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Expert Advice-Treatment of Urinary Tract Infections in Traditional Chinese Medicine(TCM):

Taking Control of Urinary Tract Infections

Anne is a retired woman who had been plagued by bladder and urethral infections for twenty years. She experienced frequent, painful urination, with incomplete emptying of the bladder and accompanying lower back pain. All these symptoms got worse when she was fatigued. In 1995, she came to my clinic, TCM Health Center, and was treated with acupuncture and a time-tested herbal formula. After ten treatments her symptoms were under control, and she then continued to use the herbal formula, UrinClearing (Zhi Bai Di Huang Wan) to maintain her urinary tract health.

A healthy urinary tract is most desirable, particularly for women who have had a urinary tract infection and are at risk for developing more infections. Women are affected by urinary tract infections 25 times more often than men. Between the ages of 20 and 50, women are 50 times more likely to get this type of infection. Statistics indicate that up to 90 percent of the women in this country will experience at least one recurring episode of urinary tract infection in their lives.

Urinary Tract Infections: East and West
Based on evidence from ancient medical texts, the treatment of urinary problems challenged Chinese medicine from the earliest times. The Yellow Emperorís Classic of Medicine, written 2300 years ago, explored effective treatments for urinary tract infections (classified as "stranguria"), using acupuncture and herbal treatments that are still in use today. French chemist and microbiologist Louis Pasteurís 1862 findings on how germs cause disease revolutionized scientific theories about infectious diseases, including urinary tract infections. Antibiotics have been prescribed since World War II, based on the 1928 discovery by British bacteriologist Alexander Fleming of penicillin, the first safe and successful antibiotic.

The urinary tract is comprised of the two kidneys, the ureters (the tubes that connect the kidneys to the bladder), the bladder, and the urethra (the channel that carries urine from the bladder out of the body). In traditional Chinese medical etiology/physiology, this system is called the Lower Burner. The Lower Burner is responsible for separating "clean" body fluids from "dirty" body fluids, and facilitates the excretion of urine from the body.

Based on Pasteurís work, conventional medicine claims that bacteria such as Escherichia coli, virus such as the herpes simplex virus, and fungus such as candida are the cause of urinary tract infections. The most common bacteria that causes urinary tract infections is Escherichia coli (E. coli). The main weapons in conventional medicineís arsenal are drugs Ė antibiotics to kill bacteria, and other symptom-relieving drugs for pain, etc.

Chinese medicine, which has been evolving for several thousand years, does not have a "germ theory" of disease. However, diagnosis and treatment are based on careful observation and time-tested approaches to every type of disease and injury. To diagnose health problems, symptoms are grouped into patterns, and the patterns are then typically treated with acupuncture and herbal formulas, as well as dietary modifications and other lifestyle recommendations. Two common patterns of urinary tract infections are the retention and accumulation of Damp Heat in the body, and Spleen and Kidney Deficiency. Damp Heat accumulation can be due to the consumption of hot spicy foods, meals high in fats and sweets, alcohol consumption, certain medications, and improper personal hygiene. Spleen and Kidney Deficiency is based in chronic illness, aging, pregnancy, menopause, and emotional stress. Both these patterns are discussed in detail in the following section. Many of the traditional Chinese herbal formulas have very strong anti-bacterial or anti-viral properties, but are safe enough to take over a longer period of time. In modern China, both Western antibiotics and traditional herbal formulas are used to treat urinary tract infections, but it is generally thought that the herbal formulas are better for chronic infections.

Patterns and Treatment of Urinary Tract Infections in Chinese Medicine
Over the centuries, a complicated system of diagnosis evolved in traditional Chinese internal medicine that differentiated various types of genito-urinary problems. These patterns were classified under the title of "stranguria syndromes," and encompass the diagnosis and treatment of all urinary tract infections, urinary tract stones, urinary tract tumors, etc. The two common patterns mentioned above, Damp Heat pattern and Kidney Spleen Deficiency pattern, are discussed here:

Damp Heat Pattern. Damp Heat can be caused by the habitual consumption of hot, spicy or greasy foods, sexual intercourse during menstruation, or direct attack from bacteria or virus. Damp Heat-type infections can also be triggered by certain types of drugs and by a history of irregular menstrual cycles. Symptoms include: a frequent and urgent desire to urinate; a burning or painful sensation during urination; cloudy or yellow-milky colored urine; aversion to pressure on the lower abdomen; alternating spells of fever and chills; a bitter taste in the mouth; nausea; vomiting; constipation; a yellow-sticky tongue coating; and a rapid, "soggy" pulse. Herbs that relieve these symptoms by promoting increased urination (diuresis) include akebia stem (Mu Tong), plantain (Che Qian Zi), knot grass (Bian Xu), and dianthus (Qu Mei). Among the possible Chinese herbal formulas, UT Clearing (Ba Zheng San) is popularly used.

