Patient's question:
How to handle benign prostatic hyperplasia with pain?Detailed medical history and consultation purpose: Self-care
Duration of the current illness and persistence: One year
Current general condition: Swollen pain
Medical history: None
Previous diagnoses, treatments, and outcomes: Ultrasound diagnosis
Additional tests: None
Other: None
Doctor's answer:
Hello! Prostate hyperplasia in the elderly develops slowly and gradually worsens, primarily manifesting as urinary dysfunction, urinary tract infections, and chronic renal insufficiency. In Traditional Chinese Medicine (TCM), it is believed that this condition is often caused by the decline of zang-fu organ functions, which fails to support yang and open orifices. Insufficient kidney qi leads to the inability of yin to transform, resulting in disrupted opening and closing functions, thereby causing difficulty in urination.Furthermore, TCM holds that water is the ultimate yin, so its root lies in the kidneys. Water is transformed by qi, so its manifestation is in the lungs. Water fears earth, so its control is in the spleen. When the functions of the lung, spleen, and kidney are impaired, water and dampness accumulate internally, leading to the generation of turbidity. When these pathogenic factors descend to the lower burner, various lower burner diseases may arise.
Based on this, I believe that in the treatment of prostate hyperplasia, it is not sufficient to focus solely on diuretic therapy. Instead, the approach should integrate lung-expansion, spleen-strengthening, kidney-tonifying, and qi-regulating and turbidity-resolving methods into a unified strategy for comprehensive treatment. This is because the lung is the "protective cover" (huagai), governing qi and serving as the source of water above. If the lung qi is not properly dispersed, qi stagnates and water channels become obstructed. Therefore, the treatment principle should focus on dispersing and unblocking the upper burner, lifting lung qi to restore its clear and descending nature, thereby regulating the descending function. This method, known as "lifting the lid to open the source" for the lower burner, is supplemented by invigorating the middle burner to raise qi and clear turbidity. When upper qi ascends, lower orifices naturally open—a technique known as "treating lower diseases from the upper." Adding warming yang and tonifying kidney methods enhances the effectiveness of this approach.
The formula recommended is modified Huangqi Gancao Decoction. The reference prescription is as follows:
- Astragalus root (Huangqi): 15g
- Plantain seed (Cheqianzi): 30g
- Licorice root (Gancao): 20g
- Bupleurum root (Shengma): 12g
- Radix et Rhizoma Polygoni multiflori (Huai Niu Xī): 15g
- Epimedium (Yinyanghuo): 15g
- Slender stone (Huashi): 30g
Modifications:
- For constipation, add Cistanche (Roucongrou): 20g.
- For urinary discomfort, add Dandelion (Pugongying): 25g and Euonymus root (Mutong): 10g.
- For cough and asthma, add Apricot kernel (Xingren): 5g and Asarum (Xixin): 5g.