Hematuria in Traditional Chinese Medicine
Understanding different hematuria patterns according to TCM theory
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Condition Categories
Condition Categories
Hematuria, commonly referred to as blood in urine, is a condition characterized by the presence of red blood cells in the urine, making it appear reddish or brownish. This symptom can indicate various underlying conditions, ranging from urinary tract infections to more serious diseases affecting the kidneys or urinary tract.
Hematuria can be visible to the naked eye (gross hematuria) or detectable only under a microscope (microscopic hematuria). It's a symptom that warrants medical evaluation to determine its cause.
Traditional Chinese Medicine (TCM) approaches hematuria from a holistic perspective, focusing on the balance and flow of Qi, the body's vital energy. In TCM, hematuria is often seen as a manifestation of underlying disharmonies within the body's organ systems, particularly the Kidneys and Bladder.
Treatment in TCM aims to restore balance and address the root cause of the symptom through a combination of herbal medicine, acupuncture, dietary recommendations, and lifestyle modifications.
TCM Patterns for Hematuria
Heat
Intense, ascending pathogenic force that consumes body fluids, disturbs the mind, and accelerates all physiological processes
Causes: Blood in urine, Bloody urine, Red urine
Heat is a major pathogenic factor in Traditional Chinese Medicine that can arise from external invasion or internal generation. Heat has the characteristics of burning intensity, rising upward, consuming qi and fluids, and generating wind and disturbing blood. In TCM philosophy, normal physiological warmth is called "minor fire" (少火) which maintains life functions, while pathological heat is "major fire" (壮火) which damages the body.
Damp-Heat in the Bladder
Blood in urine
Along with: Frequent and urgent urination, Urinary burning, Urination stopping in the middle of flow, Dark urine, Cloudy urine, Hematuria, Fever, Dry mouth without desire to drink, Lower abdominal fullness and pain, Feeling of heat
Full-Heat in the Small Intestine
Blood in urine
Along with: Restlessness, Insomnia, Tongue ulcers, Mouth ulcers, Throat pain, Deafness, Cardiac burning sensation, Abdominal pain, Craving for cold beverages, Scanty and dark urine, Hematuria, Urinary burning
Greater Yang Accumulation of Blood
Blood in urine
Along with: Lower abdominal distension, Lower abdominal fullness, Hematuria, Restlessness
Heat victorious agitating Blood
Blood in urine
Along with: Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria
Heart Fire blazing
Bloody urine
Along with: Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety, Feeling of heat, Insomnia, Flushed face, Hematuria, Dark urine, Bitter taste in the mouth
Heat in the Blood
Bloody urine
Along with: Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia, Hematuria, Vomiting blood, Cough of blood, Nosebleeds, Excessive menstruation
Kidney Yin Deficiency With Empty-Heat Blazing
Bloody urine
Along with: Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms, Afternoon heat sensation, Evening heat sensation, Scanty and dark urine, Hematuria, Dry throat, Preference for sipping, Dizziness, Tinnitus, Hearing loss, Lower back pain, Nocturnal emission, Hypersexuality, Dry stools
Damp-Heat
Red urine
Along with: Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst, Feeling of heat, Feeling of heaviness, Bitter taste in the mouth, Acne
Mind Disturbance
Disruption of consciousness, mental clarity, and emotional equilibrium causing restlessness, confusion, or withdrawal
Causes: Blood in urine, Bloody urine
Mind Disturbance represents a broad category of patterns in Traditional Chinese Medicine involving disruptions to consciousness, mental clarity, emotional stability, and cognitive function. These patterns affect the Shen (spirit/consciousness), which according to classical texts resides in the Heart and is distributed among the five organs.
Heat victorious agitating Blood
Blood in urine
Along with: Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria
Heart Fire blazing
Bloody urine
Along with: Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety, Feeling of heat, Insomnia, Flushed face, Hematuria, Dark urine, Bitter taste in the mouth
Dampness
Heavy, sticky moisture that obstructs body functions and creates sluggishness
Causes: Blood in urine, Red urine
Dampness manifests as swelling, bloating, a feeling of heaviness in the head and limbs, and digestive issues. It's like having waterlogged tissues that make everything feel heavy and slow. Common signs include a thick, greasy tongue coating, sticky mouth sensation, and stools that are difficult to flush.
