Edema Maine

In healthy people, the normal regulatory functions of the nervous system, the endocrine system, and the kidney help maintain a functional water metabolic balance, which prevents the occurrence of edema even in the case of excessive water intake. When there is excessive secretion of antidiuretic hormone, combined with insufficient renal blood flow and glomerular filtration, and insufficient adrenocortical function, the water metabolic balance collapses, and edema develops as a result. Traditional Chinese medicine considers edema to belong in the following category of fu-zhong (swelling).

The invasion of pathogens, imbalance between work and rest, or improper diet all may cause a disturbance in the flow of qi, and retention of water in the body, resulting in water flowing to the muscular surface and forming edema. Commonly seen types of edema include wind edema, severe edema due to hypofunction of the spleen, stony edema, anasarca with shortness of breath, edema with impairment of the kidney, edema of the spleen, cardiac functional failure, edema during menstruation, edema during pregnancy, etc.

Chen treated 27 cases of simple edema in the lower limbs with modification of Wu Ling San. The modified formula consisted of Gui Zhi (Cinnamon Twigs), Fu Ling (Poria), Ze Xie (Alisma), Zhu Ling (Polyporus), Che Qian Zi (Plantain Seed), Bai Zhu (white Atractylodes), Fu Zi (processed Aconite), Niu Xi (Achyranthes), and Huang Qi (Astragalus). Modifications were added to suit individuals' symptoms. The results: all 27 cases reported that swelling subsided completely in 14 days (19 of the cases did so in just 7 days).(1)

Li et al. treated 50 cases of functional edema with Sen Ling Bai Zhu San. The formula consisted of the following herbs: Ren Shen (Ginseng), Bai Zhu (Atractylodes), Fu Ling (Poria), Bai Bian Dou (Dolichos), Yi Yi Ren (Coix), Sha Ren (Amomum Fruit), and Jie Geng (Platycodon Root). The formula was taken orally three times daily, with 14 days constituting one course of treatment. The results showed that after 1-2 courses of treatment, 42 cases significantly improved, 5 cases had improved, and the remaining 3 cases did not respond to the treatment.(2)

Ming treated 98 cases of idiopathic edema with modified Bu Zhong Yi Qi Tang. The modified formula consisted of the following single herbs: Huang Qi (Astragalus), Dang Shen (Codonopsis), Ze Xie (Alisma), Bai Zhu (Atractylodes), Chai Hu (Bupleurum), Chen Pi (Citrus), Dang Gui (Chinese Angelica Root), Chi Shao (Peony Red), Chuan Lian Zi (Melia), Sheng Ma (Cimicifuga), and Mu Dan Pi (Moutan). The formula was further modified to suit individual patients' symptoms. One dose of the formula in decoction was administered daily, and the course of treatment lasted two weeks. The results showed that: 80 cases greatly improved, 15 cases had improved, and the remaining 3 cases did not respond to the treatment, with the total effectiveness rate being 96.9%.(3)

Lin Hai Fei treated 30 cases of cardiogenic edema with a modified Fang Ji Fu Ling Tang formula. The modified formula consisted of Fang Ji (Stephania), Fu Ling (Poria), Ze Xie (Alisma), Zhu Ling (Polyporus), Huang Qi (Astragalus), Gui Zhi (Cinnamon Twigs), Dang Shen (Codonopsis), and Gan Cao (Licorice). The formula was further modified to suit individual patients' symptoms. One dose of the formula in decoction was administered daily. The results: after 1~3 weeks of treatment, 18 cases had their swelling subsided, their urine volume increased, and other symptoms improved, 8 cases had swelling reduced, and other symptoms improved, and the remaining 4 cases did not respond to the treatment, showing a total effectiveness rate as 86.7%.(4)

Wang et al. treated 70 cases of edema by tonifing the kidney and invigorating qi. Among the patients were those suffering from glomerular nephritis, idiopathic edema, hypothyroidism, and chronic cardiac insufficiency. The basic formula of the treatment included the following herbs: Bu Gu Zhi (Psoralea), Shan Zhu Yu (Cornus), Gui Zhi (Cinnamon Twigs), Xian Mao (Curculigo), Fu Ling (Poria), Tu Si Zi (Cuscuta), Huang Qi (Astragalus Root), Shu Di Huang (prepared Rehmannia), Dang Shen (Codonopsis), Ze Xie (Alisma), Che Qian Zi (Plantain Seed), and Yi Mu Cao (Leonurus). This formula was modified to suit individual patients' symptoms. The herbs were decocted in water for oral administration, one dose per day taken at three separate times. The study results were: 24 cases greatly improved, 28 cases showed much improvement, 14 cases improved, and the remaining 4 cases did not respond to the treatment, with the total effectiveness rate being 94%.(5)