Chinese Herbs Graphic Differential Treatment of Frequent Urination in Elderly Patients
by Wei Zixiao
Xiyuan Hospital of China Academy of TCM Institute (100091)

Appearing originally in The Journal of Traditional Chinese Medicine


Frequent urination is a commonly seen symptom in our clinical practice. The degrees of severity may be different as to the various chief complaints presented by patients such as frequent urination, oliguria, emergent urination, dysuria and vesicle tenesmus etc. Among the young and middle-aged patients, it is mostly seen in female urinary tract infection, which is generally easily and quickly treated. Treatment often seems comparatively more difficult for those patients with repeated attacks. For elderly patients, this syndrome often appears to be more intractable with a higher incidence of relapses. These recurrences are due to the weak body resistance and greater number of inducing factors in elderly patients. These factors include inflammation of the urinary tract and around the urethra (including gynecological inflammation, prostatitis), diabetes, kidney diseases and urinary obstruction induced by various factors. Besides, cystoparalysis resulted from prostatic hyperplasia, diabetes and diseases of the nervous system, although without bacterial infection, may also have these symptoms, or even retention of urine. Meanwhile, the above diseases may also be the inducing factors of infection of the urinary tract. Therefore, in our treatment a clear distinction must be made between the infectious causative factors and the non-infectious ones; and some probable chronic diseases should be controlled.

In Chinese medicine, this group of symptoms are characteristic of stranguria which is treated according to the differentiation of zangfu and the eight principle syndromes, supplemented with special herbs for the five types of stranguria (i.e. hematuria, urinary incontinence, galacturia, uropsammus and pollakuria), the effect of which is usually superior to western medicines. Here are several points which should be paid attention to in the treatment of this syndrome so as to raise the therapeutic effect.

  1. Since the aged people often have the body constitution with deficiency of and insufficiency of yang, problems of deficiency complicated with excess and simultaneous occurrence of cold and heat should be taken into consideration in the making of differential diagnosis, even if there exists downward flow of damp-heat. Pure cold-cooling prescriptions must be avoided, for they may prolong the duration of the illness and result in recurrences.

  2. There are two circumstances under which the superficiality must be urgently treated, one being retention of urine, the other excessive pathogenic heat with cold-heat symptoms. Treatment retention of urine should be based on the principle of promoting diuresis combined with external treatments such as acupuncture, moxibustion, medicinal hot compress or fomentation; while the treatment for pathogenic heat with cold-heat symptoms should include a large dosage of heat-clearing and detoxifying herbs to promote diuresis. For those with dry stool or constipation, purgation is adopted to clear away heat and promote bowel movement.

  3. Doctors must know fairly well about the above-mentioned chronic diseases and take notice of the changes in the related indexes, which matters much in the control of the illness, and in the prevention of recurrences.

  4. In medication, herbs, regardless of if you know them through your clinical experience or through your education, must be prescribed according to their nature and taste, channel tropism and their compatibilities in ancient recipes. This medication not only makes a flexible selection of herbs, enhances therapeutic effect but also ensures the continuity of differential treatment.

Here are the commonly used recipes in differential treatment:

Commonly used herbs for various symptoms:


Yin/Yang Symbol Acupuncture.com

Contacting Acupuncture.com...