Damp-Heat in the Bladder
Blood in urine
Along with: Frequent and urgent urination, Urinary burning, Urination stopping in the middle of flow, Dark urine, Cloudy urine, Hematuria, Fever, Dry mouth without desire to drink, Lower abdominal fullness and pain, Feeling of heat
Damp-Heat
Red urine
Along with: Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst, Feeling of heat, Feeling of heaviness, Bitter taste in the mouth, Acne
Yin Deficiency
Depletion of cooling, moistening fluids causing dryness, false heat rising, and restless agitation throughout the body
Causes: Bloody urine
Yin Deficiency represents a fundamental pattern in Traditional Chinese Medicine where the body's yin fluids - blood, essence, and body fluids - become depleted, losing their ability to cool, moisten, and anchor the yang energy, resulting in relative hyperactivity of yang and internal heat manifestations.
Kidney Yin Deficiency With Empty-Heat Blazing
Bloody urine
Along with: Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms, Afternoon heat sensation, Evening heat sensation, Scanty and dark urine, Hematuria, Dry throat, Preference for sipping, Dizziness, Tinnitus, Hearing loss, Lower back pain, Nocturnal emission, Hypersexuality, Dry stools
Blood Deficiency
Insufficient blood to nourish the body, causing paleness, dizziness, and dryness throughout the system
Causes: Heamaturia, Bloody urine
Blood Deficiency represents a fundamental lack of blood volume or quality in the body, resulting in organs, tissues, and the mind being undernourished. In Traditional Chinese Medicine, blood not only refers to the red fluid in our vessels but encompasses the body's entire nourishing and moistening functions.
Loss of Blood
Heamaturia, Bloody urine
Along with: Nosebleeds, Uterine hemorrhage, Hematuria, Hematochezia, Cough of blood, Vomiting blood, Dark menstrual clots, Excessive menstruation, Bloody sputum
Phlegm
Thick, sticky pathological fluid that obstructs body functions and can manifest anywhere in the body
Causes: Bloody urine
Phlegm is both a pathological product and a pathogenic factor in Traditional Chinese Medicine. It results from impaired fluid metabolism when the body's transformative functions fail, particularly affecting the Spleen, Lungs, and Kidneys. Classical texts emphasize that "the Spleen is the source of phlegm production, while the Lungs are the storage vessel for phlegm."
Phlegm in Kidneys or Gallbladder
Bloody urine
Along with: Frequent and urgent urination, Urinary dysfunction, Hematuria
Herbal Formulas for Hematuria
Traditional Chinese Medicine formulas used to address hematuria
Xi Jiao Di Huang Tang
Addresses these hematuria patterns:
Main Actions
- Treats severe fevers and Heat in the Blood system
- Removes Blood Stagnation
Addresses These Hematuria Pattern Variations
Heat victorious agitating Blood
How it manifests:
Blood in urine
Accompanying symptoms:
Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds...
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Loss of Blood
How it manifests:
Heamaturia, Bloody urine
Accompanying symptoms:
Nosebleeds, Uterine hemorrhage, Hematuria, Hematochezia, Cough of blood, Vomiting blood...
Ba Zheng San
Addresses these hematuria patterns:
Main Actions
- Clears Heat and Fire
- Promotes urination
- Unblocks painful urinary dribbling
- Purges Fire
Addresses These Hematuria Pattern Variations
Damp-Heat in the Bladder
How it manifests:
Blood in urine
Accompanying symptoms:
Frequent and urgent urination, Urinary burning, Urination stopping in the middle of flow, Dark urine, Cloudy urine, Hematuria...
Bai He Di Huang Tang
Addresses these hematuria patterns:
Main Actions
- Moistens the Lungs
- Enriches the Body Fluids
- Clears Heat and cools the Blood
Addresses These Hematuria Pattern Variations
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Dao Chi San
Addresses these hematuria patterns:
Main Actions
- Clears the Heart
- Promotes urination
Addresses These Hematuria Pattern Variations
Full-Heat in the Small Intestine
How it manifests:
Blood in urine
Accompanying symptoms:
Restlessness, Insomnia, Tongue ulcers, Mouth ulcers, Throat pain, Deafness...
Gu Jing Wan
Addresses these hematuria patterns:
Main Actions
- Nourishes Yin
- Clears Heat
- Stops bleeding
- Stabilizes the menses
Addresses These Hematuria Pattern Variations
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Hua Ban Tang
Addresses these hematuria patterns:
Main Actions
- Clears Qi-level Heat
- Cools the Blood
Addresses These Hematuria Pattern Variations
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Liang Ge San
Addresses these hematuria patterns:
Main Actions
- Drains Fire
- Unblocks the bowels by clearing the Upper Burner
- Draining the Middle Burner
Addresses These Hematuria Pattern Variations
Heart Fire blazing
How it manifests:
Bloody urine
Accompanying symptoms:
Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety...
