Summary of Professor Sheng Dong’s Thought on Diagnosing and Treating Kidney Diseases through Urine Examination

Abstract

Chronic nephritis is more common in clinical practice, and its course is long, recurrent, and difficult to cure, which brings high difficulty to clinical diagnosis and treatment. Professor Sheng Dong has extensive clinical experience in diagnosing and treating kidney disease. His core approach organically integrates macroscopic TCM syndrome differentiation with modern microscopic examination, forming a unique urine-based diagnosis and therapeutic framework. This paper systematically sorts out and summarizes the experience of nephrology diagnosis and treatment based on urine diagnosis based on literature research and typical cases (nephrotic syndrome combined with tuberculosis infection). Professor Dong put forward the core view that urine is the “mirror of the pathogenesis” of kidney disease, and the diagnosis and treatment of urine is carried out throughout the whole process of diagnosis and treatment, forming a diagnosis and treatment path of “macro-micro-dynamic adjustment”. At the macroscopic syndrome differentiation level, by observing urine characteristics such as urine color, urine volume, and abnormal urination, combined with the signs of the tongue and pulse, the condition is accurately judged, and the deficiency and excess of the internal organs, the nature of pathogenic factors and the depth of the disease are clarified. In terms of microscopic interpretation, modern medical microscopic indicators such as urine protein, urine occult blood, and β2 microglobulin are interpreted as TCM pathogenesis such as “subtle loss of intake”, “collateral damage and blood overflow”, and “toxic stasis and paralysis”. In dynamic treatment, follow the principle of “syndrome changes with lesions, prescriptions change with symptoms”, and adjust the treatment plan and focus according to the changes in micro indicators and macro symptoms, such as clearing heat and dampness during the active period of proteinuria, and focusing on strengthening the spleen and kidney, nourishing qi and essence. This diagnosis and treatment idea effectively makes up for the problem of insufficient identification of microscopic pathology of early kidney disease by traditional Chinese medicine, realizes the organic connection between traditional Chinese medicine syndrome differentiation and modern medical examination, and can provide specific reference for clinical doctors to diagnose and treat kidney disease, help optimize diagnosis and treatment ideas, improve the accuracy of syndrome differentiation and drug pertinence, and its relevant experience needs to be further promoted in combination with clinical practice to help inheritance and innovation.