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　　What are the causes of淋证的 onset?

　　How is淋证 caused? Briefly described as follows:

　　1, Bladder damp-heat

　　Eating too much spicy, hot, fatty and sweet food, or excessive drinking, can lead to damp-heat, which descends to the bladder; or unclean lower body, filthy pathogenic factors侵入 the bladder, leading to damp-heat, and developing into淋证. If the urine is burning and painful, it is called 热淋; if damp-heat accumulates, the urine is subjected to its refining, day by day, the impurities in the urine are precipitated into sand and stones, it is called 石淋; if damp-heat accumulates in the lower jiao, leading to the dysfunction of qi transformation, unable to separate the clear and turbid, the fat and fluid following the urine, the urine being like grease or ointment, it is called 膏淋; if heat is excessive and injures the collaterals, forcing blood to flow recklessly, the urine being涩痛 with blood, it is called 血淋.

　　2, Deficiency of the spleen and kidney

　　Long-term淋证 without relief, damp-heat consumes the vital energy; or old age, long illness, weak body, and excessive fatigue, as well as irregular sexual life, can all lead to deficiency of the spleen and kidney. Deficiency of the spleen leads to the descent of middle qi, and deficiency of the kidney leads to the instability of the lower yuan, resulting in continuous dripping of urine. If it occurs upon exertion, it is called 劳淋; if there is insufficient middle qi and qi deficiency leading to descent, it is called qi淋; if there is deficiency of kidney qi and the lower yuan is not stable, unable to control the fat and fluid, the fat and fluid descending, the urine becoming turbid, it is called 膏淋; if heat is excessive and injures the collaterals, forcing blood to flow recklessly, the urine being涩痛 with blood, it is called 血淋.

　　3, Liver qi stagnation

　　Annoyance injures the liver, causing qi stagnation and insufficient ventilation, with qi stagnation transforming into fire, or qi and fire stagnating in the lower jiao, affecting the qi transformation of the bladder, leading to distension in the lower abdomen, difficult and painful urination, residual dribbling, and developing into qi淋, which belongs to the excess syndrome of qi淋; qi淋 caused by the descent of middle qi is the deficiency syndrome of qi淋.

　　What complications can淋证 easily lead to?

　　What are the symptoms of stranguria? A brief description is as follows:

　　1. Frequent, urgent urination, dripping pain, acute abdominal pain, and soreness in the腰部 are the main symptoms of various types of stranguria, and are the main basis for diagnosing stranguria. According to the different clinical characteristics of various types of stranguria, different types of stranguria can be determined.

　　2. After a long course or recurrence, symptoms such as low fever, low back pain, distension and pain in the lower abdomen, and fatigue often occur.

　　3. More common in married women, often triggered by fatigue, changes in mood, and external pathogenic factors.

　　Enhancing physical fitness, preventing internal injury due to emotional disorders, eliminating various external pathogenic factors and internal damp-heat factors such as holding urine, overeating rich and sweet foods, overindulgence in desires, unclean external genitalia, damp-heat toxins, etc., is an important aspect for preventing the onset and recurrence of stranguria. Paying attention to the hygiene of pregnancy and postpartum period is of great significance for preventing the occurrence of postpartum stranguria. Actively treating diseases such as diabetes can also reduce the occurrence of this condition. Patients with stranguria should drink plenty of water, eat a light diet, avoid greasy, pungent, spicy, and fragrant foods; abstain from sexual activity; and pay attention to appropriate rest, which is helpful for an early recovery.

　　Stranguria belongs to the category of traditional Chinese medicine. It can be diagnosed by pulse and tongue diagnosis. A urinalysis can be performed first. If the increase of white blood cells in the urine is prominent, it is often considered to be urinary tract infection and inflammation, and a midstream urine bacterial culture and urine nitrite test can be performed. In addition, if urinary tuberculosis is suspected, urine sediment should be examined for tuberculosis bacilli, and tuberculosis skin test should be performed. If it is considered to be possible prostate inflammation, anal palpation of the prostate and routine examination of the prostate fluid can be performed. If it is suspected to be non-infectious cystitis, cystoscopy can be performed. If an increase of red blood cells in the urine is prominent, it is often seen in urinary tract stones and bladder cancer, and urinary tract B-ultrasound, intravenous pyelography, abdominal plain film, and searching for shed cells in the urine should be performed. If the urine is turbid and suspected to be chyluria, a urine ether test should be performed, and if necessary, lymphangiography imaging examination. If all the examinations are normal, it is mostly urethritis.

　　The following is a brief description of the dietary principles for stranguria.

　　1. Drink plenty of water, and eat a light diet.

　　2. Avoid greasy, pungent, spicy, and fragrant foods.

　　3. Abstain from sexual activity, and pay attention to appropriate rest, which is helpful for an early recovery.

　　The following is a brief description of the traditional Chinese medicine treatment methods for stranguria.

