MindMap Gallery 2 Acute glomerulonephritis mind map
This is a mind map about 2 acute glomerulonephritis, pediatric renal diseases in traditional Chinese medicine, including definition, traditional Chinese medicine, pathogenic bacteria, characteristics, causes, diagnostic points, differential diagnosis, etc.
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This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
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acute glomerulonephritis
definition
(Acute nephritis) The main clinical features are acute onset, edema, oliguria, hematuria, proteinuria and hypertension.
Yangshui
Traditional Chinese Medicine
Edema, hematuria
Pathogenic bacteria
Hemolytic Streptococcus
Features
age
Children aged 3-12 years old, more common in school-age children, males > females
prognosis
In most children, swelling subsides, gross hematuria disappears, and blood pressure returns to normal within 2 to 4 weeks of onset. Residual microscopic hematuria usually disappears within 3 to 6 months. The development of treatment measures combining traditional Chinese and Western medicine, Significantly reduce the serious complications of this disease, and the prognosis is good
Cause and pathogenesis
Diagnostic points
Medical history
History of prodromal infection: 1-4 weeks before the onset of the disease, there is a history of streptococcal infection or other acute infection such as respiratory or skin infection.
clinical manifestations
General cases - edema, oliguria, hematuria, proteinuria, and hypertension can be seen; accompanied by fever, fatigue, headache, dizziness, cough and shortness of breath, Nausea, vomiting, anorexia, abdominal pain, diarrhea, difficulty urinating, etc.
Severe cases - complications such as ❶hypertensive encephalopathy, ❷severe circulatory congestion, ❸acute renal failure, etc. can be seen in the early stage
Auxiliary inspection
Urinary RBC↑, increased erythrocyte sedimentation rate, antistreptolysin (ASO)↑, complement↓, abnormal renal function, etc.
atypical cases
Only microscopic hematuria; complement C3 in patients with non-streptococcal infection is not low.
Differential diagnosis
And NS, IgA nephropathy, primary rapidly progressive glomerulonephritis, acute urinary tract infection
Dialectical thinking
Distinguish between false and true
Good and bad
The onset is sudden, changes quickly, and edema and hematuria are more obvious.
Good and evil love
The edema has subsided, urine output has increased, and gross hematuria has disappeared, but microscopic hematuria or proteinuria has not recovered, and there is often lingering dampness and heat. There are differences between yin deficiency and qi deficiency.
Differentiating normal syndromes and changing syndromes
Mild syndrome - generally manifested by common syndromes such as Feng Shui conflict syndrome, damp heat internal invasion syndrome, etc.;
Severe syndrome - severe edema of the whole body, persistent oliguria and anuria, and critical syndromes of evil trapping the heart and liver, water in the heart and lungs, and water poisoning internal obstruction may occur in a short period of time. The smaller the urine output, the longer the duration, the more obvious the edema, and the greater the possibility of changes.
Treatment principles
In the acute stage, it is important to eliminate evil spirits, and in the recovery stage, it is important to strengthen the body and eliminate evil spirits.
Attention ⚠️
It should be sweated, purged, exuded, purified, and nourished, and the spleen and stomach should always be taken care of.
When encountering severe edema on the head and face, the evil is on the surface of the skin, and the theory should be based on "if it is on the skin, it is caused by sweating".
If the urination is difficult or the amount is obvious, it should be treated according to the theory that "it is not a cure for dampness that is not good for urination."
If the throat is red and swollen or the skin is sore, it should be treated with heat-clearing and detoxifying medicine.
During the recovery period, symptoms of righteousness, deficiency, and evil are mostly manifested. In the early stage, dampness and heat are the main symptoms. Treatment should be to clear away heat and reduce dampness, accompanied by strengthening the body; In the later stage, when the dampness and heat gradually disappear, the treatment should be to strengthen the body and clear away heat and reduce dampness.
