Effective Herbal Remedies for Chronic Glomerulonephritis: Evidence-Based TCM Formulations and Modern Clinical Applications

Traditional Chinese Medicine (TCM) has evolved significantly in recent decades, transitioning from time-honored decoctions and herbal soups to standardized, clinically validated herbal formulations. These modern TCM preparations—produced under strict quality control and supported by both clinical trials and pharmacological research—offer targeted, reproducible therapeutic benefits for complex chronic conditions like chronic glomerulonephritis (CGN). Crucially, treatment is never one-size-fits-all: TCM practitioners rely on precise pattern differentiation (Bian Zheng)—assessing individual manifestations such as yin deficiency, qi deficiency, damp-heat accumulation, or kidney-liver disharmony—to select the most appropriate formula. This personalized, mechanism-driven approach enhances safety, efficacy, and long-term renal protection.

First-Line Herbal Therapies with Robust Clinical Validation

Among all TCM-based interventions for CGN, Tripterygium Glycosides Tablets (TGT) stand out as the most extensively studied and widely prescribed option. Originally developed for autoimmune rheumatic disorders—including rheumatoid arthritis and lupus—TGT gained recognition in nephrology after pioneering work by leading experts at the Nanjing General Hospital of the Eastern Theater Command (formerly Nanjing Military Region General Hospital). Their landmark clinical studies demonstrated remarkable efficacy in reducing proteinuria, suppressing microscopic hematuria, stabilizing estimated glomerular filtration rate (eGFR), and delaying disease progression in patients with IgA nephropathy, membranous nephropathy, and other forms of chronic glomerulonephritis. Today, TGT remains a cornerstone therapy—particularly for patients with active immune-mediated injury—when used under careful medical supervision and regular monitoring.

Renal-Protective Formulations for Long-Term Support

Beyond immunomodulation, long-term kidney preservation is equally critical. Several high-quality herbal formulas have demonstrated strong nephroprotective effects through antioxidant activity, anti-fibrotic signaling, mitochondrial support, and tubular cell regeneration. Notable examples include:

Bailing Capsules: Targeted Support for Tubulointerstitial Health

Derived from the medicinal fungus Paecilomyces hepiali, Bailing Capsules are clinically proven to reduce oxidative stress in renal tubules, inhibit TGF-β1–driven fibrosis, and improve microcirculation within the kidney interstitium—making them especially valuable during the maintenance phase of CGN management.

Golden Water Treasure (Jinshuibao): Enhancing Cellular Energy and Repair

This fermented mycelial preparation—standardized to contain cordycepin and adenosine—supports mitochondrial biogenesis and ATP synthesis in podocytes and proximal tubule cells. Clinical data show it helps sustain renal function, lower urinary NAG enzyme levels (a marker of tubular damage), and improve fatigue and anemia commonly associated with CKD progression.

Pattern-Specific Formulas: Precision Medicine Rooted in Classical TCM

Accurate syndrome differentiation remains essential for optimal outcomes. Below are evidence-informed, pattern-matched formulations recommended by leading TCM nephrology guidelines:

For Qi-Yin Deficiency Syndrome (Fatigue, Dry Mouth, Low-Grade Fever, Pale Tongue)

Nephritis Recovery Tablets and Qiju Dihuang Wan (Lycii & Chrysanthemum Rehmannia Pill) nourish kidney yin and tonify spleen-stomach qi—effectively alleviating proteinuria, nocturia, and dizziness while improving overall vitality. Shenyan Shu Capsules further strengthen this action with added herbs that promote blood circulation and reduce stasis-related inflammation.

For Damp-Heat Syndrome (Foamy Urine, Burning Sensation, Yellow Tongue Coating, Irritability)

Shenfu Kang Granules clear heat, drain dampness, and resolve turbidity—targeting underlying inflammatory pathways linked to complement activation and endothelial dysfunction. Its formula includes Alisma, Plantago Seed, and Phellodendron, all shown in vitro to inhibit NF-κB translocation and reduce urinary IL-6 and MCP-1 excretion.

Time-Tested Classical Formulas with Modern Relevance

Two foundational prescriptions from the Essential Prescriptions of the Golden Chamber continue to shape contemporary CGN treatment strategies:

Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) serves as the gold-standard formula for kidney yin deficiency—a common constitutional pattern in early-to-mid stage CGN. Its balanced combination of rehmannia, cornus, dioscorea, alisma, moutan, and poria supports glomerular basement membrane integrity and modulates RAAS overactivity.

Jisheng Shenqi Wan (Ji Sheng's Kidney-Qi Pill), a modification of Liuwei Dihuang Wan enriched with cinnamon twig and aconite root, is indicated when kidney yang deficiency coexists—characterized by cold limbs, edema, low back pain, and diminished urinary concentration. Modern studies confirm its ability to upregulate aquaporin-2 expression and improve sodium handling in distal nephron segments.

When integrated thoughtfully into a comprehensive care plan—including dietary counseling, blood pressure optimization, SGLT2 inhibitor use where appropriate, and lifestyle coaching—these herbal therapies offer a powerful, science-aligned complement to conventional nephrology practice. Always consult a licensed integrative nephrologist or TCM physician board-certified in internal medicine to ensure safe, synergistic, and patient-centered treatment.