　　1. Hot stranguria

　　Symptoms: Frequent, short urination, burning and pricking pain, yellow and red urine color, acute abdominal pain, or chills and fever, bitter taste, nausea and vomiting, or low back pain, or constipation, yellow greasy coating, and slippery and rapid pulse.

　　Treatment method: Clear heat, promote diuresis, and relieve stranguria.

　　Herbal medicine: Ba Zheng San. The efficacy of this formula is to clear heat and eliminate fire, and promote diuresis and relieve stranguria. Wu Tong, Che Qian Zi, Bie Xù, Qú Mài, and Huá Shí promote diuresis and relieve dampness; Da Huang, Shan Nai, and Gan Cao Sha clear heat and eliminate fire. If constipation and abdominal distension occur, use raw Da Huang in large doses and add Zhì Shí to relieve abdominal bloating and eliminate heat; if accompanied by chills and fever, bitter taste, and nausea and vomiting, use Xiao Chai Hu Decoction to harmonize Shaoyang; if damp-heat injures the eyes, remove Da Huang and add raw Shí Di, Zhī Mu, and Bai Máo Gēn to nourish yin and clear heat; if heat toxin spreads throughout the San Jiao, enters the营 and blood, it is urgent to treat the symptoms first, using Huang Lian Jie Du Decoction combined with Wu Wei Xiao Du Yin to clear heat, eliminate fire, and detoxify.

　　2, Stone stranguria

　　Symptoms: Urine occasionally contains sand and stones, difficult urination, or sudden interruption of urination, urgency and pain in the urethra, contraction and pain in the lower abdomen, or severe pain in the waist and abdomen, blood in the urine, red tongue, thin yellow tongue coating, wiry or rapid pulse. If the pain persists and the sand and stones do not leave, it may be accompanied by pale complexion, listlessness, lack of Qi and strength, pale tongue with tooth marks on the edges, and thin and weak pulse; or hidden pain in the waist and abdomen, hot palms and soles, red tongue with little bitterness, and thin and rapid pulse.

　　Treatment method: Clear heat and drain dampness, promote urination and expel stones.

　　Herbal medicine: Shiwei San. The formula includes Shiwei, Dongkuizi, Qumai, Huashi, and Cheqianzi, most of which are diuretic and promote urination drugs, their清热effect is not as strong as Bajing San, so it is only used for Shi stranguria, and it must be used with Jinqiancao, Haishajin, and Jinenjin to enhance the effect of dissolving stones and hardening. If there is severe pain in the waist and abdomen, add Shaoyao, with Gancao to relieve pain; if there is blood in the urine, add Xijicao, Shengdi, and Liujie to cool the blood and stop bleeding; if there is fever, add Pugongying, Huangbai, and Dahuang to clear heat and purge fire. For Shi stranguria that has lasted for a long time, if there are signs of both deficiency and excess, attention should be paid to both the root and the branch; for those with Qi and blood deficiency, use Er Shen San combined with Bajian Tang; for those with yin fluid consumption, use Liuwei Dihuang Wan combined with Shiwei San; for those with insufficient kidney Yang, use Jin Gui Shenqi Wan combined with Shiwei San.

　　3, Qi stranguria

　　Symptoms: For实证, it is characterized by sticky urination, dripping without relief, fullness and pain in the lower abdomen, thin white tongue coating, and deep and wiry pulse. For虚证, it is characterized by prolapse and distension in the lower abdomen, residual urine after urination, pale complexion, pale tongue, and weak, thready pulse.

　　Treatment method: For实证, it is advisable to promote Qi and疏导; for虚证, it is advisable to tonify the middle Qi.

　　Herbal medicine: For实证 use Chenxiang San; for虚证 use Bu Zhong Yi Qi Tang. Chenxiang San includes Chenxiang, Jupi, which promote Qi, Danggui and Baishao, which soften the liver, Gancao, which clears heat, Shiwei, Huashi, Dongkuizi, and Wangbuluoxing, which promote urination and relieve stranguria. For those with chest oppression and胁胀, add Qingpi, Wuyao, and Xiaohuixiang to promote liver Qi; for those with long-term Qi stagnation and blood stasis, add Honghua, Chishao, and Niuxi to activate blood and remove blood stasis. Bu Zhong Yi Qi Tang is used to tonify the middle Qi. If there is also blood deficiency and kidney deficiency, use Bajian Tang with double Fuling and add Duzhong, Gouqizi, and Huai Niuxi to tonify Qi and nourish blood, and tonify both the spleen and kidney.

　　4, Blood stranguria

　　Symptoms: 实证 is characterized by hot, burning, and painful urination, with deep red urine; or with blood clots, pain and urgency increase; or with irritability, yellow tongue coating, and slippery and rapid pulse. 虚证 is characterized by light red urine, mild pain and涩滞in urination, soreness and weakness in the lower back and knees, fatigue, pale tongue, and thin and rapid pulse.

　　Treatment method: For实证, it is advisable to clear heat and promote urination, cool the blood and stop bleeding; for虚证, it is advisable to nourish yin and clear heat, tonify deficiency and stop bleeding.