UT Clearing (Ba Zheng San)

Akebia Stem (Mu Tong)

Plantain (Che Qian Zi)

Knot Grass (Bian Xu)

Dianthus (Qu Mei)

Talc (Hua Shi)

Rhubarb (Dai Huang)

Gardenia (Zhi Zi)

Licorice (Gan Cao)

Spleen Kidney Deficiency Pattern. The most common causes of any type of chronic deficiency pattern are: long-standing illness; the long-term use of immunity-suppressing drugs; slow recovery from surgery or childbirth; a health problem that is left untreated, or inadequately treated. Deficiency symptoms that apply specifically to urinary tract infections include: dribbling urination; frequent urination during the night; dull pain during urination; sporadic urination, with the urine coming in spurts; recurrence of infection with fatigue; fever that comes and goes; pain or soreness in the lower back; fatigue; dizziness; pale tongue body; and a weak pulse. Herbs that promote health by tonifying the Spleen include dioscorea (Shan Yao) and poria (Fu Ling). Herbs that tonify the Kidney include rehmannia (Di Huang), cornus fruit (Shan Zhu Yu), cuscuta seed (Tu Si Zi), and schizandra fruit (Wu Wei Zi). Two widely-used and effective Chinese herbal formulas are UrinClearing (Zhi Bai Di Huang Wan) and Dioscorea Formula (Wu Bi Shan Yao Wan).

Dioscorea Formula (Wu Bi Shan Yao Wan)

Dioscorea (Shan Yao)

Poria (Fu Ling)

Alisma (Ze Xie)

Rehmannia (Shu Di Huang)

Cornus (Shan Zhu Yu)

Morinda (Ba Ji Tian)

Cuscuta(Tu Si Zi)

Eucommia (Du Zhong)

Cyathula (Niu Xi)

Schizandra (Wu Wei Zi)

Cistanche (Rou Cong Rong)

Applications of the Chinese Medicine Approach
With a urinary tract infection, any part of the tract can be infected, from the urethra to the kidneys, and the symptoms will be similar: frequent, painful, difficult urination, with urgency, burning, or dribbling. Applications of the Damp Heat or Spleen Kidney Deficiency patterns to specific areas of infection are described below.

Cystitis. The medical term for bladder infections is cystitis, which is especially common in women, particularly during their reproductive years. Cloudy and bloody urine is seen. Burning pain during urination indicates the Damp Heat pattern. Dull or vague pain during urination indicates the Kidney Spleen Deficiency pattern.

Urethritis. Infection of the urethra is called urethritis. Bacteria, viruses or fungi can cause urethritis. A discharge containing pus from the urethra might be seen. Often, in women, the reproductive organs such as the vagina, cervix, ovaries, and fallopian tubes are likely to be infected also. The treatments for cystitis can be applied to urethritis.

Interstitial Cystitis. A painful, but non-infectious, inflammation of the bladder is called interstitial cystitis. Middle-aged women are most commonly affected by this condition. Pus and blood are observed in the urine. UrinClearing (Zhi Bai Di Huang Wan) is recommended for interstitial cystitis.

Nephritis. A kidney infection is called nephritis. Escherichia coli, a bacterium that lives in the large intestine, causes about 90 percent of kidney infections. Chills, fever, lower back pain, nausea, and/or vomiting are some common symptoms. Frequent urination with burning or sharp pain indicates the Damp Heat pattern. Frequent urination, urgent urination, or painful urination with back pain indicate the Kidney Spleen Deficiency pattern.

Ureteritis. An infection of the ureter is called ureteritis. The spread of a kidney infection or a bladder infection to the ureter can cause ureteritis, as well as the backup of urine into the ureters from the bladder on a regular basis. The treatment for kidney infections or bladder infections can be applied to ureteritis.

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