Hematuria (Mixed Deficiency-Excess Pattern)

Blood disorders arise when heat damages the blood vessels, Qi fails to contain the blood, or blood stasis obstructs the vessels, causing blood to flow outside its normal channels. Their main clinical features include bleeding from the mouth, nose, or other orifices; bleeding from the upper or lower body openings; or purplish skin spots. Hematuria is a disorder characterized by blood, sometimes with clots, mixed in the urine. Depending on the amount of bleeding, the urine may appear pale red, bright red, like water used to rinse meat, or pale soy-sauce-colored. This condition is also known as “blood in the urine” or “bloody urination.” In Western medicine, hematuria associated with urinary tract disorders such as glomerulonephritis, renal tuberculosis, or kidney tumors may be assessed and treated according to TCM pattern differentiation for blood disorders.

Hematuria refers to an increased number of red blood cells in the urine, with more than 3 red blood cells per high-power field on microscopic examination of the urine sediment. It is classified as gross hematuria or microscopic hematuria according to whether it is visible to the naked eye. Gross hematuria must be distinguished from other causes of red urine. A key distinction is that after centrifugation, the supernatant in gross hematuria is not red and the sediment contains many red blood cells; in red urine due to other causes, the supernatant remains red after centrifugation and the sediment contains few red blood cells. Note: ① Do not rely on dipstick testing to determine whether hematuria is present, because hematuria, hemoglobinuria, and myoglobinuria can all produce a positive red blood cell or occult blood result on dipstick testing. Many other factors can also affect dipstick results, leading to a false-positive rate of around 50%. ② Exclude pseudohematuria and establish whether true hematuria is present, mainly by taking a medical history and ruling out urine contamination by menstrual blood and the very rare deliberate fabrication of hematuria.

TCM Pattern Differentiation and Medication Guide

|Common Symptoms

Clinical description:

Hematuria, difficulty urinating, soreness and weakness in the lower back and knees, a heavy and tired feeling in the body, poor digestion, pale tongue body, thin yellow coating, slippery and rapid pulse

In plain language:

  • There is blood in the urine, which may look red or blood-tinged during urination.
  • Urination is difficult or does not flow freely, and may require effort.
  • The lower back and knees feel sore and weak, and may feel unable to support the body well when walking or standing.
  • The body feels heavy and tired, with more fatigue during activity and low energy.
  • Food is not digested easily and may cause bloating, discomfort, or acid reflux, with a sensation that food is lingering in the stomach.
  • The tongue appears pale, with reduced color.
  • The tongue coating is thin and yellow.
  • The pulse feels slippery and relatively fast, with a smooth flow and a rapid rate.

|Treatment Approach

Clinical description:

Strengthen the Spleen and benefit the Kidneys; clear heat and promote the resolution of dampness.

In plain language:

  • Support the Spleen’s digestive function and nourish Kidney Qi, with the aim of easing poor appetite, fatigue, or soreness and weakness in the lower back and knees.
  • Clear internal heat and encourage the elimination of dampness, with the aim of easing heaviness and fatigue, scanty dark urine, or swelling of the lower limbs.

|Related Products

The products listed below are for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.

References

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