(Key for symbols used: "+" = Reinforcing; "-" = Reducing; "+/-" = Neutral; "^" = Moxibustion)

Cystitis is a bacterially caused inflammation of the internal wall of the urinary bladder. Acute cystitis is clinically marked by sudden onset of lower abdominal pain and frequent, dripping, and painful urination, accompanied by macroscopic blood in the urine and pyuria. The manifestations of chronic cystitis are similar to or milder than those of acute cystitis, and reoccur frequently. According to TCM cystitis belongs to the category of Lin Zhen (stranguria), and is caused by attack of exogenous damp-heat or internal production of damp-heat, leading to accumulation of damp-heat in the lower Jiao.

I. STANDARD TCM ACUPUNCTURE TREATMENT OF CYSTITIS

Cystitis is generally divided into two types --- damp-heat in the Lower Jiao and deficiency of the spleen and kidney. Acupuncture points of the Bladder, Gallbladder, Ren and Spleen Meridians are frequently selected in its treatment.

1. Damp-Heat in the Lower Jiao

Manifestations of cystitis: Frequent, painful, and dripping urination with burning sensation, dark or turbid urine.

Tongue: Red body with yellow and sticky coating.

Pulse: Soft and rapid.

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

Acupuncture Point Prescription & Manipulation:

Primary acupuncture points:

RN-3 Zhongji -

BL-28 Pangguanshu -

SP-6 Sanyinjiao -

SP-9 Yinlingquan -

BL-39 Weiyang -

KI-2 Rangu -

GB-34 Yanglingquan -

Explanation:

• RN-3 Zhongji, KI-2 Rangu and BL-28 Pangguanshu clear damp-heat from the urinary bladder;

• SP-6 Sanyinjiao and SP-9 Yinlingquan promote the spleen’s function of transportation of water to drain dampness;

• BL-39 Weiyang and GB-34 Yanglingquan clear damp-heat in the lower jiao.

Secondary acupuncture points according to conditions:

1. Difficulty in urination--- BL-32 Ciliao [-] and BL-33 Zhongliao [-];

2. Hematuria--- SP-10 Xuehai;

3. High fever--- LI-11 Quchi [-];

4. Sandy urine--- LI-4 Hegu [-], LR-4 Zhongfeng [-];

5. Turbid urine--- KI-6 Zhaohai [-].

2. Deficiency of Spleen and Kidney

Manifestations of cystitis: Intermittent dripping urination with dull pain, which is induced by exertion, fatigue, listlessness, soreness and weakness of the loins and knees, poor appetite, loose stools.

Tongue: Pale tongue.

Pulse: Weak or feeble.

Treatment Principle: Reinforce the spleen, invigorate the kidney and relieve stranguria (cystitis).

Acupuncture Point Prescription & Manipulation:

Primary acupuncture points:

BL-20 Pishu + ^

BL-23 Shenshu + ^

RN-3 Zhongji + ^

RN-4 Guanyuan + ^

ST-36 Zusanli + ^

SP-6 Sanyinjiao + ^

DU-4 Mingmen + ^

Explanation:

• BL-20 Pishu, ST-36 Zusanli and SP-6 Sanyinjiao reinforce the spleen and tonify qi;

• BL-23 Shenshu, RN-4 Guanyuan and DU-4 Mingmen reinforce the kidney and tonify yang;

• RN-3 Zhongji regulates the urinary bladder to relieve stranguria.

Secondary acupuncture points according to conditions:

1. Poor appetite and abdominal distention--- RN-12 Zhongwan [/]

II. EXPERIENTIAL TREATMENT

1. Puncturing BL-54 Zhibian

Indications: Acute cystitis or acute urethritis.

Acupuncture Point Prescription:

BL-54 Zhibian

Manipulation: Insert a 3-cun needle through the skin at the point, push the needle with its tip toward the perineum 3 cun deep. Rotate the needle to induce needling sensation radiating to the perineum, retain the needle for 20 minutes, and rotate the needle once during the retention. The cystitis treatment is given once a day. Generally, one treatment will bring about effective results and three treatments are needed in total.

2. Acupuncture and Moxibustion on KI-6 Zhaohai

Indications: Chronic cystitis or urethritis.

Point Prescription:

KI-6 Zhaohai

Manipulation:

Insert the needle perpendicularly into the point, lift, thrust and rotate it to induce arrival of qi, retain the needle for 30-40 minutes, and manipulate it every 10 minutes. If the patient’s condition belongs to the cystitis category of yang deficiency, apply moxibustion on the point. Ignite a moxa stick, hold the stick and keep the ignited end 0.5-1 cun from the skin of the point until the patient feels slight burning pain. Usually, apply the moxibustion on each side for 5-7 minutes. The treatment with acupuncture or moxibustion is given once daily, with 10 treatments as a course. For mild cases, only 2-3 treatments are needed, and to severe cases, two or three courses may be given.

3. Ear Acupuncture

Indications: Acute or chronic cystitis or urethritis.

Ear Point Prescription:

Primary points:

Bladder, Abdomen, Pelvic Cavity.

Secondary acupuncture points according to conditions:

1. Damp-heat syndrome--- Sanyinjiao, Endocrine and Shenmen;

2. Yang deficiency syndrome with a long-term course--- Kidney and Spleen.

Manipulation: See page 247.

Comment:

Acupuncture and moxibustion is effective in relieving symptoms of cystitis, and is a good therapy for chronic cystitis. In some cases, chronic cystitis can be cured by acupuncture therapy.

About the author, GANGLIN YIN

Dr. Yin received his M.D. from Hunan University of Traditional Chinese Medicine (HUTCM) in Changsha, China in 1982 and received three years of postgraduate training at the same medical school. From 1985 to 1996, he taught and practiced TCM in HUTCM, and he was promoted as Associate Professor of Acupuncture in 1994. From 1997 to 2000, he taught and practiced TCM at the International College of Traditional Chinese Medicine in Victoria, Canada. In June of 2000, Yin practiced and lectured at the Atlantic Institute of Oriental Studies in Florida. Presently, he is the Principal of Oshio College of Oriental Medicine at Victoria, BC. His long and distinguished career in TCM includes teaching students from the Europe, America, Africa, and Asia and treating patients in China, Russia and Canada, as well as publishing several books on acupuncture, moxibustion, Qi-gong and herbology in both Chinese and English.

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