Benign prostatic hyperplasia is one of the common diseases among middle-aged and elderly men, mainly characterized by frequent urination, an increased number of nighttime urinations, and difficulty in urination. In severe cases, urinary retention or urinary incontinence may occur, and even renal function impairment may appear.
This disease belongs to the category of “Jinglong” in traditional Chinese medicine. The main cause is the deficiency and decline of kidney qi in the elderly, resulting in poor qi transformation and sluggish blood circulation, which is related to the dysfunction of the kidney and bladder.
The pathogenesis of this disease can be summarized as follows:
① In the elderly, the qi of the spleen and kidney is deficient, resulting in weak propulsion, and the inability to transform and transport water-dampness. Eventually, phlegm-dampness condenses and blocks the urethra, leading to this disease.
② The prostate area is where the liver meridian passes. Stagnation of liver qi and abnormal drainage can lead to stasis of qi and blood, blocking the urethra; or in the elderly, due to deficiency of qi and decline of yang, they cannot move qi and blood. Over time, the qi and blood circulation is not smooth, and it accumulates into phlegm. Phlegm and blood condense in the urinary tract; or if one holds urine for too long, the stagnant essence and turbid stasis accumulate and do not disperse, stagnating in the urinary orifice, resulting in the failure of the bladder to transform qi and causing this disease.
③ If water-dampness accumulates internally, it can transform into heat due to stagnation, or improper diet can generate damp-heat, or external damp-heat invasion, or excessive drinking of alcohol can gather dampness and generate heat, etc. All of these can lead to the downward pouring of damp-heat, stagnation and accumulation, and obstruction in the lower jiao, inducing this disease.
Syndrome Differentiation and Treatment of Benign Prostatic Hyperplasia in Traditional Chinese Medicine
- Downward Pouring of Damp-Heat
Syndrome: Frequent and yellowish urination, burning or stabbing pain in the urethra, difficult urination, or even dribbling urination or complete urinary retention, distension in the lower abdomen; or dry stools, bitter and sticky taste in the mouth; dark red tongue, yellow and greasy coating, slippery and rapid or wiry and rapid pulse.
Therapeutic method: Clear heat and remove dampness, relieve stranguria and open the closed urinary tract.
[Example of Ointment Formula]
(1) Modified Bazheng San Ointment
[Composition] Plantaginis Semen 100g, Dianthi Herba 100g, Polygoni Avicularis Herba 100g, Talcum 100g, Gardeniae Fructus 100g, Glycyrrhizae Radix et Rhizoma 100g, Tetrapanacis Medulla 30g, Rhei Radix et Rhizoma 100g.
[Preparation method] Decoct the above medicinal materials with an appropriate amount of water for 3 times, filter the juice and remove the dregs. Combine the filtrates of these 3 times and concentrate them by heating to form a clear paste. Add rock sugar to make the ointment.
[Usage] Take 15-20g each time, 2-3 times a day, and dissolve it in warm water for oral administration.
(2) Bixie Fenqing Ointment
[Source] Zhang Yan, A Comprehensive Guide to the Preparation and Application of Ointment Formulas for the Regulation and Treatment of Chronic Diseases [M]. Beijing: China Press of Traditional Chinese Medicine, 2020.
[Composition] Dioscoreae Hypoglaucae Rhizoma 200g, Smilacis Glabrae Rhizoma 200g, Plantaginis Semen 200g (wrapped and decocted), Alpiniae Oxyphyllae Fructus 200g, Phellodendri Chinensis Cortex 150g, Acori Tatarinowii Rhizoma 200g, Linderae Radix 150g, Alismatis Rhizoma 150g, Coicis Semen 150g, Cyathulae Radix 150g, Atractylodis Rhizoma 150g, Fritillariae Thunbergii Bulbus 150g, Scutellariae Radix 150g, Forsythiae Fructus 100g, Taraxaci Herba 100g, Tetrapanacis Medulla 100g, Honey-fried Glycyrrhizae Radix et Rhizoma 100g, Paeoniae Radix Alba 100g, Artemisiae Scopariae Herba 150g.
