Treatment of Renal Hematuria with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

ABSTRACT

Renal hematuria is caused by glomerular damage and basement membrane rupture due to coagulation dysfunction， ischemia and hypoxia， and immune function damage， resulting in red blood cells exuding through glomerular filtration membrane and excreting with urine. It is mainly manifested as microscopic and macroscopic hematuria. Among them， microscopic hematuria is characterized by microscopic urine sediment examination， there are three or more red blood cells per high-power microscopic field. Traditional Chinese medicine （TCM） believes that the pathogenesis of renal hematuria always belongs to ''asthenia in origin and sthenia in superficiality''， and ''asthenia in origin'' is caused by the deficiency of the three viscera of the lung， spleen， and kidney， while ''sthenia in superficiality'' is caused by the combination of dampness and blood stasis and the external disturbance of wind pathogens. The key pathogenesis features are ''deficiency， dampness， heat， blood stasis， and wind''. After consulting the TCM literature related to renal hematuria， the author found that the common syndrome types of renal hematuria in clinical practice were the deficiency of both Qi and Yin， the deficiency of both Yin and fire， the unsteadiness of kidney Qi， the deficiency of spleen and kidney Yang， the wind heat hurting the collateral， the dampness-heat blocking， and the blood stasis and internal resistance. The commonly used classical or temporal prescriptions included Shenqi Dihuangtang（参芪地黄汤）， Zhibai Dihuangtang（知柏地黄汤）， Wubi Shanyaowan（无比山药丸）， Jisheng Shenqiwan（济生肾气丸）， Sishenwan（四神丸）， Yinqiaosan（银翘散）， Bazhengsan（八正散）， Sanrentang（三仁汤）， Xuefu Zhuyutang（血府逐瘀汤）， Danggui Shaoyaosan（当归芍药散）， Xiaoji Yinzi（小蓟饮子）， Buzhong Yiqitang（补中益气汤）， et al. Self prepared prescriptions mainly include Tongluo Ningxue prescription （通络宁血方）， Qingre Zhixue prescription（ 清热止血方） and Wuteng Tongluo drink （五藤通络饮）. The traditional Chinese medicine is commonly used for the treatment of Xueniaoling granules（血尿灵冲剂）， Xueniaoan capsules（血尿安胶囊）， Ningmitai capsules（宁泌泰胶囊）， Huangkui capsules（黄葵胶囊） and Yishen nixuexiao granules（益肾溺血消颗粒）， which constantly enriched the treatment of renal hematuria. The combination of TCM and western medicine has obvious advantages. The treatment of renal hematuria in clinical practice often combines with modern medical methods， which has a good therapeutic effect on the improvement of symptoms and indicators of renal hematuria. At present， many doctors have made in-depth exploration on the etiology， pathogenesis， and clinical treatment of renal hematuria， but few scholars have made detailed induction and collation in recent years. Therefore， the author has collated the clinical data on the treatment of renal hematuria with TCM in the past ten years， and reviewed it from the aspects of etiology， pathogenesis， and clinical research， to provide useful references for clinical intervention and delay the progress of renal disease.