Clinical Treatment of Proteinuria in Renal Involrement of Sjogren's Syndrome Based on the Theory of "Dryness and Dampness as the Guiding Principle"

Expand
  • 1.Department of Nephrology third Clinical School of Anhui University of Traditional Chinese Medicine
    Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Anhui Hefei 230031, China
    2.Shouxian Traditional Chinese Medicine Hospital Blood Purification Center Anhui Huainan 232200, China
    3.Department of Geriatrics Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
    Shanghai 200003, China
    4.Department of Nephrology the Fifth Affiliated Hospital of Anhui University of Chinese Medicine
    Lu'an Traditional Chinese Medicine Hospital Anhui Lu'an 237005, China
    5.Nephrology Department of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
    Institute of Traditional Chinese Medicine Nephrology at Shanghai University of Traditional Chinese Medicine
    Key Laboratory of Liver and Kidney Disease Syndrome of the Ministry of Education Shanghai Key Laboratory of
    Traditional Chinese Medicine Clinical Practice Shanghai 201203, China

Received date: 2024-11-01

  Revised date: 2025-05-20

  Accepted date: 2025-08-05

  Online published: 2025-08-06

Supported by


Abstract

Renal involvement of Sjögren's syndrome RISS clinically manifests primarily as tubulointerstitial nephritis and glomerular disease often accompanied by symptoms related to proteinuria hypokalemia and abnormal calcium-phosphorus metabolism significantly impacting the quality of life of the patients. Modern medicine cannot cure RISS proteinuria and struggles to address the systemic symptoms of RISS patients comprehensively. This study based on the theory of "dryness and dampness as the guiding principle" proposed by Yu Guopei of the "Xin'an doctors" combined with our team's clinical experience analyzes the traditional Chinese medicine TCM treatment of RISS proteinuria. It suggests that although the pathological locations involved in RISS are extensive when proteinuria occurs clinically the focus is on the spleen and kidney which are closely related to pathological products such as blood stasis and turbid dampness. The following three major mechanisms and treatments are proposed ①Dryness disturbing the lungs causing Qi stagnation and blood stasis. Emphasis should be placed on the causal relationship between dryness Qi stagnation and blood stasis. Treatment should focus on nourishing Yin and blood regulating Qi and dissolving blood stasis using modified Jie Zao Decoction ②Spleen and kidney deficiency with dryness and dampness intertwined can lead to the spleen failing to elevate clear Yang and the kidney failing to consolidate essence resulting in the leakage of fine substances and endogenous damp-turbidity. Treatment should aim at regulating and supplementing the spleen and kidney restoring Qi movement using modified Huoxiang Zhengqi Powder ③Kidney deficiency leading to an imbalance in opening and closing functions exacerbates the degree of fine substance loss. Over-supplementation may result in non-acceptance of tonification. A combination of reinforcement and reduction should be applied focusing on consolidating the kidney enriching essence resolving blood stasis and expelling turbidity using modified Jin Suo Gu Jing Wan.


Cite this article

CHEN Shiyao, BI Rui, ZHU Liying, WANG Xiaoxing, JIANG Peng, HE Liqun, GAO Jiandong .

Clinical Treatment of Proteinuria in Renal Involrement of Sjogren's Syndrome Based on the Theory of "Dryness and Dampness as the Guiding Principle"

[J]. CHINESE JOURNAL OF MEDICINAL GUIDE, 2025 , 27(6) : 601 -605 . DOI: magtech.2024.11.01-00001

References

       [1 邹瑶,凌光辉,田静,等.原发性干燥综合征肾损害研究进展[J.中南大学学报(医学版),2018433):320-326.

         2  曹玉,何立群,胡静.慢性肾脏病蛋白尿的中医药治疗进展[J.中国中西医结合肾病杂志,2024258):742-743.

         3  陈家琦,赵晰.慢性肾脏病蛋白尿的中医研究进展[J.内蒙古中医药,2024431):166-168.

         4  余学清,赵明辉,陈江华.肾内科学(第3版)[M.北京:人民卫生出版社,2020125.

         5  王辉编著;宋学海主编.易经[M.昆明:云南人民出版社,2011.

         6  (清)余国佩撰;边玉麟,夏学传点校.医理[M.北京:中国古籍出版社,1987.

         7  林姝枫.原发性干燥综合征的中医证素特点及其与血清球蛋白水平的相关性研究[D.福建中医药大学,2023.

         8  王永钧.肾脏病理与微观辨证[C.10届全国中西医结合肾脏病学术会议论文集. 200917-21.

         9  张赛,张勉之,侯秀娟,等.基于《黄帝内经》“浊阴”理论探讨干燥综合征肾损害的病机与证治[J.中华中医药杂志,2024396):2805-2808.

         10 刘星,熊国良.中医药治疗肾性蛋白尿文献的用药规律的数据挖掘[J.广州中医药大学学报,2023406):1558-1564.

         11 梁芷艺,游德森,张坪,等.中医药治疗蛋白尿研究文献可视化分析[J.中国中医药图书情报杂志,2024484):142-148.

         12 (金)李杲著.脾胃论[M.北京:中国中医药出版社,2019.

         13 刘馥溧,巴元明.巴元明运用滋肾封髓汤治疗干燥综合征肾损害临证经验[J.时珍国医国药,2023349):2259-2261.

         14 冯朝丽.干燥综合征肾损害临床特点与中医证型的相关性研究[D.山东中医药大学,2020.

         15 周明爱,周慧,庄步辉.左振素老中医辨治干燥综合征肾损害经验撷英[J.福建中医药,2011422):24-25.

         16 吕茜倩,冉黎,张容.中西医结合治疗干燥综合征合并肾损害的文献分析[J.医学信息,2023362):35-38.

         17 (清)余国佩著.婺源余先生医案[M.北京:中医古籍出版社,2005.

         18 (清)汪昂著;周鸿飞,刘永辉点校.医方集解[M.郑州:河南科学技术出版社,2017.

         19 吴美翠.寒温并用攻补兼施的组方思路及临床应用[J.中医药通报,2015145):13-15.

         20 马丁,宋立群.宋立群治疗寒地干燥综合征肾损害经验采撷[J.山西中医,20244011):6-7.

Outlines

/