Refractory Edema of Nephrotic Syndrome Treated by Acupuncture based on the Principle of “When Swelling is Below the Waist， Urination should be Induced”： A Case Report

ZHANG Qian; Li Tongxia; ZHANG Ning

doi:10.13288/j.11-2166/r.2024.06.018

您当前的位置：

首页 >

文章列表页 >

Refractory Edema of Nephrotic Syndrome Treated by Acupuncture based on the Principle of “When Swelling is Below the Waist， Urination should be Induced”： A Case Report

更新时间：2024-04-09

- Refractory Edema of Nephrotic Syndrome Treated by Acupuncture based on the Principle of “When Swelling is Below the Waist， Urination should be Induced”： A Case Report
- Journal of Traditional Chinese Medicine Vol. 65, Issue 6, Pages: 657-660(2024)
- 作者机构：
  
  中国中医科学院望京医院，北京市朝阳区望京中环南路6号，100102
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2024.06.018
  CLC：
- Received：15 November 2023，
  
  Revised：2024-01-09，
  
  Published：17 March 2024
- 稿件说明：
移动端阅览
张倩,李同侠,石凯峰等.基于“腰以下肿，当利小便”针刺治疗肾病综合征难治性水肿1例[J].中医杂志,2024,65(06):657-660.

ZHANG Qian,Li Tongxia,ZHANG Ning.Refractory Edema of Nephrotic Syndrome Treated by Acupuncture based on the Principle of “When Swelling is Below the Waist， Urination should be Induced”： A Case Report[J].Journal of Traditional Chinese Medicine,2024,65(06):657-660.
张倩,李同侠,石凯峰等.基于“腰以下肿，当利小便”针刺治疗肾病综合征难治性水肿1例[J].中医杂志,2024,65(06):657-660. DOI： 10.13288/j.11-2166/r.2024.06.018.

ZHANG Qian,Li Tongxia,ZHANG Ning.Refractory Edema of Nephrotic Syndrome Treated by Acupuncture based on the Principle of “When Swelling is Below the Waist， Urination should be Induced”： A Case Report[J].Journal of Traditional Chinese Medicine,2024,65(06):657-660. DOI： 10.13288/j.11-2166/r.2024.06.018.

摘要

水肿是肾病综合征的典型症状之一，临床治疗以对症使用利尿剂为主，但疗效不稳定。报告针刺治疗肾病综合征难治性水肿1例，该患者以双下肢水肿为主症，按之凹陷，不易恢复，西医对症治疗后疗效不显。中医辨证为脾肾亏虚、水湿内蕴证，基于张仲景《金匮要略》“腰以下肿，当利小便”治则，针刺水道、水分以通利小便，针刺三阴交、漏谷、阴陵泉、足三里以健脾益肾，标本兼治，治疗3日后小便通利，双下肢水肿已消。

Abstract

Edema is one of the typical symptoms of nephrotic syndrome， and symptomatic diuretics is mainly used in clinical practice but with unstable effect. This paper reported a case of refractory edema of nephrotic syndrome treated by acupuncture. The patient was mainly manifested as edema in both lower limbs， which were sunken when pressed and difficult to recover. After symptomatic treatment with western medicine， the effect was not obvious. In traditional Chinese medicine， this patient was diagnosed as spleen-kidney depletion and water-dampness internal accumulation syndrome. Based on the principle of “when swelling is below the waist， urination should be induced” in ZHANG Zhongjing's

Essentials from the Golden Cabinet

（《金匮要略》）， it is recommended to puncture at Shuidao （ST 28） and Shuifen （CV 9） to promote urination， at Sanyinjiao （SP 6）， Lougu （SP 7）， Yinlingquan （SP 9） and Zusanli （ST 36） to fortify the spleen and boost the kidneys and treat the root and branch simultaneously. After 3-day treatment， urine becomes smooth， and the edema of both lower limbs disappeared.

