Diseases of Urinary System


Acupuncture for prostatitis
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Introduction
Prostatitis is a commonly encountered disease of urinary system in men. It is either acute or chronic. Acute prostatitis is marked by stimulating symptoms of the urinary tract, bloody urine in the end of urination and perineum pain. Chronic prostatitis is marked by delayed urination, dripping after urination, or discharge of whitish turbid prostate fluid, or seminal emission, premature ejaculation and impotence. It is similar to stranguria, spermatorrhea, gonorrhea and semen in urine in TCM. Prostatitis is usually caused by exogenous damp-toxin, excessive drinking of alcohol, partiality to pungent and greasy foods, or excessive sexual life and endogenous asthenia-heat that lead to accumulation of damp-heat in the lower energizer. The major manifestation is sthenia in branch. Prolonged duration leads to asthenia of liver and kidney yin and asthenia of spleen and kidney yang, further resulting in qi stagnation and blood stasis marked by asthenia of the root or mixture of asthenia and sthenia.

Syndrome Differentiation
1. Downward Migration of Damp-Heat
Burning sensation in the urinary tract, yellow and scanty urine, profuse whitish secreta from the external orifice of urethra, bitter taste and dryness of mouth, thirst and desire to drink water, retention of dry feces, red tongue, yellow and greasy tongue fur, slippery and rapid pulse.

2. Accumulation of Heat-toxin
High fever, aversion to cold, hematuria, pain in defecation, deep-red tongue with yellow and dry fur, taut, rapid and powerful pulse.

3. Stagnation of cold in the liver vessels
 Dull pain in the lower abdomen and testis, aggravation with cold and alleviation with warmth, white and slippery tongue fur, deep and taut or slow pulse.

4. Asthenia of Liver and Kidney Yin
Aching in the loins and sacral region, flaccidity of legs, feverish palms, soles and chest, insomnia and dreaminess, seminal emission, dizziness, vague pain in the perineum, burning sensation in the urinary tract, red tongue with scanty fur, deep, thin and rapid pulse.

5. Asthenia of Spleen and kidney Yang
Dripping urination, profuse urine in the night, pale complexion, cold limbs, flaccidity of limbs, edema, loose stool, spermatorrhea, impotence, light-colored tongue with white fur, thin and weak pulse.

6. Qi Stagnation and Blood Stasis
Prolonged duration, hematuria, bloody semen, fullness and pain in lower abdomen, dripping or silky urination, deep-red tongue or with ecchymoses, taut or unsmooth pulse.

Treatment
1. Body Acupuncture
Prescription:
Zhongji (CV 3), Ciliao (BL 32), Sanyinjiao (SP 6) and Yinlingquan (SP 9).
Modification: For downward migration of damp-heat, Qugu (CV 2), Zhibian (BL 54), Pangguangshu (BL 28) and Sanjiaoshu (BL 22) are added; for accumulation of heat-toxin, Quchi (LI 11) and Hegu (LI 4) are added; for stagnation of cold in liver vessels, Dadun (LR 1 ) and Taichong (LR 3) are added; for asthenia of liver and kidney yin, Guanyuan (CV 4), Fuliu (KI 7), Taixi (KI 3), Shenshu (BL 23) and Ganshu (BL 18) are added; for asthenia of spleen and kidney yang, Mingmen (GV 4 ), Pishu (BL 20), Shenshu (BL 23) and Zusanli (ST 36) are added; for qi stagnation and blood stasis, Taichong (LR 3) and Geshu (BL 17) are added; for hematuria, Xuehai (SP 10), Geshu (BL 17) and Zhibian (BL 54) are added; for seminal emission and spermatorrhea, Jinggong (Ext.), Guanyuan (CV 4) and Dahe (KI 12) are added.

Performance:
Urine is discharged completely, then Zhongji (CV 3), Guanyuan (CV 4) and Qugu (CV 2) are needled vertically for 1.5 - 2 cun to direct the needling sensation to the perineum; Ciliao (BL 32) and Zhibian (BL 54) are needled 1.5 - 3 cun toward the bladder to direct the needling sensation to the lower abdomen and perineum; the other acupoints are needled with routine procedure. The needling technique used is mainly for reducing purpose. For the treatment of asthenia of the spleen and kidney yang, reinforcing needling technique is used together with moxibustion. For the treatment of asthenia of liver and kidney yin, mild reinforcing and reducing needling technique is used.

2. Ear Acupuncture
Prescription:
Angle of Cymba Concha (CO8), Kidney (CO10), Bladder (CO9), Liver (CO12), Triple Energizer (CO17), Ear Shenmen ( TF4 ), Pelvic Cavity ( TF5 ), Sympathetic Nerve (AH6a), Endocrine (CO18) and Adrenal Gland (TG2p).

Performance:
Each time 3 - 5 acupoints are selected with normal procedure. For the treatment of acute prostatitis, strong stimulation (with bloodletting from the tip of ear) is used. The needles are retained for a longer (45 - 60 minutes) time and manipulated at intervals. For the treatment of chronic prostatitis, moderate stimulation is used. The needles are retained for 20 minutes and the needling is done once a day.
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