Purpura nephritis actually refers to the toxicity caused by the body's inability to produce urine through the kidneys to expel waste products and excess water produced by the body's metabolism. Modern medicine believes that uremia is a series of complex syndromes arising from disorders of the body's internal biochemical processes after the loss of kidney function. Instead of a separate disease called renal failure syndrome or simply purpura nephritis.
Awareness of purpura nephritis
Purpura nephritis is a chronic damage to most of the renal parenchyma due to various reasons, and thus cannot excrete many metabolic wastes and cannot degrade certain endocrine hormones, resulting in their accumulation in the body and toxic effects. Uremic toxins include: small molecule nitrogenous substances, such as guanidine, urea, uric acid, amines and indoles and other protein metabolites; medium molecule toxic substances: including excessive blood retention of hormones: such as parathyroid hormone polypeptide, etc.; large molecule toxic substances, such as pancreatic glucagon, β2-microglobulin, lysozyme and so on. The above small, medium and large molecules, some of them are toxic to human body, some of them are harmless to human body when the concentration is normal, but if the level in blood is too high, it will also have toxic effect and cause some uremic symptoms, and with the progressive deterioration of the course of the disease to the terminal stage, then the emergence of uremia. According to statistics, every million people in China, about 100 people die of uremia every year.
The most common causes of uremia abroad are: diabetic nephropathy, hypertensive nephropathy, glomerulonephritis, polycystic kidney, etc., while in China, they are: primary chronic nephritis, obstructive nephropathy, diabetic nephropathy, lupus nephritis, hypertensive nephropathy, polycystic kidney.
Purpura nephritis is mainly manifested as
Gastrointestinal symptoms Digestive symptoms are the most common, and almost every patient has loss of appetite, abdominal distension, nausea, vomiting, acid reflux, belching and so on. Literature reports that the incidence of gastrointestinal ulcer symptoms is as high as 18% to 24%, mainly manifested as small amount of vomiting or black stool.
Hematologic symptoms Uremic patients have different degrees of renal anemia, often with skin and mucous membrane bleeding tendency, manifested as subcutaneous petechiae, gingival and subconjunctival hemorrhage, epistaxis and so on.
Cardiovascular system symptoms uremia combined with renal hypertension up to 80% ~ 90%, manifested as headache, dizziness, severe cases of vomiting, convulsions and other hypertensive encephalopathy. The incidence of uremic pericarditis is as high as 60% to 100%, and pericardial effusion occurs in 30% to 40% of uremic pericarditis. The main manifestations are discomfort in the precordial area, chest tightness and chest pain. Cardiovascular system lesions is the main cause of death of uremia, uremia due to vascular complications accounted for 64.3% of deaths.
Neuropsychiatric symptoms The incidence of neuropsychiatric symptoms in uremia reaches 13% to 86%, mainly consciousness disorder, cranial nerve damage, myalgias and epilepsy.
Respiratory symptoms The incidence of pulmonary infection in uremia is 50%, and the most common are tracheitis, bronchopneumonia, and purulent bronchitis.
Immunocompromise The incidence of urinary tract infections is 44%, and gastrointestinal and skin infections are more common.
Sexual dysfunction Men are often accompanied by impotence and premature ejaculation, and women often have menopause or menstrual cycle disorders.
The following lessons should be learned from this case of longer-term misdiagnosis: any unexplained prolonged anemia, gastrointestinal bleeding, epistaxis, skin ecchymosis; unexplained hypertension, especially in young patients, with poor antihypertensive treatment; unexplained confusion disorder, symptomatic epilepsy; and low or high potassium or acidosis that cannot be easily corrected should be thought of as a possible cause of the disease, and be subjected to further examination for confirmation of the diagnosis. to confirm the diagnosis.
Nursing care for purpura nephritis
According to the general nursing routine of internal medicine and diseases of this system.
[Observation]
1. Closely observe the changes of the condition, measure the weight, blood pressure, and the amount of water in and out of the body every day, and observe the fluid retention or insufficiency in the body.
2. Observe the signs of hypertensive encephalopathy, heart failure and pericarditis, and notify the physician of any abnormalities.
Symptomatic care
1. Patients with frequent vomiting and diarrhea should pay attention to water and electrolyte disorders, and notify the physician when symptoms occur.
2. Patients should be protected from self-injury when convulsions and whoan occur due to abnormal brain manifestations or low calcium, and physicians should be notified immediately.
3. Breath with ammonia odor, easy to complicate stomatitis, should strengthen oral care.
[General care]
1. Give high calorie, high vitamin, high quality low protein diet, can be adjusted according to the renal function of the protein intake, hypertension
the person should limit the sodium intake, if dialysis treatment has been carried out, should be given to the high quality high protein diet.
2. For those who are resting in bed and are unconscious, agitated, convulsive, or comatose, bed rails should be placed and inspections should be strengthened to prevent falling out of bed.
3. Skin care due to metabolite retention caused by skin cancer itch, available hot water bath, do not scratch the skin to avoid
infection. The skin can be scrubbed with hot water to avoid infection, and to prevent the occurrence of bedsores.
Mythical recipes
1. Fresh raw ground, fresh root, fresh lotus root 150 Gu, squeeze out the juice to drink.
2. 20 grams of persimmon leaves, fresh pig skin 100 grams of the above flavors with water to simmer juice, remove the dregs, add 100 grams of round-grained rice porridge, morning and evening each 1 bowl.