Liu Wei Di Huang Wan
Addresses these hematuria patterns:
Main Actions
- Enriches the yin and nourishes the Kidneys
Addresses These Hematuria Pattern Variations
Kidney Yin Deficiency With Empty-Heat Blazing
How it manifests:
Bloody urine
Accompanying symptoms:
Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms...
Qing Re Gu Jing Tang
Addresses these hematuria patterns:
Main Actions
- Clears Empty Heat
- Tonifies the Kidney Yin
- Stops bleeding
- Supplies Body Fluids
Addresses These Hematuria Pattern Variations
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Qing Xin Lian Zi Yin
Addresses these hematuria patterns:
Main Actions
- Clears the Heart
- Augments the Qi and Yin
- Stops turbid painful urinary dribbling
Addresses These Hematuria Pattern Variations
Heart Fire blazing
How it manifests:
Bloody urine
Accompanying symptoms:
Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety...
Qing Ying Tang
Addresses these hematuria patterns:
Main Actions
- Clears the Nutritive level Heat
- Relieves Fire Toxin
- Removes Heat
- Nourishes Yin
Addresses These Hematuria Pattern Variations
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
San Jin Pai Shi Tang
Addresses these hematuria patterns:
Main Actions
- Discharge Gallstones
- Clear Damp-Heat and promote urination
- Circulate Qi and Blood and relieve painful urination
Addresses These Hematuria Pattern Variations
Phlegm in Kidneys or Gallbladder
How it manifests:
Bloody urine
Accompanying symptoms:
Frequent and urgent urination, Urinary dysfunction, Hematuria
Shi Hui San
Addresses these hematuria patterns:
Main Actions
- Cools the Blood and
- Stops bleeding
- Clears Heat and drains Fire
Addresses These Hematuria Pattern Variations
Heat in the Blood
How it manifests:
Bloody urine
Accompanying symptoms:
Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia...
Si Ni San
Addresses these hematuria patterns:
Main Actions
- Regulates Liver and Spleen
- Eliminates Internal Heat
Addresses These Hematuria Pattern Variations
Phlegm in Kidneys or Gallbladder
How it manifests:
Bloody urine
Accompanying symptoms:
Frequent and urgent urination, Urinary dysfunction, Hematuria
Tao He Cheng Qi Tang
Addresses these hematuria patterns:
Main Actions
- Dispels Heat and
- Eliminates Blood Stagnation
Addresses These Hematuria Pattern Variations
Greater Yang Accumulation of Blood
How it manifests:
Blood in urine
Accompanying symptoms:
Lower abdominal distension, Lower abdominal fullness, Hematuria, Restlessness
Xie Xin Tang
Addresses these hematuria patterns:
Main Actions
- Drains Fire
- Resolves Toxicity
- Dries Dampness
Addresses These Hematuria Pattern Variations
Heart Fire blazing
How it manifests:
Bloody urine
Accompanying symptoms:
Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety...
Yi Huang Tang
Addresses these hematuria patterns:
Main Actions
- Strengthens the Spleen
- Dries Dampness
- Clears Heat
- Stops vaginal discharge
Addresses These Hematuria Pattern Variations
Damp-Heat
How it manifests:
Red urine
Accompanying symptoms:
Fever, Neck gland swelling, Headaches, Tight feeling in chest and stomach, Sticky taste in the mouth, Absence of thirst...
Zhi Bo Di Huang Wan
Addresses these hematuria patterns:
Main Actions
- Tonifies Yin
- Drains Fire
Addresses These Hematuria Pattern Variations
Kidney Yin Deficiency With Empty-Heat Blazing
How it manifests:
Bloody urine
Accompanying symptoms:
Flushed cheekbones, Restlessness, Insomnia, Night sweats, Low grade fever in the afternoon, Heat sensation in palms...
Zi Xue Dan
Addresses these hematuria patterns:
Main Actions
- Clears Heat
- Opens the sensory orifices
- Controls spasms and convulsions
- Extinguishes Wind
Addresses These Hematuria Pattern Variations
Heart Fire blazing
How it manifests:
Bloody urine
Accompanying symptoms:
Palpitations, Thirst, Mouth ulcers, Tongue ulcers, Restlessness, Anxiety...
Gui Pi Tang
Traditional formula for hematuria
Main Actions
- Tonifies and nourish Qi and Blood
- Tonifies Heart and Spleen
Bu Zhong Yi Qi Tang
Traditional formula for hematuria
Main Actions
- Tonifies Qi of the Spleen and Stomach (Middle Burner)
- Raises the Yang
- Detoxifies
- Lifts what has sunken