NEPHROTIC SYNDROME

Clinical Manifestations
  • Nephrotic syndrome can be caused by a wide variety of glomerular diseases. It may follow bacterial or viral infection, malignant tumors and administration of some drugs. Some immune diseases, such as systemic lupus erythematosis, allergic purpura and diabetes mellitus can be complicated by nephrotic syndrome. This disease is included in the categories of "Shui Zhong" (edema), and "Xu Lao" (consumptive diseases) in TCM.
  • Main Points of Diagnosis:
    1. Heavy proteinuria, accompanied with edema and hypoproteinemia, are three major manifestations of this syndrome. There may also be high blood pressure. Urinary protein excretion exceeds 3.5g per day. The serum albumin is lower than 30g per liter. Severe edema may appear if serum albumin is lower than 15g per liter.
    2. The alteration of blood pressure varies with different types of the disease. Hyperlipidemia is common, particularly increased cholesterol. 3. About 75 per cent of cases with nephrotic syndrome are caused by primary glomerular diseases. In children nearly 80 per cent of cases are nephrotic syndrome of minute lesion type. The rest are secondary to other diseases. Renopuncture biopsy is of much help in confirming the cases of the diseases and indicating treatment
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Chills and fever
  • Achiness
  • Stiff neck and shoulders
  • Anhidrosis
  • Headache
  • Stabbing joint pain
  • Itchy throat
  • Cough
  • Asthma
  • Aversion to Cold
  • Maybe frozen shoulder
  • * The Tai Yang symptoms remain for 2-3 days
  • Thirst with no desire to drink
  • May have vomiting immediately after drinking
  • Difficult urination
  • May have upper body edema
  • T: Normal
  • C: White
  • P: Floating and slippery
Treatment Principle
  • Promote urination
  • Dispel Dampness
  • Expel Wind
Herb Formulas
Points
Clinical Manifestations
  • Alternating chills and fever
  • Thirst
  • A bitter taste in the mouth
  • Anorexia
  • Edema
  • Vomiting and diarrhea with water intake
  • Dysuria
  • Fullness and oppression in the chest and hypochondrium
  • Diarrhea
  • T: Pink
  • C: White
  • P: Superficial and wiry
Treatment Principle
  • Harmonize the Exterior and the Interior
  • Relieve the Shao Yang
  • Dispel Water Accumulation
  • Resolve Phlegm Accumulation
Herb Formulas
Points
Clinical Manifestations
  • Aversion to Wind and Cold
  • Facial edema moving to generalized edema
  • Slight fever or fever and chills
  • Thirst
  • Slight but continuous perspiration
  • Sore, heavy limbs
  • Decreased urination
  • Headache
  • Edematous orbits
  • A red, swollen sore throat
  • Belching
  • Cough
  • Asthma
  • Dyspnea
  • Bulging eyes Severe cough
  • T: Normal
  • C: White or Thin white
  • P: Floating or Floating and big
Treatment Principle
  • Promote perspiration
  • Disseminate Lung Qi
  • Clear Heat
  • Move water
Herb Formulas
Points
Clinical Manifestations
  • Soft, weak cough with clear thin sputum
  • Physical and mental exhaustion
  • Soft, weak voice
  • Reluctance to speak
  • Shortness of breath
  • Pale face
  • Spontaneous perspiration (daytime)
  • Low resistance to the common cold
  • Tendency to blocked nose
  • T: Pale
  • C: Thin and white
  • P: Weak
Treatment Principle
  • Reinforce the Lungs
  • Strengthen Qi.