[Preparation method] Decoct all the medicinal materials thoroughly with water, remove the dregs and then concentrate the juice. Add 200g of Carapax et Plastrum Testudinis Gelatin, 500ml of yellow rice wine, and 350g of honey to make the ointment, and store it in the refrigerator for later use.
[Usage] Take 10g half an hour after breakfast and dinner, and take it with warm water.
- Deficiency of Qi in the Spleen and Kidney
Syndrome: Frequent urination, dribbling urination, thin urine stream, or even enuresis at night or urinary retention, fatigue, poor appetite, pale complexion, pale tongue, white coating, thready and weak pulse.
Therapeutic method: Tonify the spleen and replenish qi, warm the kidney and promote diuresis.
[Example of Ointment Formula] Jinying Ointment
[Source] Compendium of Medical Systems Ancient and Modern
[Composition] Rosae Laevigatae Fructus 1000g, Lycii Fructus 200g, Ginseng Radix 100g, Coicis Semen 250g, Dioscoreae Rhizoma 100g, Eucommiae Cortex 200g, Euryales Semen 200g, Corni Fructus 200g, Alpiniae Oxyphyllae Fructus 50g, Halitum 15g, Mantidis Ootheca 100g.
[Preparation method] Decoct the above medicinal materials with an appropriate amount of water for 3 times, filter the juice and remove the dregs. Combine the filtrates of these 3 times and concentrate them by heating to form a clear paste. Add the refined honey to make the ointment.
[Usage] Take 15-20g each time, 2-3 times a day, and dissolve it in warm water for oral administration.
- Stagnation of Qi and Blood Stasis
Syndrome: Difficult urination, the urine stream becomes thin or dribbles down, or stabbing pain in the urethra, complete urinary retention, or distending and dull pain in the lower abdomen, occasionally with hematuria; dark tongue or with ecchymoses and petechiae, white or thin yellow coating, wiry or unsmooth pulse.
Therapeutic method: Promote qi circulation and blood stasis, open the orifices and promote diuresis.
[Example of Ointment Formula] Niuxi Ointment
[Source] Secret Records of Feng’s Medical Treasures: Comprehensive Reference for Miscellaneous Diseases of All Sizes
[Composition] Cyathulae Radix 1500g, Moschus (artificial Moschus is used nowadays) 1g.
[Preparation method] Decoct Cyathulae Radix with clear water until it becomes an ointment, and add Moschus to make the ointment.
[Usage] Take an appropriate amount of the ointment orally.
- Deficiency of Kidney Yin
Syndrome: Frequent but unsmooth urination, scanty and hot urine, or urinary retention; dizziness and tinnitus, soreness and weakness in the waist and knees, restlessness of the five centers (palms, soles, and chest), constipation; red tongue with little fluid, little or yellow coating, thready and rapid pulse.
Therapeutic method: Nourish kidney yin, open the orifices and promote diuresis.
[Example of Ointment Formula]
(1) Modified Zhibai Dihuang Wan Ointment
[Composition] Anemarrhenae Rhizoma 100g, Rehmanniae Radix Praeparata 100g, Phellodendri Chinensis Cortex 100g, Corni Fructus 100g, Dioscoreae Rhizoma 100g, Moutan Cortex 100g, Poria 100g, Alismatis Rhizoma 100g, Salviae Miltiorrhizae Radix et Rhizoma 100g, Succini Pulvis 100g, Vaccariae Semen 100g, Pheretima 100g.
[Preparation method] Decoct the above medicinal materials with an appropriate amount of water for 3 times, filter the juice and remove the dregs. Combine the filtrates of these 3 times and concentrate them by heating to form a clear paste. Then grind 300g of Carapax Trionycis Gelatin into coarse powder, soak it with an appropriate amount of yellow rice wine, and stew it over water until it melts. Pour it into the clear paste and mix evenly, and add rock sugar to make the ointment.
