Blood strangury

Strangury (dribbling urination) with blood in the urine. Distinction is made between blood vacuity, blood cold, blood heat, and blood stasis.

Patterns

Blood vacuity (血虚 xuè xū) causes strangury with nonacute pain on urination, pale red urine, and a rapid vacuous pulse.

Medicinal therapy: Enrich yīn and nourish the blood using Six-Ingredient Rehmannia Decoction (六味地黄汤 liù wèi dì huáng tāng) plus arborvitae leaf (Platycladi Cacumen, 侧柏叶 cè bǎi yè), plantago seed (Plantaginis Semen, 车前子 chē qián zǐ), and white peony (Paeoniae Radix Alba, 白芍药 bái sháo yào), or swallowing Origin-Boosting Powder (益元散 yì yuán sǎn) with Eight-Gem Decoction (八珍汤 bā zhēn tāng).

Blood cold (血寒 xuè hán) causes strangury with dark-colored bloody urine, dry-white facial complexion, and a slow sunken pulse.

Medicinal therapy: Warm the kidney using either Golden Cabinet Kidney Qì Pill (金匮肾气丸 jīn guì shèn qì wán) plus achyranthes (Achyranthis Bidentatae Radix, 牛膝 niú xī), a decoction of zanthoxylum root (Zanthoxyli Radix, 花椒根 huā jiāo gēn) taken cold.

Blood heat (血热 xuè rè) causes strangury marked by scorching heat and stabbing pain with bright red bloody urine, and a forceful pulse.

Medicinal therapy: Cool the blood and clear heat using formulas such as Field Thistle Drink (小蓟饮子 xiǎo jì yǐn zi), Red-Abducting Powder (导赤散 dǎo chì sǎn), or Anemarrhena, Phellodendron, and Rehmannia Decoction (知柏地黄汤 zhī bǎi dì huáng tāng).

Blood stasis (血瘀 xuè yū) causes strangury marked by pain in the penis like the cutting of a knife, dark clots in the urine, hard fullness of the smaller abdomen, and a sunken stringlike or rapid pulse.

Medicinal therapy: Quicken the blood and dispel stasis using a paste made of achyranthes (Achyranthis Bidentatae Radix, 牛膝 niú xī), or formulas such as Peach Kernel and Carthamus Four Agents Decoction (桃红四物汤 táo hóng sì wù tāng) or Peach Kernel Qì-Coordinating Decoction (桃核承气汤 táo hé chéng qì tāng).

Acumoxatherapy: Base treatment mainly on the three yīn channels of the foot and alarm and back transport points of BL (CV-3 and BL-28). Main points: BL-28 (Bladder Transport, 膀胱俞 páng guāng shù), CV-3 (Central Pole, 中极 zhōng jí), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), LR-2 (Moving Between, 行间 xíng jiān), and KI-3 (Great Ravine, 太溪 tài xī).

• For blood vacuity, add KI-2 (Blazing Valley, 然谷 rán gǔ), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), BL-20 (Spleen Transport, 脾俞 pí shù), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), needling with supplementation. For blood cold, add BL-23 (Kidney Transport, 肾俞 shèn shù), GV-4 (Life Gate, 命门 mìng mén), CV-4 (Pass Head, 关元 guān yuán), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), needling with drainage and adding moxa.
• For blood heat, add SP-10 (Sea of Blood, 血海 xuè hǎi), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and BL-27 (Small Intestine Transport, 小肠俞 xiǎo cháng shù), needling with drainage.
• For blood stasis, add BL-17 (Diaphragm Transport, 膈俞 gé shù), SP-10 (Sea of Blood, 血海 xuè hǎi), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and LR-3 (Supreme Surge, 太冲 tài chōng), needling with drainage or with even supplementation and drainage.