Herb Formulas
Points
Clinical Manifestations
  • Calcaneus pain
  • May be bone spur
  • Unproductive cough or
  • Scanty, sticky phlegm or
  • Sometimes blood-streaked sputum
  • Dry mouth
  • Dry throat
  • Low back and knees sore and weak
  • "Steaming Bone" tidal fever
  • Night sweats
  • Malar flush
  • Maybe hoarse voice
  • Maybe pain in shin, foot, and heel
  • Spermatorrhea
  • Irregular menses
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish and Reinforce the Lungs and Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Sallow complexion
  • Physical and mental fatigue
  • Anorexia
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools
  • Shortness of breath
  • Edema in limbs, especially lower limbs
  • Maybe anasarca
  • Maybe abdominal distention
  • Shortness of breath
  • Cough
  • Urinary retention
  • Lower abdominal fullness
  • Extreme thirst
  • Palpitations
  • Lower abdominal distention
  • Lower abdominal palpitations
  • Dizziness
  • Abdominal pain
  • T: Pale
  • C: White and moist
  • P: Soft and even
Treatment Principle
  • Warm Yang
  • Strengthen the Spleen
  • Benefit Qi
  • Move water
Herb Formulas
Points
Clinical Manifestations
  • Loose stools
  • Urinary difficulty
  • Scanty urination
  • T: Normal
  • C: Slippery and white
  • P: Floating and rapid
Treatment Principle
  • Regulate water circulation
  • Drain Dampness
  • Strengthen the Spleen
Herb Formulas
Points
Clinical Manifestations
  • Sallow complexion
  • Anorexia (maybe with vomiting)
  • Four limbs feel tired and heavy
  • Abdominal and epigastric distention after eating
  • Maybe acid regurgitation or vomiting
  • Loose stools or watery stools containing undigested food
  • Shortness of breath
  • Pain in the epigastrium with cold sensations (pain is relieved by warmth)
  • Cold limbs
  • Feeling chilled
  • Frequent, clear urination
  • Mental fatigue
  • Maybe scanty urine with edema
  • Maybe clear, watery vaginal discharge
  • T: Pale
  • C: Thin and white
  • P: Deep and weak
Treatment Principle
  • Warm the Center
  • Dispel Cold
Herb Formulas
  • Shi Pi Yin
  • With little or no edema Cold or no obvious symptoms: Bu Zhong Yi Qi Tang
  • Chinese Patent Medicines:
    Fu Zi Li Zhong Wan
    Bu Zhong Yi Qi Wan
Points
Clinical Manifestations
  • Fullness in the chest and hypochondrium
  • Palpitations
  • Shortness of breath
  • Coughing up clear, watery sputum
  • Dizziness
  • Vertigo (when standing)
  • Dyspnea
  • Anxiety
  • Tinnitus
  • Difficult urination
  • Mild edema
  • Cold feet
  • Headache
  • Migraine
  • Weak abdomen
  • T: Pale and swollen
  • C: White and slippery or greasy
  • P: Slippery and wiry or soggy or Soft or Deep and tight
Treatment Principle
  • Warm and transforms Phlegm and congested Fluids
  • Strengthen the Spleen
  • Resolve Dampness
Herb Formulas
Points
Clinical Manifestations
  • Sallow complexion or
  • Complexion white and shiny
  • Mental fatigue
  • Cold extremities
  • Bodily edema which is more severe in the region below the waist
  • Anorexia
  • Loose stools containing undigested food
  • Weakness of the loins
  • Oliguria
  • Body cold
  • Limbs icy
  • Low back, knees and abdomen feel Cold and painful
  • Lower abdomen feels Cold and painful
  • “Cock-crow” diarrhea (occurs at about 5 am)
  • Edema of face and limbs
  • Dysuria
  • T: Pale, moist and swollen
  • C: Thin and white or White and greasy or Whitish smooth
  • P: Deep, thready, weak and maybe slow
Treatment Principle
  • Warm the Kidneys
  • Strengthen the Spleen
  • Promote diuresis to reduce edema
Herb Formulas
Points
Clinical Manifestations
  • Restlessness
  • Irritability
  • Thirst
  • Nocturnal emission
  • Insomnia
  • Dream disturbed sleep
  • Lack of spirit
  • Fatigue
  • Low back pain
  • Tinnitus
  • Dysuria
  • Depression
  • Turbid urine
  • Abnormal uterine bleeding
  • Polyuria
  • Enuresis
  • Seminal emission
  • Leukorrhea
  • Blood tinged leukorrhea
  • Anorexia
  • Dry mouth
  • Dry Tongue
  • Five Sole Heat
  • Fever
  • Physical and mental overexertion
  • T: Red
  • C: Little or None
  • P: Deep and rapid
Treatment Principle
  • Clear Heart Fire
  • Disperse Damp-Heat
  • Benefit Qi and Yin
  • Promote urination
Herb Formulas
Points

Clinical Manifestations
  • Insomnia with much dreaming
  • Spermatorrhea with erotic dreams
  • Premature ejaculation
  • Irritability
  • Easily startled
  • Palpitations
  • Poor memory
  • Dizziness
  • Tinnitus
  • Low back soreness
  • Legs weak
  • Tidal fever
  • Night sweats
  • Dry mouth
  • Red cheeks
  • Urine short and red
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Reduce Fire
  • Make Heart and Kidney communicate.
