【 Dietary principles 】 The following are common in clinic, which are described respectively:
1. Concealed type: The patient may have no symptoms, or mild edema, dizziness, backache, fatigue, etc. When they are tired, have a cold or have a fever. Laboratory tests usually find nothing except mild abnormal urine routine or changes in renal function. Consider reducing work, pay attention to the combination of work and rest, and there is no restriction on diet.
2. Nephropathy: The patient's urine protein is large, and the daily output is mostly 3 ~ 3.5g, which often leads to low plasma protein, so a large amount of protein should be supplemented. At the same time, the concentration of cholesterol in the blood is also obviously increased, accompanied by edema, and its degree is generally inversely proportional to the decrease of plasma protein. Therefore, we should control the fat diet and adopt foods with low sodium and diuretic effect.
3. Hypertension type: the blood pressure is generally around160 ~180/90 ~110mmhg. Symptoms such as headache, dizziness and visual impairment often occur, and renal function is impaired. At this time, a low-salt or salt-free diet should be adopted, and the protein and calories should not be too high. Eat some foods that clear the liver and improve eyesight and avoid the wind.
Renal anemia is a common complication. protein and foods rich in iron, vitamin B 12 and folic acid should be supplemented in time.
4. Diet content 1. Staple food: Rice and flour are the main food, but as it, miscellaneous grains, beans and their products contain high non-essential amino acids, it should be matched with meat, eggs, fish, poultry and other foods with high quality in protein that can provide essential amino acids. It is required to eat more starchy and digestible foods, such as wheat starch, rice flour, vermicelli, vermicelli, potatoes, biscuits, sweets, etc., which are all removed from protein. Self-made method of wheat starch: add water to flour to form dough, knead it by hand for 10 minute, keep it at room temperature for 1~2 hours, and wash away gluten (plant protein); Add water, which is about 4 times the weight of flour, gently knead it repeatedly by hand, and wash the starch into the water until the starch slurry is sticky. If the operation is repeated twice, the starch slurry is allowed to stand for precipitation, put into a cloth bag to drain water, and dried in the sun to obtain wheat starch. Boil noodles with boiling water when eating. If the viscosity is not enough, you can add a little flour. Lotus root starch can be used as a snack on weekdays.
2. protein: The supply of protein depends on whether the patient has anemia, proteinuria and changes in blood urea nitrogen. Under normal circumstances, the weight of protein per kilogram per day is1g. If a large amount of protein is excreted in urine with obvious anemia and edema, and the blood urea nitrogen is close to the normal value, the supply of protein should be increased to1.5 ~ 2.0g per kg body weight per day, and the daily total protein is about100g. Moreover, animal proteins with high biological value should be used, such as milk, various dairy products, eggs (each egg contains about 5g of protein), fresh fish and lean meat. Eat less staple food and beans. Some people calculate it according to the demand of normal people plus the protein lost in patients' urine for 24 hours, but generally more is needed.
3. Moisture: In case of edema or hypertension, the amount of drinking water should be strictly controlled, and the daily drinking water should not exceed 65,438+000 ml. The simple calculation method is to add 500 ml of urine on the first day.
4. Salt: Chronic nephritis is often accompanied by renal insufficiency, especially when the sodium regulation ability is obviously poor. In order to prevent water and sodium retention, avoid salt to avoid aggravating edema. When the patient's urine output is less than 500 ml per day, salt should be strictly avoided. After edema, Chinese medicine advocates avoiding salt for a hundred days. When edema subsides, blood pressure is not high, and urine volume is normal, it is not necessary to avoid salt. When eating a low-salt diet, use salt 1~3 grams every day, and do not eat salty and alkaline foods. Children should use no more than 1 g of salt every day. The sodium content of common foods per 100g is below100g: beef, pork, chicken, Chinese cabbage, cauliflower, lettuce, wax gourd, watermelon, pumpkin, loofah, tomato, taro, water chestnut, amaranth, garlic, green onion, leek and beans. The sodium content exceeds 200 mg: oil cake, tofu, mushrooms, laver, pickled mustard tuber, fennel, sesame paste, Sichuan winter vegetables, potherb mustard, shrimp skin, sauce and so on.
In the process of avoiding salt, patients often buy salt-free soy sauce, which contains potassium but does not contain sodium, and can be used for patients with normal renal function, excessive urine output and low blood potassium. However, if the patient's renal function is poor, it is best not to use it when the urine volume is small, because potassium is excreted with urine. If urine volume is small and potassium excretion is small, hyperkalemia may occur, endangering the heart and even inhibiting the beating of the heart, causing accidents. Some patients take Qiu Shi, a traditional Chinese medicine, at the stage of avoiding salt. There are two kinds of Qiu Shi: Qiushi and Xianqiushi. Light Qiu Shi mainly contains calcium urate and calcium phosphate, and contains no sodium, so it can be taken. Salty autumn stone contains sodium chloride and should not be selected.
5. Iron: Patients with chronic nephritis are often accompanied by refractory anemia due to factors such as renal hematopoietic deficiency and hypoproteinemia. At this time, it is equally important to supplement iron, vitamin B 12 and folic acid. Foods include rape, fungus, red dates, longan, red beans, Chinese cabbage and so on.
