Senile micturition is equivalent to modern medicine senile urethral syndrome, frequent micturition, urgency and is the only (or painful urination), abdominal bulge and other symptoms, and 2 urine bacterial culture negative, and the exclusion of elderly patients with tuberculosis, fungi and anaerobic bacteria of urinary tract infection. Its card lingering, easy to attack.
Reference to the disease of modern Chinese medicine nephrology diagnosis.
Two, Chinese medicine treatment
(1) differentiation of symptoms and signs
1, Spleen Yang is not up, hot and humid bet
Symptom: frequent micturition, long disease does not heal, recurrent, urine Yuli, urethral burning, less abdominal distension, suprapubic pain is not obvious, Yaoxisuanruan, shortness of breath, lassitude, anorexia, pale tongue, greasy fur, smooth pulse.
Treatment: Buzhongyiqi, qingrelishi.
Medicinal: Astragalus 30g, ginseng 15g, angelica 10g, 15g, 5g, Atractylodes Zhigancao Bupleurum 10g, Cimicifuga 10g, tangerine peel 10g, Poria 20g, 20g, 10g, cypress, coix seed.
Add: Yaoxisuanruan, solid yuan is not obvious, people participate in the reuse of galangal seed, Radix Linderae, yam warming kidney and reducing urine. Acute urinary frequency, urethral and glowing, with Miao powder. If the painful urination is very stuffy with little tingling, dark tongue, sublingual vein engorgement was on the basis of peach kernel, safflower, etc.. Stasis of goods.
2, liver qi stagnation, damp heat of bladder
Symptom: frequent micturition, urine have Yuli, urethral burning, less abdominal distension, suprapubic pain is not significant, hypochondriacdiscomfort, Qi, pale tongue, yellow greasy moss, pulse string.
Methods: Liver Qi, clearing heat and removing dampness.
Prescription: Xiaoyao Powder and Polyporus decoction.
Medicinal Bupleurum 15g, Radix Paeoniae Alba 15g, angelica 15g, Poria Atractylodes 20g, 15g 20g 15g, Polyporus, Alisma, talc 15g, gelatin 15g, licorice 15g.
Add: two on liver qi stagnation, flank fullness, and peel and Cyperus to liver qi; pain stress with turmeric, Yin Hu in pain Qi; anorexia plus medicated leaven, hawthorn, malt to Xiaoshi appetizer; damp heat, Shi Wei with emphasis, and reaction heat and dampness. Below the waist cold limbs, low temperature, urine dripping, pale tongue, white complexion cystine, thready pulse, spleen deficiency, subsidence, reuse of Huangqi and Baizhu 20g; under the yuan is not solid, with long unhealed, urine Yuli, distending pain in the lower abdomen, waist and knees, pale tongue, greasy moss, pulse thin, belongs to the spleen kidney two falsely, reuse of Codonopsis 20g, Cimicifuga 5g, and yam 20g, Rosa 15g.
3, Qi and yin deficiency, dampness heat of bladder
Symptom: frequent micturition, urine have Yuli, urethral burning, less abdominal distension, recurrent, suprapubic pain is not obvious, shortness of breath, lassitude, pale tongue, less moss, pulse fine.
Treatment: Supplementing Qi and nourishing Yin, clearing heat
Prescription: Qingxinlianziyin Decoction
Medicinal: Astragalus 30g, dangshen 20g, stone lotus 15g, Digupi 15g, bupleurum 15g, Poria 15g, Ophiopogon japonicus 15g, Plantago 20g, Scutellaria 10g, Pyrrosia 20g, dandelion 30g, Oldenlandia 20g, licorice 15g.
Add: deficiency stress, increase the dosage of Astragalus, Codonopsis modified ginseng to Qi Yin deficiency; with emphasis, Anemarrhena, asparagus with nourishing yin; damp heat stress, and Rhizoma imperatae, Polygonum aviculare, Herba Dianthi by qingrelishi. Long Lin does not heal, urine Yuli, distending pain in the lower abdomen, waist and knees, plus Gorgon fruit, yam, Rosa 20g.
4, Yang deficiency of spleen and kidney, bladder.
Symptom: frequent micturition, urgency of urination, dripping wet, or abdominal bulge, urine clear long, when the stop condition, when work is made, with backache leg soft, aversion to cold, dizziness, pale tongue, thin white fur or greasy, thready pulse.
Treatment: Kidney Yang, gas and water
Prescription: Jinguishenqi pill
Medicinal: 10g first prepared aconite decoction, Guizhi 10g, Cornus 15g, yam 15g, Poria cocos 15g, 10g, 10g, Alisma Moutan Achyranthes 10g, Rehmannia 20g, dodder 20g.