Herb Formulas
Points
Clinical Manifestations
  • Facial complexion pale and sallow
  • Both cheeks slightly red
  • Dizziness
  • Dry eyes
  • Blurred vision
  • Spots before the eyes
  • Numbness of limbs
  • Flaccid paralysis (Wei syndrome)
  • Weakness
  • Tinnitus
  • Deafness
  • Forgetfulness
  • Five Sole heat
  • Low-grade fever
  • Night sweats
  • Insomnia
  • Stools difficult to pass
  • Constipation
  • Dry mouth and tongue
  • Lower back and knee pain
  • Urinary difficulty
  • Weakness of the lower back, knees and extremities
  • Steaming bones
  • Light-headedness
  • Vertigo
  • Chronic dry, sore throat
  • Toothache
  • Wasting and thirsting disorder (Xiao Ke)
  • Muscular weakness
  • Irritability
  • Dry skin
  • Spontaneous and nocturnal emissions
  • Tidal fevers
  • Loose teeth
  • Dripping urine
  • Thirst
  • Swollen gums, painful and light red in color
  • Numbness and weakness at the waist and knees
  • Heel pain
  • Urinary incontinence
  • Pain at midline and in lower back
  • Irregular menses or
  • Scanty menses or
  • Amenorrhea
  • Vaginal discharge
  • T: Red
  • C: Little or None
  • P: Thready and rapid (large at the Kidney positions)
Treatment Principle
  • Enrich Yin
  • Nourish the Essence of the Liver and Kidneys
  • Reduce Deficiency Fire
Herb Formulas
Points
Clinical Manifestations
  • Dizziness
  • Tinnitus or deafness
  • Poor memory
  • Aching, soreness or weakness of low back
  • Spermatorrhea or premature ejaculation
  • Aching in bones
  • Aching in leg and heel
  • Dry mouth
  • Thirst
  • Night sweats
  • Five sole heat
  • Malar flush
  • Low grade fever in the afternoon
  • Dry throat, maybe recurrent sore throat
  • Dry stools and / or constipation
  • Urine short and red
  • Heightened libido
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Reinforce the Kidneys
Herb Formulas
Points
Clinical Manifestations
  • Chronic cloudy, scanty, yellow urine or
  • Opaque urine like rice-water
  • Dizziness
  • Tinnitus or deafness
  • Poor memory
  • Aching, soreness or weakness of the low back
  • Spermatorrhea or
  • Premature ejaculation
  • Aching in the bones
  • Aching in the leg and heel
  • Dry mouth
  • Thirst
  • Night sweats
  • Five Sole Heat
  • Malar flush
  • Low grade fever in the afternoon
  • Dry throat, maybe recurrent sore throat
  • Dry stools and/or
  • Constipation
  • Urine short and red
  • Heightened libido
  • If Heart Fire also Flares:
    Insomnia
    Frequent dreams
    Palpitations
  • If Liver Yang also Rises:
    Dizziness
    Blurred vision
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Subdue Fire
Herb Formulas
Points
Clinical Manifestations
  • Aversion to Cold
  • Edema of whole body particularly at and below the waist
  • Cold extremities
  • Scanty urination
  • Abdominal distention with full sensations
  • Edema of the legs
  • Cold sensations in the lower body
  • Sensory numbness
  • Low back pain, aching and heaviness
  • Severe pitting edema
  • Fatigue
  • Feeling nervous and cold with mental weariness
  • Face gray and congested or pale
  • Urinary difficulties
  • Oliguria
  • Severe:
    Ascites
    Edema of scrotum
