Ruan Shiwei's Experience in Treating Nephrotic Syndrome from the Perspective of Triple Energizer
Professor Ruan Shiwei bases his approach on the principles of"individualized treatment according to person,disease,and syndrome,"combining the changes in qi,blood,yin,and yang of the zang-fu organs within the triple energizer.He believes that the onset of nephrotic syndrome is closely related to these changes.The fundamental pathogenesis lies in the obstruction of water pathways in the triple energizer and the dysfunction of ascending and descending processes.The primary treatment principles are to dispel pathogens and strengthen healthy qi,supplemented with methods of dispersing,promoting diuresis,attacking and removing,invigorating the spleen,war-ming the kidney,replenishing qi,and nourishing yin.Professor Ruan believes that for upper energizer syndromes,diagnosed as wind-wa-ter mutual fighting syndrome,the treatment emphasizes ventilating the lung and regulating water pathways,clearing the upper and solidi-fying the lower,so Modified Ephedra and Fructus Forsythiae and Semen Phaseoli Decoction is often used.For wind-cold predominance,Lianqiao(Fructus Forsythiae)can be removed,and Suye(Folium Perillae)and Guizhi(Ramulus Cinnamomi)added to relieve the exterior and disperse cold.For severe coughing and asthma,Qianhu(Radix Peucedani)can be added to direct qi downward and relieve asthma.For sweating with aversion to wind,Hanfangji(Radix Stephaniae Tetrandrae)and Shenghuangqi(Radix Scutellariae)can be added to tonify qi and strengthen the exterior and promote diuresis and remove edema.For middle energizer syndromes,diagnosed as ex-ternal dampness pathogen syndrome or spleen deficiency with dampness predominance,Modified Six Harmony Decoction,Modified Gin-seng and Poria and White Atractylodes Powder,pr Modified Yang-Raising and Stomach-Boosting Decoction can be used accordingly.For lower energizer syndromes,diagnosed as kidney yin deficiency syndrome or kidney yang deficiency syndrome,Modified Anemarrhena and Phellodendron and Rehmannia Pill,Life-Saving Kidney Qi Decoction can be used respectively.For frequent urination,it is proper to remove Zexie(Rhizoma Alismatis)and Cheqianzi(Semen Plantaginis),but add Tusizi(Semen Cuscutae)and Buguzhi(Fructus Psor-aleae)to consolidate essence and reduce urination.For breathlessness and sweating,Wuweizi(Fructus Schisandrae Chinensis)can be added to astringe and consolidate.If accompanied by dizziness,headache,palpitations,and insomnia,Shenglonggu(Os Draconis)and Shengmuli(Concha Ostreae)can be added to calm and sedate the mind.For fatigue and desire to sleep,along with nausea,Fuling(Po-ria)and Liuyuexue(Herba Serissae)can be added to invigorate the spleen and eliminate dampness.For conditions affecting the triple energizer,diagnosed as spleen-kidney deficiency syndrome,qi-yin deficiency with dampness syndrome,or dampness stagnation and blood stasis syndrome,Modified Kidney-Replenishing and Turbidity-Reducing Decoction,Modified Heart-Clearing Lotus Seed Beverage,and Modified Chinese Angelica and Peony Powder,etc.in Beneficial Formulas from the Taiping Imperial Pharmacy can be used respec-tively.
nephrotic syndrometreating from the perspective of triple energizertriple energizerRuan Shiwei
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