Stranguria (Lin Syndrome)
SYMPTOMS AND SIGNS: Lin syndrome in Chinese medicine mostly refers to urinary tract infection. Others, such as urolithiasis, cystitis, urethritis, acute prostatitis, stones in the urinary tract, acute nephritis, acute pyelonephritis are also classified with the Lin syndrome of Chinese medicine.
The symptoms are: dysuria or oliguria, frequent, short, and painful urination, pain can radiate to lumbar or abdominal areas, scanty urine, hot or burning sensation, or obstructed feeling when urinating, distention of lower abdomen.
ETIOLOGY AND PATHOLOGY: Traditionally, Lin has been categorized as five type: Si Lin (stranguria due to urinary stone), Qi Lin (stranguria due to Qi stagnation or Qi deficiency), Xue Lin (stranguria complicated by hematuria), Gao Lin (stranguria complicated by chyluria), and Lao Lin (stranguria due to over working). The major causative factor of Lin syndrome is due to the stay and stagnation of damp-heat at Xia Jiao (the lower burner, or the lower warmer). The damp-heat may be derived from excessive fatty, fried, spicy and hot food, or form the excessive alcohol. At the chronic stage, the Lin syndrome is mostly connected with the deficiency of spleen and kidney. Another factor is that excessive liver fire stagnates or affects the function of lower burner, which causes the Qi Lin.
1. Si Lin or Re Lin
Indications: Painful and scanty urine, or with small stone, or obstructed feeling when urinating, oppression and pain sensation at lower abdomen, twitching, or spasmodic pain of lumbar regions, oliguria with reddish urine, red tongue, thin yellow coating, rapid pulse.
Treatment & Formulas: To clear the damp-heat; diuretic function to eliminate the stone.
- Ba Zheng San (Dianthus Formula, Item No. 2008): This is the first choice formula for dysuria and oliguria due to damp heat at lower burner.
2. Qi Lin (Stranguria due to Qi Stagnation or Qi deficiency):
Qi stagnation type: dysuria, oliguria, full and extended feeling of lower abdomen, green or purplish tongue, deep wiry pulse.
Qi deficient type: heavy and dropping feeling of lower abdomen, or pain at abdominal area, dysuria, dripping discharge of urine after urination, pale face and tongue, weak and thready pulse.
Treatment & Formulas:
Qi stagnation type: regulate the stagnated Qi and harmonize the liver.
Qi deficiency type: tonify the middle Qi (Qi of spleen and stomach).
3. Xue Lin (Stranguria Complicated by Hematuria):
Damp-heat type: hot, burning, and painful sensation when urinating, reddish urine, or blood clots seen in urine, sharp and spasmodic pain, or restlessness, yellow coating, rolling and rapid pulse;
Kidney Yin deficient type: chronic stage of above type, pale or light reddish urine, sore and weak sensation at lumbar regions, fatigue, light red tongue, thready and rapid pulse.
Treatment & Formulas:
Damp-heat type: clear the damp-heat, cool blood and stop bleeding.
Kidney Yin deficient type: Tonify the kidney Yin and clear deficient heat to stop bleeding.
- Xiao Ji Yin Zi is a typical formula for hematuria due to damp heat. Its ingredients are as follows:
- Sheng Di Huang (Raw Rehmannia, Item No. 1077): 19%
- Xiao Ji (Small Thistle): 14%
- Pu Huang (Typhae Pollen, Item No. 1210.1): 8%
- Ou Jie (Lotus Node, Item No. 1260): 8%
- Hua Shi (Talcum, Item No. 1213): 14%
- Mu Tong (Akebia, Item No. 1031): 6%
- Dan Zhu Ye (Lophatherum, Item No. 1186): 8%
- Zhi Zi (Gardeniae Fructus, Item No. 1178): 8%
- Dang Gui (Chinese Angelica, Item No. 1214): 8%
- Gan Cao (Licorice, Item No. 1072): 6%
- Lian Zhi Qing Xin Yin (Lotus Seed Combination, Item No. 2254): Clear the heat of heart and its connected Fu organ, small intestine. Both heart and small intestine are connected with stranguria complicated by hematuria.
- Dang Gui Liu Huang Tang (Tang-kuei and Six Yellow Combination, Item No. 2231):This is a strong formula for clearing the heat in San Jiao (triple burner) so as to cool down the blood heat and stop bleeding.
- Zhi Po Ba Wei Wan (Anemarrhena, Phellodendron, and Rehmannia Formula, Item No. 2123): This is a very good formula to treat stranguria due to kidney Yin deficient type.
4. Gao Lin (Stranguria Complicated by Chyluria):
Damp-heat type: Turbid white urine, dysuria, burning and pain sensation when urinating, red tongue, greasy coating, rapid pulse.
Kidney Yin deficient type: chronic stage of above type, fatty urine, less burning and pain sensation when urinating, gradual weight loss, dizziness, fatigue, weakness and soreness at lumbar regions, pale tongue, greasy coating, thready and weak pulse.
Treatment & Formulas:
Damp-heat type: clear the damp-heat, eliminate the turbid and ascend the pure essence.
Kidney Yin deficiency: Tonify the kidney Yin and strengthen the essence storage.
- Ba Zheng San (Dianthus Formula, Item No. 2008): For the damp-heat type.
- Liu Wei Di Huang Wan (Rehmannia Six Formula, Item No. 2051): For the kidney Yin deficient type.
- Jin Suo Gu Jin Wan (Lotus Stamen Formula, Item No. 2114): This is an astringent formula for essence loss due to the kidney deficiency.
5. Lao Lin (Stranguria due to Overworking):
Indications: Prolonged and chronic stage of stranguria of any types, dripping discharge of urine, dysuria, fatigue, pale tongue, weak pulse. Symptoms are worse after working or any other activities, better when in a restful situation
Treatment & Formulas: Tonify the kidney and spleen.
- Gui Pi Tang (Ginseng and Longan Combination, Item No. 2261 ): It treats the spleen deficiency type.
- Huang Qi Jian Zhong Tang (Astragalus Combination, Item No. 2213): It treats spleen weakness.
- Shen Ling Bai Zhu San (Ginseng and Atractylodes Formula, Item No. 2173): It eliminates dampness by promoting the function of spleen and stomach.
- Ba Zhen Tang (Tang-kuei and Ginseng Eight Combination, Item No. 2010): It tonifies the Qi and blood.
- Fang Ji Huang Qi Tang (Stephania and Astragalus Combination, Item No. 2102): It strengthens the spleen and eliminates the dampness.