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    Medical Case 1:

    Male, 40 years old
    Chief complaint: Fatigue for 5 months
    Admission date: 2006-09-27
    Physical examination: Back pain on left side, urination sluggish, abdominal bloated and poor appetite.
    Physical Findings: Abdominal distention, percussion tenderness over left kidney region
    Lab: BUA:442umol/L, Urea: 8.81mmol/L, Cr: 300umol/L.
    Kidney biopsy results showed "chronic glomerulonephritis".

    Diagnosis:  

    1. Chronic renal insufficiency (azotemia)
       
    2. Chronic glomerular nephritis (focal sclerosis)


    After integrative therapies of Western Medicine and TCM, the patient's condition improved a lot. Retest of renal function: CO2: 19.2 mmol/L, Cr: 190 umol/L, Urea: 9.6 mmol/L, the results of Laboratory Findings show an obvious decrease. Clinical symptoms had disappeared. The patient was discharged on 2006-10-10.

    Integrative therapies of Western Medicine and TCM for primary or secondary kidney diseases.

    Medical Case 2:
    Male, 22 years old
    Chief complaint: “Recurrent Oliguria, massive leukuresis, edema of face and bilateral lower limbs for 2 years”, diagnosed with "refractory nephrotic syndrome".
    History: The patient used to be treated by massive hormone therapy, cyclophosphamide, CellCept and cyclosporine A in other hospitals, but the medicines barely worked. The symptoms can be relieved a little by Dextran-40 plus Furosemide 60-100mg everyday, the total urine volume of 24 hours is around 800ml. The patient and his family were desperate.
    Admission Date: 2006-5-9
    Physical examination: Severe edema of eyelids and bilateral lower limbs, the skin pits when pressed, massive ascites and frothy urine, dark tongue with teeth-mark around, yellowish greasy fur, deep and slow pulse.
    Lab: Moderately severe anemia (RBC: 2.95×1012/L, HGB: 88g/L, HCT: 0.26), Hypercoagulable blood (PLT: 326×109/L; FIB: 7.231g/L, APTT: 42.7g/L, APTT-R: 1.334g/L), high blood lipids level (CHOL: 11.62mmol/L, TG: 2.11mmol/L, HDL: 2.03mmol/L, LDL: 6.99mmol/L), massive leukuresis (PRO:>3.0g/L), total urinary protein for 24 hours:4610mg, Hypoproteinemia (ALB: 9.8g/L, GLB: 18.9g/L), hematuria under microscopy and hyperuricacidemia were also observed.
    Diagnostic Examination: B-type ultrasonography of kidney: enlarged bilateral kidney in full shape, diffuse lesions.

    Admitting Diagnosis: Refractory nephrotic syndrome
    TCM: Edema (yin edema - yang deficiency of both the spleen and kidney)

    The treatment plan of integrative therapy of Western Medicine and TCM was established according to patient's physical symptoms and medical history. Through the course of treatment, TCM played an important role in prevention and treatment of hormonal therapy side effects. After one year's treatment, the patient recovered well. Side effect such as infection of renal and hepatic lesion of hormone and immune suppression did not appear during the treatment. During the follow-up visit of the following year after discharge, all the lab findings are within normal ranges, no sign of relapse.

    Comment: Integrative therapy of Western Medicine and TCM is the key factor to treat refractory nephrotic syndrome. In this case, Chinese herbs played very important roles not only in preventing the side-effects of hormone and guaranteeing the hormonal therapy runs smoothly, but also in preventing rebound phenomenon after reducing the amount of hormone, shortening medication period, consolidating the effect of hormone therapy, repairing the injured organs' function, and restoring the balance of yin and yang, qi and blood.

    TCM treatment of difficult nephritic syndromes has its advantages. In this case, we learn that invigorating the lung and the kidney is the basic method to affect a permanent cure. And good blood circulation should be adopted consistently. Meanwhile, we should pay attention to the application of expelling wind-damp, clearing lung and eliminating phlegm. By these methods, we can prevent inflammation and coagulation, remove immune complexes, lower the lipid and decrease glomerulosclerosis and extracellular matrix deposition so as to prevent kidney damage and hasten renal injury repairs.

    Integrative therapies of Western Medicine and TCM for primary or secondary kidney diseases.


    Medical Case 3:
    Patient with pain on the left waist for 6 days, male, 42 years old, was hospitalized in Clifford Hospital on December 8th 2006. Symptoms: Tired, pain on the left waist, nausea, poor sleep quality, yellow urine, normal urine output, dry stool. Physical check: The whole skin and sclera was light yellow; pain on the right abdomen when pressing (+); pain on the left kidney when pressing and knocking (+); red tongue; yellow and thick coated tongue, slow pulse; Color Ultrasounds: Left ureteral stones on the left side and medium kidney stones in water in the left kidney; scabrid virtual liver echo; gall bladder wall slightly rough, splenomegaly (slight).

    Diagnosis: 

    1. Left ureteral stones on the left side and medium stones in water in the left kidney
       
    2. Chronic renal insufficiency, azotemia
       
    3. Liver is damaged.


    We adopted Chinese Medicine therapy to relieve spasm and pain, expel stones and improve kidney function. After the treatment, the patient's symptoms were eased. Review on December 16, B ultrasound: The stones were expelled, scabrid virtual liver echo, Kidney function had returned to normal. He was discharged on December 19th 2006.
    Splenomegaly (slight);
    December 18 Routine Urine: LEU: 15Cells/uL WBC: 10 piece/uL MS: 1.0+
    December 18 Biochemistry: Normal blood creatinine and aminotransferase,
     GGT: 59U/L
    December 18 Routine Blood: Normal cholesterin
    December 18 Blood-fat: Normal
     

     
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