6. Potassium salt: When the daily urine output of patients is above 65,438+000 ml, it is unnecessary to control the intake of potassium; When the urine volume is below 1000 ml, or there is high blood potassium, low potassium food should be chosen. The potassium content of common foods per 100g is lower than100g: eggs, pig intestines, pig blood, pigskin, sea cucumber, gluten, lotus root starch, bean jelly, vermicelli, water chestnut, pumpkin and wax gourd. , and the potassium content of more than 300 mg includes meat, viscera, chicken, fish and shrimp skin.
7. Vitamins: Eat more fresh vegetables and fruits, such as white gourd, day lily, fresh lotus root, radish, tomato, peach, pear, orange and watermelon. , and supplement vitamin C, carotene and B vitamins.
5. Eat less or no spicy food and fishy hair, such as goose, rooster, pig head, hairtail, yellow croaker, etc.
6. Patients can choose sweetened milk, biscuits, lotus root powder, bread, jujube porridge, barley porridge, egg soup, etc. Breakfast; For breakfast in the morning, you can use various fruits, such as oranges, apples, peaches and watermelons. For lunch, you can eat wheat starch, rice, white flour, scrambled eggs with tomatoes, sweet and sour carp, Chinese cabbage vermicelli, vermicelli meatball soup, sweet and sour lotus root slices, fried pork slices, boiled chicken and so on. In the afternoon, noodles with shredded chicken soup can be served, such as milk rice porridge, wheat starch, wonton, jujube cake and egg drop soup. For dinner, red date porridge, chestnut porridge, butterscotch porridge, lotus seed porridge, scrambled eggs, shredded potatoes cooked in vinegar, fried pork slices and cornmeal porridge are better.
7. The diet of patients with chronic nephritis and nephropathy should include 250g of milk, 2 eggs, 0/00g of lean meat, 0/00g of bean products, 500g of vegetables, 0/~ 2g of fruits, 400g of staple food and 20g of vegetable oil. It contains about protein 120g, 60g of fat, 350g of sugar and 2400kcal of heat.
[treatment prescription] 1. Broad bean syrup: aged broad bean (the best in several years) 120g, brown sugar 90g. Put the shelled broad beans and brown sugar into a casserole, add 5 cups of clear water, and simmer to 1 cup, and take it several times. Usually eat on an empty stomach in the morning and drink it in 5 days. It is effective for nephritis edema and proteinuria.
2. Broad bean stew: 160 grams of moth-eaten broad beans, stewed with pork. Worm beans 1~8, beef stew set. Do not use it with spinach. It is effective for nephritis and edema.
3. Broad bean coating syrup: broad bean coating 10 kg, brown sugar 2.5 kg, boiled into 5000 ml extract, divided into 50 bottles, 20 ml each time.
4. Braised garlic with carp: 1 Carp strips are eviscerated without scaling. Fill the fish belly with garlic cloves, wrap it in paper, tie it with thread, wrap it in yellow mud, cook it in ash, remove the paper mud and eat the fish.
5. Watermelon garlic: 1 watermelon (weight less than 1kg) and 7-9 garlic heads (no garlic heads, 7-9 garlic heads can be used instead). Methods: Wash the watermelon and gouge out 1 cube with a belt; Put the peeled garlic cloves into the melon, then cover the peeled melon, put it in a cage, put the mouth up, and steam it in water. Eat all the meat, juice and garlic cloves when eating, preferably 1 time or 1 day. It is observed that it is generally effective to take 5~7 watermelons continuously.
6. Black fish and winter melon soup: 1 piece of black fish, viscera removal, and winter melon soup (without salt) can eliminate edema.
7. Steamed crucian carp with Amomum villosum: 1 fresh crucian carp (about 200g) and Amomum villosum 3g. First, the crucian carp is peeled and the intestinal dregs are removed, washed, mixed with proper amount of oil, salt and Amomum villosum, put into the belly of the fish, sealed with bean powder, put on a plate, covered tightly with a bowl, steamed in water and taken.
8. Stewed black-bone chicken with astragalus.
9. Green duck soup: 65438+ 0 green ducks, 5 tsaoko, 50g red beans. First, remove the duck's hair and intestines. Put adzuki bean and Amomum tsaoko into the belly of duck, sew and cook. Then add five seasonings to blend and eat on an empty stomach.
10. Garlic-flavored duck: 1 blue-headed duck (above 1.5kg) and 50g garlic seeds. Stew in the pot until cooked (use a little sugar instead of salt), take a few tablets every 1 day and 1 tablet every other day.
1 1. goat milk: Drinking 500~ 1000 ml of fresh goat milk every day can eliminate proteinuria.
12. Steamed Soft-shelled Turtle: 1 Soft-shelled Turtle, without salt, can add rock sugar, and eat it on an empty stomach or with meals after steaming. It is suitable for chronic nephritis with hypertension and kidney yin deficiency.
