Non-infectious urethral syndrome is also known as non-microbial urethral syndrome and aseptic urinary frequency and voiding discomfort syndrome. It is a group of syndromes in which frequency, urgency and painful urination are the main symptoms due to microorganisms such as bacteria (including Mycobacterium tuberculosis, etc.), fungi and chlamydia are clinically excluded. It is more common clinically and accounts for about 25% of urethral syndromes (75% of infectious urethral syndromes). It is often misdiagnosed as urinary tract infection and treated with antibiotics for a long time, which is not only ineffective but also increases many adverse reactions. Chinese medicine treatment has advantages.
This disease is mostly chronic process, belongs to the category of “labor gonorrhea” and “back pain” in Chinese medicine. Mostly due to depression, liver loss of drainage, unfavorable qi, depression for a long time into fire, burning fluid, Sanjiao qi-transformation failure, water channel obstruction, bladder disadvantage; or thinking and straining the heart, depleting the heart and yin, Ying Yin does not transport, can not nourish the kidney, water and fire do not help, heart and kidney do not cross, affecting the Sanjiao qi-transformation, bladder disadvantage. The pathogenesis is liver depression, heart fire, kidney deficiency, bladder dampness and heat, the treatment is to dredge the liver, clear the heart, benefit the kidney and clear the bladder.
1.Treatment according to evidence
The kidney is the essence of the heaven, where the true yin is located, and has the function of nourishing the five organs, six bowels and all the limbs and bones. The kidney is the main reservoir of essence, kidney yin deficiency, yin deficiency produces internal heat. Insufficient kidney yin and loss of the right to main water will lead to dripping urine. The symptoms are dripping urine, dry mouth and dry throat. Soreness and pain in the lower back, red tongue with little coating and fine pulse. This evidence is mostly seen in the non-infectious urethral syndrome non-episode period. The evidence belongs to deficiency of kidney yin and internal disturbance of deficiency heat. Treatment is to nourish kidney yin, clear heat and diuresis. The formula is Zhi Bai Di Huang Tang with addition and subtraction. The medicine includes Zhi Mu, Huang Bai, Sheng Di, Fu Ling, Mudan Pi, Ze Di, Huai Shan, etc.
Heart fire consumes qi and injures yin; heart yin is deficient and cannot nourish kidney yin; water and fire do not help; heart and kidney do not intermingle; bladder vaporization is unfavorable. If the heart is deficient, the body is tired, and after labor, urinary frequency and urinary urgency can easily occur, which is difficult to be cured. This evidence is mostly seen in the non-infectious urethral syndrome episodes. The evidence is due to deficiency of heart yin, internal generation of deficiency heat, and migration of heat to the small intestine. The treatment is to nourish yin and clear the heart, and diuresis to direct heat downward. Clear the heart and guide the redness of the soup, the medicine used stone lotus seed, party ginseng, poria, Qianren, scutellaria, raw earth, astragalus, maitong, licorice, etc.
Due to emotional disorders, the liver is out of control, the qi is stagnant, the water channels of the three jiao are not regulated, and the stored water and fluid cannot be excreted normally. The symptoms include frequent and urgent urination, dripping, and fullness in the abdomen, which is easy to occur when the emotions are not good. Most of them have a history of seven emotions and injuries. This evidence is mostly seen in the non-infectious urethral syndrome attack period. The evidence belongs to liver stagnation and fire, and the bladder is unfavorable. The treatment is to dredge the liver and drain heat, and de-stress the bladder. The formula is Dan Gardenia Free and Easy San plus or minus, with Mudanpi, Gardenia, Poria, Atractylodes, Baihu, Bai Shao, and Plantago.
The patient originally had non-infectious urethral syndrome and felt the evil of damp-heat. Damp-heat injection, the bladder is not conducive to frequent urination, urinary urgency, painful urination, damp-heat blocking the meridians, the flow of Qi and blood is not smooth, back pain is difficult to stoop, this evidence is mostly seen in the acute phase of non-infectious urethral syndrome. The evidence belongs to damp-heat obstruction and bladder loss. The treatment is to clear heat and dry dampness, and to de-stress the bladder. The formula is Si Miao San. The medicine includes Atractylodes macrocephala, Phellodendron chinensis, Semen Coix seeds, Cow’s knee and Gardenia jasminoides.