　　Herbal medicine: For实证 use Xiji Yinzi; for虚证 use Zhipei Dihuang Wan. Xiji Yinzi formula includes Xijicao, Shengdi, Puhuang, and Liujie, which cool the blood and stop bleeding; Xijicao can be used up to 30g, and Shengdi is best when fresh. Mutong and Zhuyeqi reduce heart fire and promote urination; Zhui zi clears the fire of the Sanjiao; Huashi promotes urination and relieves stranguria; Danggui guides blood back to its meridians; Shenggancao clears fire and harmonizes the营to relieve pain; if there is a lot of blood and severe pain, it can be taken with Sanqi and Shuhupi powder to resolve blood stasis and stop bleeding. Zhipei Dihuang Wan nourishes yin and clears heat, and can also be supplemented with Huanliancao, Ejiao, and Xijicao to tonify deficiency and stop bleeding.

　　5. Gao Lin

　　Symptoms: For实证 (syndrome of excess), the urine appears turbid like milky water, settling like cotton, with floating oil like fat on top, or with clots, or mixed with blood, with hot and涩 (viscous) pain in the urethra, red tongue, yellow greasy coating, and a weak and rapid pulse. For虚证 (syndrome of deficiency), the disease persists for a long time, recurring repeatedly, with urination like grease, and the涩 (viscous) pain is reduced, but the body becomes thinner day by day, with dizziness and fatigue, lumbago and knee weakness, pale tongue, greasy coating, and a thin and weak pulse.

　　Treatment method: For实证 (syndrome of excess), use clearing heat and relieving dampness, clarifying and purging turbidity; for虚证 (syndrome of deficiency), use tonifying deficiency and astringing fluid.

　　Herbal medicine: For实证 (syndrome of excess), use Chengshi Decoction for clarifying turbidity; for虚证 (syndrome of deficiency), use Gao Lin Decoction. In Chengshi Decoction for clarifying turbidity, 萆解 (Baijie) and 菖蒲 (Changpu) clear dampness and turbidity; 黄柏 (Huangbai), 车前子 (Cheqianzi) clear heat and relieve dampness; 白术 (Baizhu), 茯苓 (Fuling) invigorate the spleen and relieve dampness; 莲子心 (Lianzi xin), 丹参 (Danshen) clear the heart and activate blood circulation to unblock collaterals, making clear and turbid substances separate, dampness and heat dissipate, collaterals unblock, and body fluids return to their proper channels. If there is distension in the lower abdomen and urination is not smooth, add 乌药 (Wuyao) and 青皮 (Qingpi); if there is blood in the urine, add 小蓟草 (Xiaojicao) and藕节 (Oujie), and 茅根 (Mao Gen). In Gao Lin Decoction, 党参 (Dangshen) and 山药 (Shanyao) tonify the spleen, 地黄 (Dihuang) and 芡实 (Egu) nourish the kidney, 龙骨 (Longgu) and 牡蛎 (Muli), 白芍 (Baishao) astringe body fluids. If there is deficiency of both the spleen and kidney, with sinking of middle qi and loss of kidney astringency, Bu Zhong Yi Qi Soup combined with Qi Sheng Wan can be used to invigorate qi and elevate sinking, and nourish the kidney and astringe fluid.

　　6. Fatigue-induced stranguria

　　Symptoms: The urine is not very red and涩 (viscous), but dripping continuously, appearing and stopping intermittently, occurring with fatigue, lumbago and knee weakness, fatigue and weakness, pale tongue, and weak pulse.

　　Treatment method: Invigorate the spleen and benefit the kidney.

　　Herbal medicine: Wubuyao pill. This formula has the effects of invigorating the spleen and dampness, and benefiting the kidney and astringing fluid. Among them,山药 (Shanyao), 茯苓 (Fuling), 泽泻 (Zexie) invigorate the spleen and relieve dampness, while 熟地 (Shuddi), 山茱萸 (Shanyaozhi), 巴戟天 (Bajitian), 菟丝子 (Tusizi), 杜仲 (Duzhong), 牛膝 (Niuxi), 五味子 (Wuweizi), 肉苁蓉 (Roucongrong), 赤石脂 (Chishizhi) benefit the kidney and astringe fluid. If there is spleen deficiency and qi sinking, with symptoms such as a坠胀 (dizziness and distension) in the lower abdomen, and urine dripping out in drops, it can be used together with Bu Zhong Yi Qi Soup to invigorate qi and elevate sinking; if there is kidney yin deficiency, with symptoms such as a flushed face, restlessness, a red tongue, and a thin and rapid pulse, it can be used together with Zhishi Baidu Pill to nourish yin and reduce fire; if there is kidney yang deficiency, with symptoms such as a pale face, aversion to cold, cold limbs, a pale and bitter thin white tongue, and a deep and thin pulse, it can be used together with You Gui Wan to warm the kidney and invigorate kidney yang, or use 3g of deer horn powder, taken twice a day.