关键词

Keywords

references

KODNER C . Diagnosis and management of nephrotic syndrome in adults ［J］. Am Fam Physician ， 2016 ， 93 （ 6 ）： 479 - 485 .

DOUCET A ， FAVRE G ， DESCHÊNES G . Molecular mechanism of edema formation in nephrotic syndrome： therapeutic implications ［J］. Pediatr Nephrol ， 2007 ， 22 （ 12 ）： 1983 - 1990 .

林浩，黄文辉，黄龙记，等 . 温阳利水法治疗难治性水肿体会［J］. 新中医， 2019 ， 51 （ 4 ）： 284 - 286 .

梁悦 . 温针灸配合芒硝外敷治疗脑卒中后偏瘫肢体肿胀的临床疗效观察［D］. 哈尔滨：黑龙江中医药大学， 2021 .

DIAZ M ， AGRAZ I ， SOLER MJ . Anti-phospholipase A2 receptor antibody and spontaneous remission in membranous nephropathy ［J］. Clin Kidney J ， 2019 ， 12 （ 1 ）： 33 - 35 .

HLADUNEWICH MA ， TROYANOV S ， CALAFATI J ， et al . The natural history of the non-nephrotic membranous nephropathy patient ［J］. Clin J Am Soc Nephrol ， 2009 ， 4 （ 9 ）： 1417 - 1422 .

RONCO P ， BECK L ， DEBIEC H ， et al . Membranous nephropathy ［J］. Nat Rev Dis Primers ， 2021 ， 7 （ 1 ）： 69 .

NOVAK JE ， ELLISON DH . Diuretics in states of volume overload： core curriculum 2022 ［J］. Am J Kidney Dis ， 2022 ， 80 （ 2 ）： 264 - 276 .

张介宾 . 类经［M］. 郭洪耀，吴少祯，校注. 北京：中国中医药出版社， 1997 ： 15 .

岳含珍 . 经穴解［M］. 北京：中国医药科技出版社， 2020 ： 54 .

李延 . 脉诀汇辨校释［M］. 汪剑，主编.北京：中国中医药出版社， 2012 ： 292 .

朱震亨 . 丹溪心法［M］. 北京：中国医药科技出版社， 2020 .

王敏 . 中华董氏奇穴临床整理［M］. 沈阳：辽宁科学技术出版社， 2013 ： 122 - 123 .

查看原文

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Dynamic Sequential Diagnosis and Treatment of Pediatric Nephrotic Syndrome Based on the "Sweat Pore-Qi and Liquid-Kidney Collaterals"

Analysis on Acupuncture in the Treatment of Post-stroke Dysphagia Based on the Theory of "Latent Pathogen in Cerebral Collaterals"

Study on Evidence-Based Decision-Making of Acupuncture for Post-Prostatectomy Urinary Incontinence： based on TOPSIS Combined with Entropy Method

Identification and Treatment of Idiopathic Membranous Nephropathy Based on the Principle of "Treating Water Must be Preceded by Treating Qi"

ZHANG Zhiyuan's Experience in Using Baizhu （Atractylodes macrocephala） in Clinical Practice

Related Author

YUAN Zhenhua

CAI Mingyang

JIANG Yingying

WU Jingjing

PAN Wenqing

DING Zichao

ZHANG Shuzi

REN Xianqing

Related Institution

Pediatrics Department，The First Affiliated Hospital of Henan University of Chinese Medicine

Pediatric Medical College，Henan University of Chinese Medicine

Clinical Medical College of Acupuncture Moxibustion and Rehabilitation，Guangzhou University of Chinese Medicine

Guangdong Provincial Key Laboratory of Acupuncture and moxibustion of Chinese Medicine

School of Traditional Chinese Medicine，Anhui University of Chinese Medicine

Address：No.16, Nanxiao street, Dongzhimen, Dongcheng District, Beijing Postal code：100700
Tel：010-64035632 Email：jtcmcn@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010102007558号
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