Urinary tract infections can be divided by site into upper urinary tract infections (pyelonephritis, ureteritis) and lower urinary tract infections (cystitis, urethritis). Acute upper urinary tract infections (acute pyelonephritis) can cause life-threatening sepsis, diffuse intravascular coagulation (DIC), and adult respiratory distress syndrome (ARDS). Chronic pyelonephritis in young children, especially those before the age of 5, can easily affect kidney development. Chronic pyelonephritis in the elderly can cause hypertension and chronic renal failure. Urinary tract infections belong to the categories of gonorrhea, water qi, and deficiency labor in Chinese medicine. The symptoms are described more completely in the Jin Kui Yao Yao: “When gonorrhea is a disease, the urine is like corn, the abdomen is stringy and urgent, and the pain leads to the umbilicus”. Urinary tract infection, especially chronic urinary tract infection, is one of the common clinical diseases and difficult to treat. In recent years, the application of traditional Chinese medicine, clinical observation and research on the treatment of urinary tract infections in Western medicine has confirmed the effectiveness of Chinese medicine and the combination of traditional Chinese and Western medicine in the treatment of this disease. Clinical manifestations I. Cystitis is usually referred to as lower urinary tract infection. The main manifestations of cystitis in adult women are symptoms of bladder irritation, i.e., frequent, urgent, painful urination, leukocyturia, occasionally hematuria, or even flesh-eye hematuria, and discomfort in the bladder area. There are usually no obvious symptoms of systemic infection, but a few patients may have back pain and low fever (will not exceed 38.50C). The blood leukocyte count is often not elevated. This type is most common in adults with urinary sensation. Cystitis occurs after sexual intercourse and is also seen in gynecological surgery, after menstruation and in older women with vulvar itching. The causative organism is mostly Escherichia coli, but in young women about 25% can be coagulase-negative staphylococci, and occasionally also Proteus mirabilis, Pseudomonas aeruginosa, etc. Acute pyelonephritis can occur at all ages, but is most common in women of childbearing age, with an acute onset and the following symptoms. General symptoms High fever, chills, temperature between 38~390C, but can be as high as 400C. The fever pattern varies, usually flaccid, but can be intermittent or indolent. Headache, generalized aches and pains, and profuse sweating when the fever subsides. Urological symptoms Patients have low back pain, mostly dull or sore, with different procedures, a few have abdominal cramps, radiating along the ureter toward the bladder, and on physical examination there is pressure pain at the point of the upper ureter (the point where the outer edge of the psoas major muscle crosses the twelve ribs), and positive percussion pain in the kidney area. Patients often have bladder irritation symptoms such as urinary frequency, urgency, and painful urination, which may precede systemic symptoms in the case of episodic infection. Urinary tract symptoms are often not obvious in pediatric patients. At the onset of the disease, in addition to systemic symptoms such as high fever, there are often convulsions and seizures. Gastrointestinal symptoms may include loss of appetite, nausea, vomiting, and individual patients may have pain in the upper and middle abdomen or the whole abdomen. Chronic pyelonephritis has milder symptoms than the acute phase, and sometimes may manifest as asymptomatic bacteriuria. More than half of the patients have a past history of acute pyelonephritis, followed by symptoms such as malaise, low-grade fever, anorexia and lumbago, and lower urinary tract irritation such as urinary frequency, urinary urgency and pain. Acute exacerbations also occur from time to time. In recent years, it has been suggested that chronic pyelonephritis is characterized by scarring of the renal calyces, deformation of the renal pelvis and calyces, water retention, unsmooth kidney shape, or unequal size of the two kidneys. Chronic pyelonephritis has a complex clinical presentation and is prone to recurrent attacks. Renal papillary necrosis is one of the serious complications of pyelonephritis, which often occurs in severe pyelonephritis with diabetes mellitus or urinary tract obstruction. It can be complicated by Gram-negative bacillary sepsis or lead to acute renal failure. Perirenal abscesses are often the direct result of severe pyelonephritis (90% of cases), and the causative organisms are mostly gram-negative bacilli, especially Escherichia coli, which are the most common. Patients mostly have diabetes mellitus, urinary stones and other unfavorable factors. Patients often present with significant unilateral lumbago and pressure pain in addition to the exacerbation of symptoms of pre-existing pyelonephritis, and some individual patients may have a palpable abdominal mass. X-ray abdominal radiographs, nephrograms and renal tomograms are useful for diagnosis. Prompt treatment with strong antimicrobial agents and intensive supportive therapy is recommended. Infective stones are often caused by pyelonephritis caused by urea-degrading bacteria such as Bacillus variegatus, which can cause kidney stones (15.4% of stones). These stones are mainly composed of magnesium ammonium phosphate. They are often large antler-shaped, mostly bilateral, and often harbor pathogenic bacteria in the small fissures of the stone. Because antibacterial drugs do not easily reach the place, it is easy to lead to the failure of urinary sensation treatment. Infection coupled with urinary tract obstruction can lead to faster destruction of renal parenchyma and renal function damage. Fourth, gram-negative bacillus sepsis urinary sensation is one of the main causes of gram-negative bacillus sepsis, mostly occurs in acute urinary sensation, especially after the use of cystoscopy or the use of catheters. Severe complicated urinary sensitization, especially if complicated by acute renal papillary necrosis, is also prone to Gram-negative bacillary sepsis. Occasionally, it is seen in severe uncomplicated pyelonephritis. Gram-negative bacillus sepsis is dangerous, with sudden chills and high fever, often resulting in shock and a serious prognosis, but clinically it can be without fever and elevated white blood cells. The treatment is the same as that for general Gram-negative bacillary sepsis.