13. Fresh lettuce: 250g of lettuce, appropriate amount of yellow wine, salt and monosodium glutamate. Peel and wash lettuce, cut or scrape into filaments, add salt (a little), mix well, marinate for a while and drain the juice. Then add rice wine and monosodium glutamate and mix well.
14. Corn seed: 1 serving of corn seed, 3 times of water, decoction instead of tea, taken in the morning and evening, has a long-term detumescence effect and can also reduce urine protein.
15. Winter melon porridge: fresh winter melon 80 ~ 100g, dried winter melon seeds/kloc-0 ~15g, fresh 30g, appropriate amount of japonica rice, effective in reducing swelling.
16. Plantago leaf porridge: 30-60g fresh plantain leaves, scallion 1 stalk, and japonica rice 1-2 slices, cooked and eaten, have diuretic and hemostatic effects.
17. Stigma Maydis frying: 50g of Stigma Maydis, 600ml of water, decocting for 20-30min, boiling into 300-400ml of liquid, filtering, twice a day.
The other side: 60 grams of dried corn stigma, 500 ml of water, fried to 250 ml, 1 time, morning and evening 1 time, potassium chloride 1 g, three times a day.
18. Corn must be sucked through a tube for several months.
19. ebony charcoal: 3g ebony charcoal, taken twice. By 7-8 weeks, urine protein can disappear.
20. Pepper eggs: 7 white tiger trees, fresh eggs 1 piece. First drill an egg into a hole of 1, then put white pepper into the egg, seal the hole with flour, wrap it in wet paper, steam it in a steamer, peel off the eggshell when taking it, and eat the egg and pepper together. Adults 2, children 1. 10 day is a course of treatment, and the second course of treatment is taken after 3 days' rest.
2 1. stewed carp with wax gourd: 500g of wax gourd and 250g of carp, stewed with water. Eat soup, melon and fish. It can reduce swelling and diuresis.
22. 60 grams of peanuts and red dates in the same clothes, simmer soup. Eat peanuts, red dates, drink soup and take it continuously. It has better effect on urinary protein around "+".
23. Peanut 120g, broad bean 250g, casserole with 3 bowls of boiling water, and simmer. When the water is brownish red, add a proper amount of brown sugar to take it. It is slightly better than taking broad bean syrup alone.
24. 30 grams of mulberry, 20 grams of raw coix seed and 20 grams of raisins. Cook porridge with appropriate amount of rice and take it twice.
25. celery juice: 500g fresh celery, mashed to get juice, taken with boiled water, daily 1 dose. Or 60 grams of celery root, decocted in water. Suitable for hypertension.
26. Boiled kidney with bean: 30g of beans with shell, pork kidney 1, cooked with the same food. Or 60 grams of bean shells, eggs 1 piece, boiled in water and soup, mainly used for kidney deficiency and low back pain. Or 1 pair of pig kidney and Eucommia ulmoides Oliv. 30g (or walnut kernel 30g) are cooked together to treat kidney deficiency and lumbago.
27. Astragalus porridge: 20g of Astragalus membranaceus, 200ml of water, decocted to100ml, and dregs are removed to leave juice. Use 50 grams of japonica rice, add about 300 ml of water, and cook until the rice flower soup is thick. You can add a little brown sugar when eating, and eat one meal every morning and evening, 7~ 10 days is a course of treatment.
28. Gourd shell jujube soup: 50 grams of gourd (also known as gourd) shell, 30 grams of winter melon skin, 30 grams of watermelon skin, jujube 10 grams, add about 400 ml of water, fry to about 150 ml, remove residue, and take soup, daily 1 dose until edema subsides. Suitable for nephrotic type.
29. Wash taro (taro), slice, bake and grind, add brown sugar and mix well, 50g each time, twice every 1 day.
30. 500g of soybeans and 500g of rapeseed, stir-fried, 6g each time, twice every 1 day. It is also applicable when accompanied by renal anemia.
3 1. Poria cocos cake: Poria cocos fine powder 250g, rice flour 250g (preferably half glutinous rice flour and half japonica rice flour) and sugar 250g. Add appropriate amount of water to the above raw materials, make them into paste, and bake them into extremely thin pancakes in a flat pan with low fire.
32. Broad bean cake: 500 grams of broad beans and 300 grams of brown sugar. Put the broad beans in a pot, soak them in water, peel them, cook them in a pot until cooked, add brown sugar and mash them into a paste, and let them cool for later use. Put the bean paste into a porcelain enamel basin and cut it into small pieces 4 cm long and 6 cm wide with a knife. Breakfast one day 1 time.
33. Maogen pineapple instant drink: 250g of fresh Maogen, 2500g of fresh pineapple juice and 500g of sugar. First, put fresh cogongrass rhizome into a pot, add water to decoct, and take the medicine juice. After 3 minutes, the residue was removed. Then, when the pot is almost dry, pour the pineapple juice in. When it is heated to be thick, stop the fire, wait for the temperature, mix in dry white sugar powder, mix well, dry in the sun, crush and bottle for later use. Every time 10g, soak in boiling water and take it suddenly, three times a day.
34. 500 grams of wax gourd and 250 grams of carp, stew with appropriate amount of water, drink soup, eat wax gourd and fish. Take it twice a day.