[Usage] Take 15-20g each time, 2-3 times a day, and dissolve it in warm water for oral administration.
(2) Ziyin Gushen Ointment
[Source] Zhang Yan. A Comprehensive Guide to the Preparation and Application of Ointment Formulas for the Regulation and Treatment of Chronic Diseases [M]. Beijing: China Press of Traditional Chinese Medicine, 2020.
[Composition] Rehmanniae Radix Praeparata 200g, Corni Fructus 200g, Anemarrhenae Rhizoma 100g, Phellodendri Chinensis Cortex 100g, Nelumbinis Plumula 100g, Ziziphi Spinosae Semen 150g, Moutan Cortex 150g, Rosae Laevigatae Fructus 150g, Cuscutae Semen 150g, Alpiniae Oxyphyllae Fructus 150g, Alismatis Rhizoma 150g, Dioscoreae Rhizoma 200g, Honey-fried Glycyrrhizae Radix et Rhizoma 100g, Angelicae Sinensis Radix 100g, Morindae Officinalis Radix 100g, Paeoniae Radix Alba 100g, Glossy Privet Fruit 150g, Mantidis Ootheca 100g.
[Preparation method] Decoct all the medicinal materials thoroughly with water, remove the dregs and then concentrate the juice. Add 200g of Carapax et Plastrum Testudinis Gelatin, 500ml of yellow rice wine, and 350g of honey to make the ointment, and store it in the refrigerator for later use.
[Usage] Take 15-20g each time, 2-3 times a day, and dissolve it in warm water for oral administration.
- Deficiency of Kidney Yang
Syndrome: Frequent urination, especially at night, the urine stream becomes thin, residual urine, shortened urination distance, or dribbling urination, or even urinary retention; listlessness, pale complexion, aversion to cold and cold limbs; pale and moist tongue, thin white coating, deep and thready pulse.
Therapeutic method: Warm and tonify kidney yang, open the orifices and promote diuresis.
[Example of Ointment Formula]
(1) Modified Jisheng Shenqi Wan Ointment
[Composition] Rehmanniae Radix Praeparata 300g, Corni Fructus 100g, Moutan Cortex 100g, Dioscoreae Rhizoma 300g, Poria 100g, Alismatis Rhizoma 100g, Cinnamomi Cortex 30g, Prepared Aconiti Lateralis Radix Praeparata 30g, Cyathulae Radix 100g, Plantaginis Semen 100g.
[Preparation method] Decoct the above medicinal materials with an appropriate amount of water for 3 times, filter the juice and remove the dregs. Combine the filtrates of these 3 times and concentrate them by heating to form a clear paste. Then grind 300g of Cornu Cervi Colla into coarse powder, soak it with an appropriate amount of yellow rice wine, and stew it over water until it melts. Pour it into the clear paste and mix evenly, and add brown sugar to make the ointment.
[Usage] Take 15-20g each time, 2-3 times a day, and dissolve it in warm water for oral administration.
(2) Bujing Ointment
[Source] Efficacious Prescriptions of Miraculous Efficacy
[Composition] Bovis Medulla (refined to remove the dregs), Juglandis Semen (peeled, stir-fried), Armeniacae Amarum Semen (peeled and with the tips removed, each 4 liang), Dioscoreae Rhizoma (half a jin).
[Efficacy] Strengthen the primordial yang, benefit the true qi, assist the stomach and moisten the lungs.
[Preparation method] Mash Juglandis Semen, Armeniacae Amarum Semen and Dioscoreae Rhizoma together into a paste, add one jin of refined honey, mix evenly with Bovis Medulla, put it into a porcelain jar, and boil it in boiling water for one day.
[Usage] Take one spoonful on an empty stomach every day.