  • T: Pale and swollen with teethmarks
  • C: White and slippery or Thin and white or Thick, white and sticky
  • P: Deep and wiry or Deep and thready
Treatment Principle
  • Warm Yang
  • TonifY the Kidneys
  • Aid water transformation
  • Promote urination
  • Reduce edema
Herb Formulas
Points
Clinical Manifestations
  • Low back and knees feel cold, weak and aching
  • Feeling chilled
  • Aversion to Cold
  • Cold limbs
  • General debility
  • Pale or waxy pale complexion
  • Urinary frequency with abundant, clear urine or
  • Oliguria with edema
  • Maybe nocturia
  • Maybe incontinence
  • Frequent cloudy, milky urination
  • Maybe greasy urine
  • Thick, white vaginal discharge
  • The urge to urinate may increase with exposure to Cold
  • The urge to urinate is worse with prolonged standing and lifting
  • Lower abdominal distention
  • Lassitude
  • Listlessness
  • Fatigue
  • Withdrawn, subdued behavior
  • Knees feel cold and aching
  • Dizziness
  • Tinnitus
  • Impotence
  • Spermatorrhea
  • Premature ejaculation
  • Low libido
  • Female infertility ("uterus cold and infertile")
  • Maybe anorexia
  • Maybe loose stools or
  • Constipation
  • Maybe chronic diarrhea or "cock crow" diarrhea
  • T: Pale and swollen or Pale, moist and swollen
  • C: Thin and white
  • P: Deep and thready - maybe slow or Slow and weak or Deep, slow and weak
Treatment Principle
  • Warm the Kidneys
  • Reinforce Kidney Yang
  • Astringe fluids
  • With turbid urine:
    Separate the turbid from the clear
    Drain Dampness
Herb Formulas
Points
Clinical Manifestations
  • Pale complexion
  • General debility with a desire for sleep
  • Aversion to Cold
  • Pitting edema
  • Hydrops in the scrotum or
  • Hydrothorax
  • Ascites
  • Frequent urination at night (with profuse proteinuria)
  • T: Pale and swollen with teeth marks
  • C: Whitish
  • P: Deep and slow
Treatment Principle
  • Strengthen the Kidneys
  • Stop proteinuria
Herb Formulas
Points
Clinical Manifestations
  • Exhaustion from long-term illness
  • Low energy
  • Lethargy
  • Aversion to Cold
  • Coolness of the extremities
  • Impotence
  • Spermatorrhea
  • Aching and weakness of the lower back and knees
  • Infertility
  • Premature ejaculation
  • Seminal emission
  • Loose stools (sometimes with undigested food)
  • Incontinence of urine
  • Edema of the lower extremities
  • Pale face
  • Spontaneous perspiration
  • Dizziness
  • Enuresis
  • T: Pale
  • P: Deep, slow and weak
Treatment Principle
  • Warm and tonify the Kidney Yang
  • Replenish the Jing
  • Tonify the Blood
Herb Formulas
Points
Clinical Manifestations
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Aching bones and joints
  • Muscle ache
  • Whole body pain
  • Aversion to Cold, especially at the back
  • Cold limbs
  • No Thirst
  • Lower abdominal pain and Cold
  • Abdomen feels chilled
  • Maybe fever
  • No thirst
  • T: Normal
  • C: White and slippery
  • P: Deep and faint or Forceless or Choppy and slow or Wiry
Treatment Principle
  • Dispel Cold
  • Warm the channels
  • Assist Yang
  • Dispel Dampness
  • Relieve pain
Herb Formulas
Points
Clinical Manifestations
