Based on the theory of "cold

qi

generates turbidity" described in the

Inner Canon of Yellow Emperor

（《黄帝内经》）， together with the physiological characteristics of children， who are considered to have an inherent insufficiency of the lung， spleen， and kidney， and the clinical features of recurrent refractory nephrotic syndrome （RNS）， this article proposes that the pathogenesis of RNS in children is characterized by

yang

deficiency with internal cold， turbidity arising from cold， latent turbidity transforming into toxin， activation by newly contracted pathogens， and turbid toxins damaging the collaterals. The core pathogenesis is identified as

yang

deficiency， turbidity coagulatio

n， and collateral damage. Accordingly， the general treatment principle is warming

yang

and eliminating turbidity， with coordination of three methods including warming

yang

to strengthen the body's foundation， promoting

yang

to relieve constraint， and raising

yang

while replenishing

qi

.

Zhenwu Decoction

（真武汤） is employed as the basic prescription with modification according to syndrome differentiation， to achieve an effect eliminating turbidity and arresting leakage， restoring kidney function by unblocking the collaterals， and consolidating recovery to prevent relapse.