---continuing
Chronic renal failure generally is considered as intermingle asthenia and sthenia, asthenia in origin and sthenia in superficiality, asthenia healthy Qi as a root, sthenia pathogenic factors as a sign by the theory of Traditional Chinese Medicine. So, let’s look at it dialectically. First we must make a clear distinction between asthenia and sthenia. No matter what stages of the disease are (at early, middle and advanced stage), there are all asthenia healthy Qi. So we should tell the difference of Yang asthenia, Yin asthenia, Qi asthenia and asthenia of Qi and Yin. At the same time of existing asthenia healthy Qi, there are more sthenia pathogenic factors. The symptoms of exogenous cold, phlegm pyrexia, fluid damp, damp turbidity, damp heat, blood stasis and convulsion should be distinguished. In order to apply them in clinical, we take asthenia healthy Qi as the main part, but sthenia pathogenic factors as subordinate in it. Also in each kind of asthenia healthy Qi, there are a few kinds of sthenia pathogenic factors. The changing contradictory between healthy Qi and pathogen can be settled quickly by this way of looking at the disease. From chronic renal failure to the stage of uremia, the patient may have manifestations of blood deficiency, so when we classify them, blood deficiency doesn’t need to be marked specifically, especially at the stage of uremia. To judge the disease from the standpoint of asthenia healthy Qi , all these are caused by deficiency of Yin, Yang, Qi and blood.
1.Asthenia Qi of Both Spleen and Kidney
Patients who have three of the following syndromes are determined as this type of disease.
Syndrome: glossless complexion, short breath and asthenia, abdominal distension, loose stool, sticky mouth and dysgeusia, not thirst or thirst without desiring to drink or drinking less, aching pain of loins and keen, coldness of hands and feet, frequent nocturia, pale tongue with tooth trace, weakness and stagnation of pulse condition. All these symptoms are commonly seen at the stage of azotemia of chronic renal failure.
2.Deficiency Yang of both Spleen and Kidney
Patients with the three of following symptoms belong to this type.
Syndrome: pale complexion, lassitude and asthenia, loose stool or edema, sticky mouth and dysgeusia, not thirst, aching pain of loins and keen, crymodynia of loins or chilly of limbs, frequent nocturia, clear and long urine, pale and tender tongue, clear tooth trace, weakness and stagnation of pulse condition. The syndromes mentioned above are often seen at the every stage of azotemia of chronic renal failure.
3.Hepatic and Renal Yin Deficiency
Patients who have three of following symptoms are considered as this type.
Syndrome: swallow complexion, bitter taste and dryness of month, dry feces, aching pain of loins and keen, coldness of hands and feet, dizziness and tinnitus, pale, red and thin tongue, tongue coatless or thin and yellow lingual fur, slow pulse or taut pulse. These syndromes are often seen at the stage of renal failure and uremia of chronic renal failure.
4. Asthenia of both Qi and Yin
This type is determined by two symptoms of deficiency Qi of both spleen and kidney and two of hepatic and renal Yin deficiency.
5.Asthenia of Yin and Yang
This type is decided by two symptoms of deficiency Yang of both spleen and kidney and two of hepatic and renal deficiency Yin.
In addition to all above, a few kinds of sthenia pathogenic factors exist in it. The patients who have any one kind of following symptoms are believed as having sthenic pathogenic factors.
(1)Exogenous Cold: wind-heat syndrome or wind-cold
(2)Phlegmopyrexia: yellowish thick expectoration and white phlegm of expectoration, yellow, sticky and greasy tongue fur.
(3)Fluid Damp: edema or chest ascitic fluid above middle degree of whole body.
(4)Damp Turbidity: frequent vomiting, pale, sticky and greasy tongue fur, urine breath and sticky mouth without desiring to drink.
(5)Damp Heat: frequent vomiting, pale, sticky and greasy tongue fur, urine breath, and liking to have cold drink, burning sensation of urination, painful urination and dysuria.
(6)Blood stasis: dark and gloomy complexion, dark lips, regular painfulness or stabling pain of loins, scaly skin or numb limbs, dark and purplish tongue or petechia and ecchymosis.
(7) Tetany: muscle shivering, peristalsis of fingers and tic pain.
(8)Wind Dryness: dryness and itch of skin.
----to be continued
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Posted: Wed Mar 14, 2007 6:16 pm
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