TCM and Nocturia
Traditional Chinese Medicine (TCM) regards nocturia as a disharmony in either the Kidney or the Spleen-Kidney Zang, particularly with regard to their Yang aspects.
Some of the roles of the Kidney Zang are governing water in the body, controlling the lower orifices (the urethra and the anus), and warming the body, a function of the Kidney's Yang aspect. The Kidney Zang is said to have a paired relationship with the Bladder Fu, which is responsible for the excretion of urine, and helps strengthen the Bladder's ability to retain urine.
The Spleen Zang, responsible for, among other things, transforming nourishment into energy for the body, functions so that its Yang aspect aids the Kidney Yang. When the Kidney Yang is weak or is not supported by the Spleen Yang, it does not properly transform the urine and cannot strengthen the Bladder's restraining power, resulting in excessive nighttime urination.
There are several causes of Yang deficiency in the Kidney and Spleen Zang, including constitutional deficiency and aging, disease, overwork, excessive sexual activity, poor diet and nutrition, and emotional imbalance.
Traditional Chinese Medical Treatment for Nocturia
Traditional Chinese Medicine treatment for nocturia focuses on the therapeutic principles of supplementing the Kidney and/or Spleen Yang and astringing (reducing) urine. Depending on the patient's presentation, they may also focus on clearing Damp-Heat, resolving Blood Stasis, and moving the Liver Qi to resolve the underlying energetic imbalance and reduce urinary frequency.
Nocturia responds well to TCM treatments. In general, herbal medicine is the most effective form of treatment and produces the fastest results. Preliminary observations of nocturia patients using herbal medicine to complement conventional treatments for prostate cancer at St. Vincent Medical Center in Los Angeles suggest positive results. Acupuncture, while showing some results, takes longer to produce symptom control unless treatment can be frequently given, which often too expensive for patients. Qi Gong exercises for nocturia, which produce a more gradual effect, are best used to strengthen Zang Fu organ systems to prevent disease and supplement acupuncture and herbal medicine intervention.
Because nocturia may indicate a serious disease, patients should first seek the advice of a conventional physician to determine the cause of the disorder before seeking TCM treatment.
Acupuncture & Nocturia
Acupuncture treatments for nocturia vary according to the differential diagnosis made by a practitioner and they usually involve both distal and local points.
Distal points for Kidney Yang Deficiency include Kidney 3 (Tai Xi) and, in case of Spleen Yang Vacuity, Stomach 36 (Zu San Li) or Spleen 4 (Gong San). Besides using acupuncture needles, practitioners might also use moxa to warm the point and nourish Yang energy.
Local points, such as Ren 4 (Guan Yan), which warms the Yang of the body, and Ren 3 (Zhong Ji), a point that specifically affects the Bladder Fu, may be used as well.
In cases when other patterns complicate the condition, such as Damp-Heat, acupuncture points that clear Damp-Heat may be used first to resolve this coexisting pattern, after which the basic underlying patterns is addressed.
Herbal Medicine & Nocturia
Herbal medicine treatment focuses on resolving the underlying Kidney and/or Kidney/Spleen Yang Deficiency conditions and helping to astringe the urine. Herbal formulas typically contain such herbs as Tu Si Zi (Semen Cuscutae Chinensis), Sang Pao Xiao (Ootheca Mantidis), and Bu Gu Zhi (Fructus Psoraleae Corylifoliae), all of which strengthen the Kidney Yang and have a powerful astringent function.
Herbs such as Shu Di Huang (Radix Rehmanniae) and Rou Gui (Cortex Cinnamomi Cassiae) may be added to strengthen the Kidney Zang and nourish its Yang aspect. Herbs such as honey-fried Huang Qi (Radix Astragali Membranacei) and Sha Yuan Zi (Semen Astragali Complanati) may be added to further strengthen the Spleen Zang and its Yang aspect.
Other herbs may be added to the formula if complicating patterns exist. If a complicating pattern is predominant or if treatment of the basic pattern results in an aggravation of other coexisting patterns, those patterns are treated first.
Qi Gong & Nocturia
Qi Gong treatment seeks to strengthen the Spleen and Kidney Zang and treat underlying energetic disturbances so that the frequency of urination declines. Qi Gong exercises might involve techniques such as focused massage of the acupuncture points, rhythmic contraction of the anal sphincter to strengthen the Kidney and the two Yin orifices, and focused repetition of the Eight Brocade Exercise #8. Qi Gong exercises for other coexisting patterns may also be given.