Urinary calculus is a common disease in the urinary
system, including calculus of the kidneys, urethral calculus, vesical calculus
and urethral calculus. This disease incidence appears obviously in certain areas.
The disease belongs to the categories of "sha lin" (strangury form urolithiasis),
"shi lin" (strangury caused by urinary calculus) and "xue lin"
(strangury complicated by hematuria) in TCM.
Main Points of Diagnosis
1.Symptoms
1) Calculus of the Kidneys: There is a dull pain in the lower
loins of the affected side, when the stones in the kidney radiates along the ureter
to the lower abdomen and the perineal region which is associated with different
degrees of hematuria. If the case turns into a complicated infection, the patient
may have fever and pus cells in the urine.
2) Ureteral Calculus: In the lumbar
region there is an acute pain which is often associated with hematuria. When the
stones happen to be in the upper 1/3 part of the ureter, the pain will be in the
costovertebral angle region and radiate to the part above iliac crest and external
side of the abdomen. When the stones descend, the region of pain will also come
down with the pain radiating to the thigh, testicle or vulva region.
3) Vesical
Calculus: There is a pain in urination and the pain is often severest at the end
of urination. This pain mainly occurs in the lower abdomen and may radiate to
the perineum and balanus. Other symptoms are often difficulty of interruption
in micturation and hematuria at the end of urination, urgent and frequent micturation.
4) Urethral Calculus: Pain in urination, thready urination, dribbling urination
, or even retention of urine may appear.
2. Signs: The patients who have kidney
calculus will have a percussion pain or a tenderness on the kidney area of the
affected side. When there is an obstruction caused by kidney calculus and urethral
calculus, sometimes, a swollen kidney will be felt. In vesical calculus and posterior
urethral calculus, stones can be felt in rectal examination. In the case of anterior
urethral calculus, a hard lump with tenderness may be felt in the local region.
3. Laboratory Examination: Through urine test the number of red blood cells
is often found increased. When the function of kidney is suspected of being impaired,
urea nitrogen and creatinine tests will be necessary.
4. X-ray Examination:
The urogram will show the majority of the stones. Use excretion urography or retrograde
urography to help you find out the positions of the stones and the functions of
both kidneys.
5. Cystoscopy: "B" type ultrasonograpny and isotope
renogram will be helpful for clinical diagnosis.
Differentiation and Treatment
of Common Syndromes
The following therapies are good for those cases in which
the transverse diameter of the stones in the kidney and ureter is less than 1
cm; the transverse diameter of the stones the urinary bladder is less than 2 cm
and there is no serious obstruction and infection, and the function of kidney
is in a good condition.
1. Internal Treatment
1) Qi-Stagnation Type
Main
Symptoms and Signs: In the waist and the lower abdomen there is distending pain,
full ache or even paroxysmal colicky pain accompanied with nausea, vomiting and
hematuria, tongue with white and greasy fur and tight and taut pulse.
Therapeutic
Principle: Promoting the circulation of qi, inducing diuresis, relieving strangury
and removing the stones.
Recipe: Modified Pyrrosia Decoction
lysimachia
pyrrosia leaf
plantago seed (piece of cloth before it is decocted with
other herbs )
cluster mallow fruit
oriental water plantain rhizome
citron
fruit
vaccaria seed
radish seed
rhubarb
all the above herbs are
to be decocted in water for oral administration.
2) Damp-Heat Type
Main
Symptoms and Signs: There is a continuous pain in the waist or the lower abdomen
accompanied with fever, frequent micturation, urgent urination, urodynia, cloudy
or bloody urine, and pyuria, tongue with yellow and greasy fur and slippery rapid
or taut rapid pulse.
Therapeutic Principle: Clearing away pathogenic heat
and dampness, relieving strangury and removing the stones.
Recipe: Modified
Eight Health Restoring Powder
lysimachia
prostrate knotweed
Chinese
pink herb
talc
phellodendron bark
capejasmine fruit
plantago seed
(piece of cloth before it is decocted in water with other herbs )
rhubarb
licorice root tip
All the above herbs are to be decocted in water for
oral administration.
3) Kidney-deficiency Type
Main Symptoms and signs:
The whole course of the illness lasts for a long period. Its symptoms are weakness
and ache of the waist and limbs, fullness of abdomen, unsmoothness and feebleness
of urination, pale tongue with thin and whitish fur, and deep and thready pulse.
Therapeutic Principle: Supplementing qi, reinforcing the kidney, relieving
stranguria and removing the stones.
Recipe: Modified Kidney-Reinforcing Decoction
prepared rehmannia root
wolfberry fruit
dogwood fruit
achyranthes
root
bighead atractylodes rhizome
eucommia bark
cinnamon bark
pilose
asiabell root
lysimachia
climbing fern spore
All the above herbs are
to be decocted in water for oral administration.
For those who are marked
by acraturesis, add of 6 grams of ginseng instead of pilose asiabell root 30 grams
of congongrass rhizome and 15 grams of milkvetch root, For those who have hematuria,
add 20 grams each of Japanese thistle and field thistle and 12 grams of sanguisorba
root.
2. Acupuncture Therapy
1. Body Acupuncture
Acupuncture Points:
Shenshu (UB 23), Pangguangshu (UB 28), Zusanli (St 36), Guangyuan (Ren 4).
Adjunct
Acupuncture Points: Zhongji (Ren 3), Sanyingjiao(Sp 6), Yinlingquan (Sp 9), Shuidao
(St 28).
Manipulation: Choose 2 or 3 acupoints each time and use strong stimulation.
Do this twice a day , retaining the needle for 20-30 minutes.
2) Electrotherapy
Acupuncture Points: The therapeutic electrode (-)is connected with Shenshu
(UB 23) or Pangguangshu (UB 28), while the (+) with Guanyuan (Ren 4) or Shuidao
(St 28).
Manipulation: Select the upper and the lower points of the affected
side for needling. The intensity of the needling should be form weak to strong
and it must be as strong as the patient could bear. Then, sustain the needling
for 20-30 minutes, 1or 2 times a day.
3) Ear Needling
Auricular Points:
In the kidney and ureter's area or the tenderness area.
Manipulation: Use
strong stimulation, retaining the needle for 15-40 minutes.
Dr. Ming's TCM
Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city,
Hunan province
China