Urinary Tract (bladder) Infection

Urinary Tract Infection Diagnosis:

Frequent, Urgent, Painful, dripping, dark urination caused by damp heat in the Bladder. Urine may contain stones, blood or a milky/greasy substance. Classically there are five Lin Zheng, although six are now recognized: Stone, Qi, Chyluria, Chronic Lao, Re (Heat), Xue (blood).

Western Medicine: Chyluria, Prostatitis, T.B. of Kidney, Cancer

Etiology (causes):

1. Shi Lin - stone (heat coagulates urine into stones)

2. Re Lin - heat (toxic damp heat attacks bladder – burning pain)

3. Xue Lin - blood (heat pushes blood out of damaged vessels)

4. Gao Lin - Chyluria (heat injures meridians impairing transform/transport)

5. Lao Lin - kidney def. (kd can’t help bladder transform urine or control gate)

6. Qi Lin -liver qi/blood stagnation fire travels down liver meridian impairing bladder)

Differentiate between:

Long Bi – retention of urine – not urgent, no pain, no blood Blood Urine – blood in the urine – not urgent, no pain, mainly blood Jing Zuo – urine with sperm during urination, usually after ejaculation.

Chinese Medicine Differentiation and Treatment

Re Lin (excess) Heat Mainly caused by damp heat, Frequent dribbling, urgent burning urination with bitter taste, fever, aversion to cold and other general damp heat accumulation symptoms. Tongue – red, yellow coat Pulse – soft, slippery, rapid

Principle of Treatment: induce diuresis to clear damp heat

Acupuncture points – sedate, foot Taiyang and Jueyin, Mu, Shu, *BL 28 and *Ren 3 (for all Lin), SP 9 (primary point to induce diuresis), LR 2 (pain and Heat) Acute onset symptoms- LI 4, SJ 6

Herbal Medicine Treatment: Ba Zheng San

Re Lin (deficient kidney Yin) Heat Deficient kidney fire, All symptoms above but less severe – mild/dull pain, lower back/knee pain and weakness, chronic Tongue – red, scanty coat Pulse – thin, rapid

Principle of Treatment: nourish kidney, clear heat

Herbal Medicine Treatment: Zhi Bai Di Huang Wan

Xue Lin (excess) Blood Frequent dribbling, urgent burning urination with bitter taste, fever, aversion to cold and redness in urine (blood in urine) Tongue – red, yellow coat Pulse – rapid

Principle of Treatment: clear heat, induce diuresis, cool blood to stop bleeding

Acupuncture points – neutral, BL 28 and Ren 3, SP 6, 10 - purge Heart Fire- PC 8, HT 8 - Kidney Qi deficiency- KI 6, 7 - Spleen Qi deficiency- ST 36, Ren 6

Herbal Medicine Treatment: Xiao Ji Yin Zi

Xue Lin (deficient kidney yin) BloodFrequent dribbling, urgent urination with mild/ dull pain, lower back/knee pain and weakness, chronic with slight red or pink colour Tongue – red, scanty coat Pulse – thin, rapid

Principle of Treatment: Nourish kidney, clear heat, stop bleeding

Acupuncture points – neutral, BL 28 and Ren 3, SP 6, 10 - purge Heart Fire- PC 8, HT 8 - Kidney Qi deficiency- KI 6, 7 - Spleen Qi deficiency- ST 36, Ren 6

Herbal Medicine Treatment: Zhi Bai Di Huang Wan + Gui Ban + E Jiao +Han Lian Cao

Qi Lin (excess – Liver Qi Stagnation)Frequent dribbling, urgent, painful urination with pain in the lower abdomen, distended pain, aggravated by stress / emotion, unfinished feeling after urination Tongue – red or normal Pulse – Wiry, deep

Principle of Treatment: regulate Qi and Blood, induce diuresis

Acupuncture points – neutral, tonify Shu, sedate Mu, BL 28 and Ren 3, BL 54 toward ST 28, BL 18, LR 14, PC 5 (ghost)

Herbal Medicine Treatment: Chen Xiang San

Qi Lin (deficient spleen Qi sinking)Frequent, dribbling, urgent urination, agg-when tired, pulling feeling in lower abdomen, amel-pressure, general Qi deficient symptoms. Tongue – pale Pulse – weak

