A case of frequent nocturnal urination treated by combining Wu Ling San with Qian Yang Seal Marrow Dan

Long, a female, 53 years old, was first seen on November 17, 2015. The patient came to seek TCM treatment for frequent nocturnal urination affecting sleep. During the consultation, we learned that the patient’s urination was basically normal during the day and frequent at night, 3 to 4 times per night, such that it affected sleep, occasional dizziness, easy mouth ulcers, dry stools followed by thin stools, light tongue with thin yellow coating, and double-ruled sunken and tight pulse. Past history: erosive gastric sinusitis, multiple ulcers of the gastric sinus, low T3 syndrome, breast hyperplasia. Professor Liu Zhilong identified the evidence as: unfavorable bladder gasification, shallow water not nourishing the dragon; the formula used Qian Yang Feng Marrow Dan combined with Wu Ling San to make the prescription: 10 grams of ripe Radix Pseudostellariae (separately wrapped, first decocted), 10 grams of fried tortoise shell, 10 grams of Chuan Huang Bai, 15 grams of light dry ginger, 10 grams of roasted licorice, 10 grams of Yu Gui Pi, 15 grams of white Poria, 20 grams of pig ling tablets, 30 grams of Jian Ze Di, 15 grams of raw Atractylodes Macrocephalae, 7 doses, decoction with water, 1 dose daily. At the follow-up on December 1, 2015, the patient reported that frequent night urination was basically cured after the former medicine, and occasionally got up at night to urinate once, and his sleep also improved. The prescription was followed by 7 more doses. Prof. Liu Zhilong believes that such patients must ask whether their sleep is affected by urination first or their sleep is affected by insomnia, and if they add the medicine of tonifying the kidney and astringent urination in the formula of tranquilization, the effect is often not very good. If sleep is affected by urination, the treatment should focus on urination. Although frequent nocturnal urination is one of the evidence of kidney deficiency, frequent nocturnal urination is not only due to kidney deficiency, but also the direct cause of frequent urination is the unfavorable bladder gasification. Therefore, the treatment should warm the kidney yang, return the qi to the kidney, and help the bladder qi to transform. The hot and humid climate in Guangdong, the popularity of herbal tea, and staying up late at night can easily lead to water deficiency in the lower part of the body and loss of fire control, so that the fire can run upward. Prof. Liu Zhilong often uses Qian Yang Seal Marrow Dan combined with Wu Ling San to treat this evidence, as in the case of this patient. In combination with Wu Ling San, it can help the bladder to move dampness and water and help the bladder to Qi-transform. If the frequency of urination is reduced, night sleep and sweet dreams can also be obtained.