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.
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