尿蛋白高

女，34岁，眼睑及两下肢浮肿1周，头昏乏力，纳差恶心，面色萎黄，腰酸肢冷，尿少，血压24/14kPa，贫血貌，两下肢凹陷性浮肿，尿蛋白(+++)，颗粒管型(++)，红细胞(+)，血肌酐238umol/L，尿素氮15mmol/L，脾肾阳虚，水湿泛滥，气虚血瘀

24岁男性，小便泡沫增多，尿常规异常，肢体无水肿，易感冒，自汗，恶风，舌澹红苔微黄，脉滑数。中医诊断瘀血阻络，虚热内扰，气虚不固。舌澹红苔薄白，脉滑数。小便色黄，泡沫较多，不易消退，纳食可，寐可。舌红苔薄白，苔薄黄。

女，50岁，水肿三年，小便短少，纳呆，口淡，腰背痠痛，全身浮肿，腹大如鼓，身肿甚，神疲，面色苍白，舌淡苔白，脉沉弱不应指。脾肾阳虚，不能运化水湿。

男，47岁，肾病综合征病史1年余，周身水肿，腹膨大，小便不利，尿色黄，大便秘，口舌干燥。舌苔厚腻，脉沉滑数。水热壅结于三焦之证。

女性，30岁，一身浮肿，腹膨满，便泄纳差，烧心，右上腹疼痛，脉濡小，舌苔薄，慢性肾炎，尿蛋白(+++)，脓球(++)

患者7岁，女性。腹痛，下肢关节疼痛，紫斑点，尿红细胞充满，蛋白(+++)，乏力，自汗，溲赤，手足心热，便秘。舌尖赤，苔白干，脉滑数。毒热蕴结血络，迫血妄行。面色柯兴征。

陈某，男，28岁。周身浮肿，面肿如斗，面色润白，形寒怯冷，神疲纳呆，泛泛欲呕，小便短小，苔白质澹胖，脉沉细。慢性肾小球肾炎型，氮质血症。脾肾阳虚，水湿潴留，气虚血瘀。肾功能异常，尿蛋白(+++)，脓细胞(+)。

患者男性，40岁。腰酸痛不适，神疲乏力，腹胀便溏，小便不利，双下肢浮肿。舌质暗澹、边尖有瘀点，苔白，脉细涩。尿检蛋白(+++)，红细胞(3~6)。诊断为慢性肾炎。辨证属脾肾阳虚，水湿内停，瘀血阻滞。

患者年龄23岁，男性。主诉浮肿数月。病程较长。中医诊断水肿病后期，脾肾两虚之证。病因病机为脾肾阳虚，水湿内停，阳气不化，水道不通。望诊见舌苔白腻。闻诊未提及。问诊见周身肿亮，皮肤裂口渗水，小便闭塞。切诊见脉伏于骨。

28岁男性，周身浮肿，面肿如斗，面色白光白，形寒怯冷，神疲纳呆，泛泛欲呕，小便短少，每日200～300ml。脾肾阳虚，水湿瘀留，气虚血瘀。面色白光白，舌象未提及，声音低微，气味未提及，脉象未提及。病程自1978年起，持续5年。

刘某，男性，38岁。周身水肿、头晕、腹胀、两胁胀痛、恶心欲吐、食后反酸、纳呆、尿量减少、大便溏薄、两手肿胀、麻木。舌黯澹，边有齿痕，苔白腻。脉沉细弦。水肿，属脾肾两虚，肾虚血瘀之证。

杨某，35岁，面目浮肿，尿检异常，腰府酸痛，嗳气纳少，脘部作胀，白带量多有腥味，脉细，苔薄白。脾虚气滞，肝经湿热下注。面色萎黄，舌苔薄白，脉细。尿检蛋白（卌），脓细胞(+)，上皮细胞()，颗粒管型少许，透明管型(+)。腹水，白带量多有腥味，腰府酸痛，脘部胀满，溲少带多，喉中有梗阻之状，苔厚腻，口苦背冷，腰酸，头昏耳鸣，苔白厚。

男，47岁，发热、体痛、膝关节痛6天，腹痛、尿少2天。流行性出血热，三期重叠，危重型。出血点、瘀斑、水肿、胸骨压痛、肾区叩痛。白细胞升高，有幼稚细胞及异淋巴细胞，尿蛋白(++)，管型(+)，尿素氮升高。面色苍白，痛苦病容，皮肤出血点，左臀部瘀斑，眼睑及结膜水肿，胸骨压痛，肾区叩痛，意识昏迷，浮肿，呼吸困难，口唇及肢端发绀，颈静脉怒张，心音低钝，血压波动，尿闭，咯血，衄血，瞳孔散大，呼吸困难，深反射亢进，浅反射消失。

男，59岁，颜面虚浮，头晕腰酸，倦怠乏力，双下肢浮肿，指痕(+++)，血清肌酐295.3mmol/L，尿素氮13.68mmol/L，24h尿蛋白定量6.85g，血白蛋白球蛋白265/227，尿常规蛋白(++++)，白细胞6～7。脾肾两虚，湿浊内阻。

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80岁男性，心肌梗死，肺部感染，伪膜性肠炎，心肝肾功能不全。心阳虚微，心力衰竭，肺源上绝，呼吸衰竭，肝损黄疸，肾竭尿少浮肿，尿蛋白(++++)，脾胃俱伤，上不受纳，下泄不止。舌象未提及，脉象未提及。

患者65岁，男性。主诉丝虫病30余年，小便混浊，劳累及进食肥甘厚味后加重，近2年尿中出现胶冻状物，本次因肉眼血尿4天入院。中医诊断久浊不愈，证型脾肾双亏。病因病机为湿热内蕴，下注膀胱，阻于脉络。舌红苔黄，脉濡。

患者年龄11岁，男性。反复浮肿3年，颜面及全身浮肿，双下肢凹陷性水肿，尿黄量少而臊，面色苍白，口微渴，喜冷饮。舌质澹红，苔薄黄而腻，脉细滑。中医诊断脾虚气弱，湿热内阻。病程较长，属慢性病程。

男性，37岁，主诉血肌酐升高8个月，Scr持续波动在500~600μmol/L。面色晦暗，腰酸乏力，胸闷偶作，纳谷欠香，大便日行1次，小便泡沫多，日间尿少，夜尿频多。舌淡红，苔薄白，脉沉弦。尿蛋白3+，隐血2+，尿素氮19.33mmol/L，血肌酐512μmol/L，尿酸531mmol/L，钾5.62mmol/L。中医诊断脾肾气虚，湿瘀互结。

女，42岁，慢性肾小球肾炎3年余，面色淡黄，眼睑浮肿，纳差乏力，腰痛，夜尿频多，尿蛋白(++), 红细胞(±), 24h尿蛋白定量2.1g/L，血清ALB 34g/L，脾肾气虚挟湿型，舌淡苔白，脉濡细