  • Continuous cramping pain in the abdomen
  • Pain is not severe
  • Pain is relieved by pressure
  • Edema of the feet
  • Urinary difficulty
  • Slight edema (primarily of the lower limbs)
  • Symptoms generally occur during pregnancy
  • Pale face
  • Fatigue
  • Heaviness of head
  • Lassitude
  • Lower abdominal pain
  • Dizziness
  • Tinnitus
  • Lumbago
  • Edema
  • Abdominal pain with edema during pregnancy due to Blood Deficiency and abnormal water circulation
  • Oliguria
  • Palpitations
  • Cold feet
  • Extreme coldness of the hands and feet
  • Vertigo
  • Weakness and numbness of lower back and legs during pregnancy or postpartum
  • Mal position of the fetus
  • Dysmenorrhea
  • Irregular menstruation
  • Right upper quadrant pain
  • Hepatomegaly
  • Anemia
  • Lack of energy
  • Sore back
  • Thirst with no desire to drink
  • T: Pale or pink maybe petechiae on margin
  • C: Thin or Greasy white
  • P: Deep and weak or Soft, floating, small and slow or Wiry and small or Wiry and rough
Treatment Principle
  • Nourish Liver Blood
  • Soften the Liver
  • Spread Liver Qi
  • Strengthen the Spleen
  • Resolve Dampness
Herb Formulas
Points
Clinical Manifestations
  • Anorexia
  • Edema
  • Abdominal distention
  • Chest and hypochondriac distention
  • Dizziness
  • Nausea
  • Vomiting
  • Vertigo
  • Thirst with no desire to drink
  • Maybe no thirst
  • Palpitations
  • Shortness of Breath
  • T: Normal
  • C: Thick and slippery
  • P: Slippery, full and maybe wiry
Treatment Principle
  • Warm and Dissolve Tan Yin
Herb Formulas
Points
Clinical Manifestations
  • Heaviness
  • Swollen extremities
  • Pain in the extremities
  • Sluggish urination
  • Aversion to Cold
  • Fever
  • Anhidrosis
  • Cough
  • Asthma with Phlegm
  • T: Swollen
  • C: Greasy and white
  • P: Tight and wiry
Treatment Principle
  • Warm Yang
  • Benefit water
  • Dispel exogenous pathogens
Herb Formulas
Points
Clinical Manifestations
  • Cough with sharp pain in the chest and hypochondrium
  • Hypochondriac distention and pain
  • Hard focal distention in the epigastrium
  • Dry heaves
  • Shortness of breath
  • Headache
  • Abdominal distention
  • Wheezing
  • Fullness in the chest
  • Dyspnea caused by extreme chest and back pain
  • Dizziness
  • Vertigo
  • Asthma
  • Rapid breathing
  • Generalized edema which is worse in the lower body
  • Difficult urination and defecation
  • T: Normal or Dark
  • C: Thick, greasy and white
  • P: Deep and wiry
Treatment Principle
  • Attack and Dispel water
Herb Formulas
Points
Clinical Manifestations
  • Cough
  • Asthma
  • Shortness of breath which is worse when lying down
  • Abdominal distention with water retention
  • Edema in the lower extremities
  • Facial edema
  • T: White bubbles
  • C: Thick, greasy and white
  • P: Thready
Treatment Principle
  • Regulate the Lungs
  • Purge Yin
Herb Formulas
Points
Clinical Manifestations
  • Generalized edema
  • Wheezing
  • Dyspnea
  • Restlessness
  • Anuria
  • Irritability
  • Thirst
  • Constipation
  • Urinary obstruction
Treatment Principle
  • Drain downward
  • Drive out water
  • Expel Wind
  • Release the Exterior
Herb Formulas
Points