4. 60 grams of palm bark, 80 grams of cypress leaves, fried into charcoal, boiled water to serve, 2 times a day.
5. 1 water fish, 9 grams of Xi root, 9 grams of crane grass. First of all, the fish will be clean, add water to boil the root of Xi, Xianhecao about half an hour, filter the juice to remove slag, and then use the juice to cook the fish, until the fish is cooked through. Season to taste and eat. Take 1 dose daily or every other day. Take 8~10 doses in a row.
6. Licorice 100 grams, Yunnan Baiyao 2 grams. Licorice with water 400 ml decoction, decoction to 150 ml can be. Daily licorice juice 10 ml punch Yunnan Baiyao 0.2 grams orally, three times a day, for 5 days as a course of treatment.
7. 300 grams of licorice. The above medicine into a large casserole with 1200 milliliters of water, decoction 1 ~ 2 hours to 450 milliliters of soup can be. Daily divided into 2 times to take down, 1 dose per day, served until the disappearance of purpura 3 days after stopping the drug.
8. 7.5 grams of sesame, turtle shell 50 grams, 25 grams of ginseng. The above medicine first fried turtle armor 30 minutes, and then under the other two flavors, fried 20-30 minutes, drink the juice, take 1-2 times a day.
9. 150 grams of jujube, comfrey 9 grams. Wash jujube, comfrey, add water and boil until jujube rotten, eat jujube drink soup, 3 times a day, 1 dose daily.
10. 60 jujubes, 50 grams of lemongrass root, water decoction, drink soup and eat jujubes in 2 times. Applicable to "renal-type allergic purpura" with proteinuria and hematuria patients.
11. 20 jujubes, 30 grams of Paeonia lactiflora, 10 grams of licorice, water decoction, 1 dose per day, divided into 2 ~ 3 times. Applicable to "abdominal purpura" with abdominal pain, diarrhea patients.
Chinese medicine
1. Freshly groundnut, buffalo horn, red peony, comfrey, silver flowers, Poria cocos, Snake Tongue Grass, gypsum, leucaena leucocephala, licorice, and so on, with additions and subtractions, decoction, and take it with water. It can cool the blood, clear heat and detoxify the toxin.
2. Astragalus, Radix Panax Ginseng, Poria, Rhizoma Atractylodis Macrocephalae, Radix Angelicae Sinensis, Radix et Rhizoma Dioscoreae, Radix Paeoniae Alba, Rhizoma Ligustici Chuanxiong, Radix Polygoni Multiflori, Radix et Rhizoma Glycyrrhizae Praeparatae, etc., with additions and subtractions. It can regulate qi and blood.
3. You can take Gui Spleen Pill or Ten Ash Pill.
Western medicine
1. Non-specific anti-allergic treatment. You can take Sincerol or Cyproheptadine orally.
2. Give vitamin C, oral or intravenous drip or oral vitamin E. It can reduce the permeability and fragility of capillaries.
3. Corticosteroid hormone, with anti-allergic, reduce the role of vascular permeability, can quickly reduce joint pain and gastrointestinal symptoms. It is suitable for joint type, renal type and abdominal type of allergic purpura with more serious skin lesions.
4. It is suitable for renal-type allergic purpura. Commonly used cyclophosphorus? amine, azathioprine or methyl? Immunosuppressants such as cyclophosphamide, azathioprine, or methotrexate.
Dietary therapy
1. Black fungus, white fungus 50 grams each, 75 grams of purple rice, boiled into a thick soup, morning and evening food.
2. 100 grams of red dates, 500 grams of rabbit, brown sugar. The rabbit washed and cut into small pieces, with red dates, brown sugar *** put the pot in the water stewed, until the meat can be rotten. Three times to finish.
3. 500 grams of jujube. Jujube washing, raw food, 10 each time, 3 times a day, continuous consumption.
4. 60 grams of pig skin, pig's feet 1, 10 jujube. Wash the three, pig skin cut into pieces, pig's hooves a cut in half, three flavors **** boiled until diluted, daily service 1 dose.
5. 10 jujube (core), chewing to eat, 3 times a day, even ate 3 ~ 5 days is effective. Applicable to allergic diesel purpura, skin bleeding purple spots.
6. 20 grams of cinnamon meat, 10 jujube, 30 grams of ginseng, water decoction, 1 dose per day, divided into 2 servings.
7. 500 grams of rabbit, 100 grams of jujube, brown sugar. Wash the rabbit meat, cut into pieces, with red dates, brown sugar *** put the pot in the water stewed, can be divided into 3 times served.
8. Raw peanut kernels (with red) 20, 7 jujube. First of all, the jujube boiled soup spare, raw peanut kernels and jujube *** pounded into mud, 1 dose per day, date soup served. Treatment of anaphylactic purpura, has the effect of promoting platelet elevation and subsiding purpura.
9. 10 red dates, 30 grams of raw earth, 10 grams of comfrey, 10 grams of licorice, decoction of water as tea.
10. 50 grams of cranesbill, 30 jujubes, water decoction, ~ 3 times drinking soup and eating dates.
* Health Disclaimer * The information on this site is for reference only, and can not replace you to go to the hospital for treatment, you can not rely on the information on this site to diagnose disease or prescription.
[Health guidance]
1. Instruct patients to adopt a reasonable diet according to kidney function.
2. Instruct patients to use medication correctly and observe side effects.
3. Pay attention to keep warm, prevent cold, prevent secondary infection.
4. Pay attention to the combination of work and rest, increase the body's immunity.
5. Regular outpatient follow-up.