Principle of Treatment: strengthen spleen Qi

Herbal Medicine Treatment: Bu Zhong Yi Qi Tang

Shi Lin (excess) StonesFrequent dribbling, urgent, painful urination with pain and stones, flow suddenly stops in mid stream, over whelming urge to go with severe pain, worse for men, if stones in kidneys severe lower back pain, stones may injure vessels = blood in urine Tongue – red yellow coat Pulse – wiry

Principle of Treatment: induce diuresis to eliminate stones

Acupuncture points– neutral, foot Taiyang and Shaoyin, BL 28 and Ren 3, BL 54 toward ST 28 (3 cun lateral to Du mai, 3rd sacral vertebrae), BL 39, KI 10 - acute attack of pain- Du 26 - Kidney Yin deficiency- BL 23, KI 3 - Qi deficiency- ST 36, Ren 6

Herbal Medicine Treatment: Ba Zheng San + Shi Wei San (stones)

Shi Lin (complicated excess / deficient) Stones Frequent dribbling, urgent, painful urination, chronic stones, fatigue, dull pain, lower back aching. Pulse – weak

Principle of Treatment: strengthen kidney, induce diuresis to eliminate stones

Acupuncture points– neutral, foot Taiyang and Shaoyin, BL 28 and Ren 3, BL 54 toward ST 28 (3 cun lateral to Du mai, 3rd sacral vertebrae), BL 39, KI 10 - acute attack of pain- Du 26 - Kidney Yin deficiency- BL 23, KI 3 - Qi deficiency- ST 36, Ren 6

Herbal Medicine Treatment: Zhi Bai Di Huang Wan + Shi Wei San (stones)

Gao Lin (excess) Chyluria Frequent dribbling urgent, painful urination, cloudy urine with floaters at surface, burning pain Tongue- red, yellow coat Pulse – rapid

Principle of Treatment: eliminate damp heat, promote separation of waste body fluids

Acupuncture points - foot Taiyang and Taiyin, BL 28 and Ren 3, Du 4 (Kidney Qi, astringe Essence), SP 6 and 9 (ascend clear Qi, descend turbid Qi)

Herbal Medicine Treatment: Bei Xie Fen Qing Yin

Gao Lin (deficient kidney Qi) Chronic frequent, dribbling, urgent, painful urination with cloudy urine, emaciation

Principle of Treatment: nourish kidney to reinforce gate

Acupuncture points - foot Taiyang and Taiyin, BL 28 and Ren 3, Du 4 (Kidney Qi, astringe Essence), SP 6 and 9 (ascend clear Qi, descend turbid Qi)

Herbal Medicine Treatment: Liu Wei Di Huang Wan + Jin Suo Gu Jing Wan

Lao Lin (kidney deficiency)Chronic frequent, dribbling, urgent, painful urination induced by over strained sexual activity, general kidney deficiency symptoms. Pulse – thin

Principle of Treatment: nourish deficiency

Acupuncture points – foot Yangming, Taiyin, Shu, BL 28 and Ren 3, BL 20, 21, 23, Du 4, Ren 4, ST 36

Herbal Medicine Treatment: Kid-yin def. - Liu Wei Di Huang Wan Kid-Qi def. - Tu Si Zi Tang Kid-Yang def. - Shen Qi Wan

Lao Lin (heart deficiency) Frequent, dribbling, urgent, painful urination accompanied by deficient heart symptoms

Principle of Treatment: nourish deficiency, induce diuresis

Acupuncture points – foot Yangming, Taiyin, Shu, BL 28 and Ren 3, BL 20, 21, 23, Du 4, Ren 4, ST 36

Herbal Medicine Treatment: Tu Si Zi Tang + Qin Xin Lian Zi Yin

Lao Lin (spleen) Frequent, dribbling, urgent, painful urination accompanied by over work, fatigued, general heaviness

Principle of Treatment: Nourish deficiency

Acupuncture points - neutral, tonify Shu, sedate Mu, BL 28 and Ren 3, BL 54 toward ST 28, Ren 4, ST 36, BL 20

Herbal Medicine Treatment: Shen Qi Wan

Alternative Treatment Methods

auricular- BL, KI, sympathetic, occipital, adrenal

electrical- good for Stone pain, SP 6, BL 61, 23 (bladder stones), BL 54 toward ST 28, ashi points, BL 28 and GB 25 (kidney stones), medium-strong stimulation

7 star- effective for prostatitis, L2-S5, Spleen and Stomach meridians