms include fullness, swelling, poor appetite, loose stools, a drum-like abdomen, restlessness, pale complexion, palpitations, dizziness, sleepiness, joint discomfort, itching all over the body, cracked skin and nails, epistaxis, drowsiness, convulsions, etc. In the late stage, both yin and yang are damaged, turbid toxins spread everywhere, obscuring the clear orifices, causing internal disturbances of liver wind, high blood pressure, severe headaches, and irritability. Although this series of syndromes is relatively complex and severe, they can still be rescued if the causes are identified and the correct treatment is given.

Currently, there is no ideal treatment for chronic renal failure. Although there are fluid dialysis therapy, hemodialysis therapy, kidney transplantation, etc., they are not widely used.

Over the years, we have used the following methods to treat uremia, focusing on warming the yang and promoting diuresis, warming the yang and reducing adverse effects, and warming the yang and unblocking the bowels, so that the spleen yang can be unblocked and the dampness and turbidity can be discharged. If dampness and turbidity turn into heat, it is superficial heat but the root cause is cold, with cold and heat mixed together, and deficiency and excess showing up simultaneously. It is quite difficult to use medicine. Bitter and cold medicines for clearing heat can easily damage Yang, while supporting Yang and consolidating the root can help the evil turn into heat. It is necessary to grasp the main contradiction in order to avoid errors in diagnosis and treatment.

Method of invigorating qi, warming yang and promoting water circulation:

It is suitable for spleen and kidney yang deficiency, internal accumulation of dampness and turbidity, severe edema accompanied by ascites, nausea, vomiting, and drowsiness. It can invigorate Qi and support Yang, strengthen the kidneys and promote diuresis, facilitate urination, and discharge turbid air in the stomach. It is advisable to choose prescriptions such as Liuwei Dihuang Decoction plus ginseng and Astragalus, Zhenwu Decoction, Wuling Powder, Ling Gui Zhu Gan Decoction, etc.

Warming Yang and Reducing Counterflow Method:

Suitable for patients with nausea and vomiting as the main symptoms. When the stomach is out of balance, dampness cannot be transformed, and turbid qi goes up against the flow, you can use perilla leaves and coptis root boiled in water instead of tea, and take it frequently; or take ginseng and pinellia soup (ginseng, pinellia, poria, tangerine peel, angelica, coix seed, Achyranthes bidentata, Amomum villosum, Cymbidium orientale, Schisandra chinensis, Aquilaria wood, cinnamon bark, citron); or take coptis root and gallbladder warming soup, which uses bitter and pungent ingredients together to wake up the spleen and harmonize the middle to reduce dampness and turbid qi.

Method of warming Yang and unblocking bowels:

It is suitable for patients with high urea nitrogen (above 40% mg), spleen and kidney yang deficiency, strong dampness and heat, and visceral qi stagnation. To clear dampness and turbidity, you can use aconite, rhubarb, radish seed, and licorice, decoct them into a concentrated juice of 100-150ml, and keep it for enema every night.

Method of calming the liver and extinguishing wind:

It is suitable for patients with evil heat invading the liver and causing convulsions, with convulsions as the main symptom and the condition is critical. When dampness turns into dryness, robs the yin fluid and causes internal wind to stir, you can use Buffalo Horn and Uncaria Decoction (Buffalo Horn, Uncaria, Mulberry Leaf, Fritillaria, Rhizoma Anemarrhenae, Rehmannia Glutinosa, Chrysanthemum, White Peony Root, Poria Wood, Licorice). In the recipe, use 10-15g of antelope horn, simmer for 1 hour, add water and drink, and simmer the remaining residue with other medicines again. If bleeding is the main symptom, evil heat is transmitted internally, both the blood and the nutrient fluid are burned, the blood does not stop, and the tongue is crimson, you can use Rhinoceros Horn and Rehmannia Decoction. At this time, uremia has entered the late stage and Chinese medicine is less effective. If you see coma, it is because dampness and turbidity are diffused and the mind is closed. You can use aromatic products that can clear turbidity and open the orifices. Take Acorus Calamus and Curcuma Decoction (Acorus Calamus, Curcuma, Gardenia, Forsythia, Chrysanthemum, Talcum, Bamboo Leaf, Moutan Bark, Burdock Seed, Bamboo Juice, Ginger Juice) internally. Yushu Dan is also known as Zijin Ingot. It is generally marked for external use and can be taken internally.

The above methods can often be used in combination. For patients with chronic renal failure accompanied by nausea, vomiting, lienti, high urea nitrogen, low carbon dioxide binding capacity, and low renal excretion function, first use perilla leaves and coptis chinensis to treat the symptoms; then use Liuwei Dihuang Decoction with ginseng and Astragalus to consolidate the foundation. It has good effects on improving renal function, enhancing the renal excretion capacity, reducing urea nitrogen, and increasing plasma protein.