Add: white and greasy fur to prepared rehmannia root, white atractylodes rhizome, plantain and 10g. Qi deficiency significantly, add Codonopsis 20g. Waist and knee pain, and eucommia, each 20g. With urinary incontinence, plus ginseng, Cimicifuga, calcined keel, calcined oyster; aversion to cold or add light aconite, cinnamon; spleen deficiency anorexia with yam, Atractylodes, hawthorn; urine astringent pain with Chuancao Xue, Curculigo, Morinda officinalis, Herba Dianthi Herba Epimedii in kidney yang, Yijing marrow the transfer function of bladder.
(two) Chinese patent medicine
1, Xiaoyaowan: Angelica, Radix Paeoniae Alba, Radix Bupleuri, Poria, Atractylodes, licorice, etc.. Each serving 9g, 2 times a day. With Shuganjianpi role for liver Qi stagnation.
2, Zishen pills: Anemarrhena, phellodendron, cinnamon. Each serving 6G, 3 times a day. This product has a clear coke under the accumulated heat, the effect of bladder, suitable for patients with obvious coke under the damp heat.
3, Gong Di pill: Rehmannia 60 grams, dodder (boiled wine) 60 grams, 60 grams Atractylodes (fried), North five flavor, Alpinia (wine fried) (wine fried), so the paper (prepared), aconite Poria, Chinese leek seed (fry) 30 grams. With the kidney yang Gujing, polyuria, spleen dampness, for the treatment of bladder is not hidden, springs more than the decline of vital gate fire, small water can not help but "kidney deficiency can not seal tibet.
(three) acupuncture treatment
The main acupoints: Guanyuan, Shenshu, Sanyinjiao, Ciliao, huiyang.
Acupoints: kidney yang deficiency, kidney yin deficiency with Mingmen; distribution, Taixi, Fuliu; lack of gas distribution, Pishu, Zusanli; damp, with perineum, Yin Ling Quan; Yaoxisuanruan, with Mingmen, yanglingquan.
Operation: the main point of a reinforcing method, available moxibustion; damp, acupoints with diarrhea. Guan yuan and other abdominal acupoint needle slightly downward obliquely, the needle forward Yin bleeding. Ciliao, 75-85mm down into second obliquely posterior sacral foramina; Huiyang: Pierce 60mm.
Selected points: bladder, urethra, kidney, God door, pillow, brain points. Have vulva allergy and allergy; insomnia, dreaminess and cortex, heart, mouth, neurasthenic; upset, irritability and heart, liver, gallbladder, endocrine; sallow complexion, anorexia with spleen and stomach qi; with spleen and stomach, liver and adrenal gland.
Operation: the auricular local disinfection with 75% alcohol, with a sensitive probe out of each point, and then take the medical tape cut into 0.6cm * 0.6cm, embedded in the 1 grain of cowherb seeds on tape central, posted on the sensitive points of selected points, and ask the patient to press every day 5-6 times, each press 2-3 minutes to ear sensitive point for the degree of fever or slight pain.
Three, Chinese medicine treatment difficulty analysis
(a) the disease is a non infectious elderly urethral syndrome, with frequent micturition, micturition discomfort as the main performance, is often misdiagnosed as urinary tract infection and long-term use of antibiotics. Therefore, in the elderly, frequent urination, urination discomfort, bacteria, microbial infection without clinical evidence, many negative urine culture and urine routine examination was normal, positive exclusion of urinary tract tuberculosis, fungi, anaerobic bacteria, gonococcus, mycoplasma and Chlamydia infection can be diagnosed.
(two) although the symptoms of urinary tract infection in elderly patients with urinary tract infection, no bacterial infection, but easy to relapse. The disease is the deficiency of evil and susceptible, righteousness more false, the love card complex, persistent. Prevention and treatment of the disease has become the focus of treatment. The treatment should be based on long-term need to supplement the righting deficiency, "keep healthy, do not be evil", is a rare disease, finally to heal.
(three) pay attention to psychological factors regulating the elderly urethral syndrome and the incidence of mental factors and death relationship, some patients are psychiatric symptoms before the disease, disease after the long-term use of antibiotics and the effect is not significant, the psychosomatic symptoms are more obvious, and manifested as irritability, sigh, memory decline, inattention, insomnia and other symptoms. At this point the heart treatment is very important to eliminate the adverse factors affecting the disease, the disease has an important role in the improvement.