Treatment by type
acute phase
Changzheng
Feng Shui fights
Swollen eyelids quickly spread to the whole body, with severe swelling of the head and face, accompanied by external syndromes
Soothes wind and relieves lungs, diuresis and reduces swelling
Ephedra, Forsythia and Adzuki Bean Soup (Ephedra 6g, Forsythia 6g, Bitter Almond 3g, Adzuki Bean 30g, Ginger 6g, 3 jujubes, Zhigancao 6g)
Internal invasion of damp heat
Swelling after sores, hematuria, short red urine, polydipsia and weight loss
Clear away heat and dampness, cool blood and stop bleeding
Five-flavored disinfectant drink (five-flavored disinfectant to treat various boils, including silver flowers, wild chrysanthemums and dandelions, and purple-flowered geranium seeds, decoction and wine are very effective) ➕Xiaojiyinzi (Xiaojiyinzi, lotus root and puhuang, Akebia talc and Dixiang, Guicao black and Gardenia light bamboo leaves, good for treating bloody and hot conditions) (Honeysuckle 15, wild chrysanthemum 6, dandelion 6, purpurea 6, purple geranium 6, thistle 9, habitat 9, talc 9, Akebia 9, cattail 9, lotus root 9, Bamboo leaves 9, angelica 9, gardenia 9, licorice 9)
change testimony
Evil trapped in heart and liver
Swelling of limbs and face, sudden headache, dizziness, vomiting and convulsions
Calming the liver and purging fire, clearing the heart and diluting water
Gendan Xiegan Decoction (gentian Xiegan, Gardenia and Chai Chai, Raw Rehmannia Plantain, Alisma Wipe, Akebia, Licorice and Danggui combined, the gallbladder meridian can expel dampness and heat) (6g each of gentian, bupleurum, rehmannia, plantain, akebia, and licorice, 9g each of skullcap, gardenia, and Alisma, 3g of angelica) ➕Lingjiao Uncaria Decoction (Yu's Lingjiao Uncaria Decoction, Mulberry Leaf Chrysanthemum Fresh Rehmannia glutinosa, Paeony Root Poria Shenchuan Beiru, Cooling Liver, Increasing Fluid and Dingfeng Recipe)
Water Lings Heart and Lungs
Swelling all over the body, sudden coughing and shortness of breath, chest tightness, palpitations, irritability and inability to lie down.
Purging the lungs and removing water, warming yang and strengthening the body
Jijiao Lihuang Pills + Shenfu Decoction (Tinglizi and rhubarb purge the lungs and remove water; fangji, Sichuan pepper, Alisma, mulberry bark, poria bark, and plantain are used to relieve water and reduce swelling; ginseng and aconite warm yang and strengthen the body)
Attention ⚠️
If this syndrome is mild, Sanzi Yangqin Decoction can be used to regulate the lungs, reduce qi, diuresis and reduce swelling; In cases of edema first and then shortness of breath, it is because the spleen transmits to the lungs. Treat the spleen specifically and lungs concurrently. Take the modified Weiling Decoction daily and Xunlao Pills at night; In cases of acute asthma first and then edema, the lungs are transmitted to the spleen. Treat the lungs specifically and the spleen concurrently. Take Lao Wan every day and modified Weiling Decoction at night.
water intoxication
Swelling all over the body, oliguria and anuria, dizziness and vomiting, or even coma
Relieves turbidity, detoxifies and diuretics
Wendan Decoction (warming gallbladder Xiaru Zhichenzhu, boiled with Poria, ginger and dates, regulates qi and resolves phlegm, benefits the gallbladder and stomach, and removes all diseases caused by gallbladder stagnation and phlegm disturbance) (Fried citrus aurantium, bamboo root, ginger pinellia, tuckahoe 6g each, 9g tangerine peel, 12g ginger, 3g licorice) ➕Fuzi Xiexin Decoction (3g each of prepared aconite, skullcap, and coptis, 6g raw rhubarb)
recovery period
Yin deficiency and evil love
Hematuria, accompanied by heat in the palms and soles, night sweats, and dark red throat.
Nourishes yin and nourishes the kidneys, and clears residual heat
Zhibai Dihuang Pills + Erzhi Pills plus or minus
Qi deficiency and evil love
Susceptible to spontaneous sweating, fatigue, yellow face, poor appetite and loose stools.
Strengthen the spleen and replenish qi, and resolve dampness and turbidity
Shenling Atractylodes Powder (Shenling Atractylodes Lentil Lotus, licorice, yam, sand and Yiren, Platycodon to float and protect the lungs, Zao Decoction to benefit the spleen and spirit)