Insufficient congenital endowment, kidney qi is not solid, bladder loss of appointment results in frequent urination, residual urination, and damage to meridians results in painful urination. Kidney qi deficiency, kidney essence deficiency, loss of moistening is seen in the waist and knee soreness; spleen qi deficiency, transportation and transformation is not conducive is seen in loss of appetite, dizziness and weakness.
The symptoms include frequent urination, incomplete draining, abdominal cramps, dizziness and weakness, loss of appetite, soreness and weakness of the waist and knees, and all kinds of symptoms in case of labor. This evidence is mostly seen in non-infectious urethral syndrome in the non-episode stage. The treatment is to tonify the spleen and kidney and to clear dampness. This formula is based on incomparable yam san. The medicine includes yam, raw earth, cuscuta, zedoary, cistanches, schisandra, poria, etc.
2.Diagnosis of the disease
The etiology of this disease is unknown and may be related to the following factors.
①Anxiety neurosis ;
② abnormalities in urodynamics, such as dysfunction of the detrusor and sphincter muscles;
(iii) allergy or chemical irritation, such as nylon underwear, topical contraceptives, detergents, deodorant sprays, etc;
④Non-specific cystitis triangularis.
Diagnostic points of this disease.
①Most often seen in middle-aged women ;
②Symptoms of frequent urination and discomfort in urination;
③Excluding urinary tract bacterial, fungal and chlamydial infections;
④There is often a history of long-term use of antibiotics that are ineffective.
3.Treatment experience
Although the disease is seen in kidney deficiency, but can not use warming medicine, so that damp heat can not go and become other diseases. The disease examination without microbial infection, but the clinical manifestations are still dominated by bladder damp heat, therefore, treatment should pay attention to nourishing kidney yin, clearing the bladder damp heat as the main, and also to clear the heart and dredge the liver.
Specific treatment on the basis of the above plus reduction, such as urinary frequency and urgency plus Fengwei 20 grams, Shiwei 20 grams to clear heat diuretic; urinary burning plus Diyu 30 grams, Gardenia 10 grams; small abdominal distension plus Taiwu 10 grams, Mu Xiang 5 grams, Neem 5 grams to regulate Qi and eliminate distension; painful urination plus licorice tip 3 grams; urethral pain is very much plus Dan Pi 10 grams; lumbar pain plus Niu Knee 10 grams; heartburn plus Huang Lian 6 grams, fried date palm 30 grams to clear heart fire and calm the mind; Add 10 grams of gardenia, a pinch of tempeh to clear the heart and remove the boredom; add 6 grams of peach kernel and 10 grams of wine rhubarb for abdominal pain.
(If the stool is clear, the same decoction; if the stool is dry, then the next) to take the peach kernel Cheng Qi Tang; bitter mouth and dry throat add 20 grams of white foxglove, 20 grams of rhizome, 10 grams of Zhi Mu, 10 grams of yellow cypress to nourish yin and generate fluids; five heartburn plus 10 grams of dandan bark, 5 grams of other nail (first decoction); women with lumps of menstruation or not working, skin nail wrong, tongue see stasis points plus 20 grams of motherwort, 10 grams of Ze Lan to activate the blood and promote water; mental trance, disturbed mind, sleep Add 30 grams of wheat, 10 grams of licorice and 5 jujubes to promote blood circulation.
4.Caution
As this disease is mostly due to emotional disorders, liver depression and qi stagnation, ineffective drainage, long depression and fire injury to yin, liver and kidney homologation, liver yin deficiency, kidney yin deficiency, bladder gasification unfavorable. Therefore, regulating the emotions is the first thing it must pay attention to. Maintaining a good mental state is a precondition for the treatment of this disease.
The basic pathogenesis of this disease is kidney deficiency and bladder dampness and heat. In the diet, attention must be paid to nourish Yin, do not eat spicy and hot rib fire food, should eat more light diuretic products, drink more water and diuretic.
Avoid allergies or chemical substances such as nylon underwear, topical contraceptives, cleaning solutions, deodorant sprays, etc. It is advisable to use cotton gauze underwear, switch to other internal contraceptives, and stop using irritating cleaning fluids and sprays.
Pay attention to the hygiene of sexual life and wash the vulva in time after sexual intercourse. Also pay attention to exclude other gynecological and male diseases to avoid misdiagnosis.