Explicação Def Yin Yang Urinary Incontinence

8/18/2019 Explicação Def Yin Yang Urinary Incontinence

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Urinary IncontinenceBy Jiang Liu, Diplomate of Oriental Medicine

Licensed Acupuncturist and Herbalist

Acupuncture & Chinese Medicine Clinic

701 N University Ave #101

Little Roc! AR 7""0

Urinary incontinence is any involuntary leaa$e o% urine or loss o%

bladder control 't can happen to anyone! but is very co((on in older

people )y(pto(s can ran$e %ro( (ild leain$ to uncontrollable *ettin$

+o(en are (ore liely than (en to have incontinence

Causes

Urinary incontinence can result %ro( anato(ic! physiolo$ic or patholo$ic

%actors! causin$ *ea bladder (uscles! overactive bladder (uscles!

bloca$e o% urinary tract! da(a$e to nerves that control the bladder

Temporary urinary incontinence

Alcohol

,verhydration

Ca-eine

.ladder irritation

Constipation

Medications

Urinary tract in%ection

Persistent urinary incontinence

/re$nancy and childbirth

Chan$es *ith a$in$

Hysterecto(y

/ain%ul bladder syndro(e

/rostatitis

nlar$ed prostate

/rostate cancer

Chronic urinary tract in%ection

.ladder cancer or bladder stones

Neurolo$ical disorders (ultiple sclerosis! /arinson2s

disease! stroe! a brain tu(or or a spinal in3ury

,bstruction tu(or or stone in urinary stones and va$inal

prolapseTypes



Stress urinary incontinence is due essentially to

insu4cient stren$th o% the pelvic 5oor (uscles

Urge incontinence is involuntary loss o% urine occurrin$ %or

no apparent reason *hile suddenly %eelin$ the need or ur$e to

urinate

Oer!o" incontinence occurs *hen the patient2s bladder

is al*ays %ull so that it %re6uently leas urine

Structural incontinence caused by structural proble(s

such as an ectopic ureter or va$inal stulas

#unctional incontinence happens in (any older people

*ho have nor(al bladder control 8hey 3ust have a hard ti(e

$ettin$ to the toilet in ti(e because o% other disorders that

(ae (ovin$ 6uicly di4cult Mi$ed urinary incontinence involves t*o or (ore types o%

incontinence

Conentional treatment

+ei$ht loss in over*ei$ht *o(en reduced stress incontinence9 :ercises

to the (uscles o% the pelvis to stren$then or retrain pelvic 5oor (uscles

and sphincter (uscles can reduce stress leaa$e9 Absorbent products

such as shields! under$ar(ents! brie%s! diapers and underpads can be

used to protect under*ear9 lectrical sti(ulation can stren$then (usclesin the lo*er pelvis9 .io%eedbac can be used to help the patient beco(e

a*are o% his or her body2s %unctionin$9 Medications can reduce so(e

types o% leaa$e9 /essaries can be used to the patients *ho have urinary

incontinence caused by va$inal prolapse9 A variety o% (aterials can be

used to add bul to the urethra and thereby increase outlet resistance9

Catheteri;ation to the bladder can be used %or the patients due to

over5o* incontinence to drain urine9 )ur$ery procedures are o%ten used

to alleviate incontinence a%ter other treat(ents have been tried!

includin$ bladder repositionin$! retropubic suspension or bladder nec

suspension sur$ery! various slin$ procedures! bladder au$(entation or

articial urinary sphincter

C%inese Medicine

)ince the co(ple:ity o% herbal (edicine! acupuncture is o%ten chosen %or

clinical studies Ho*ever! in clinical practice! acupuncture is o%ten

co(bined *ith herbal (edicine or so(e other (odalities o% Chinese

(edicine 8he %ollo*in$ types o% urinary incontinence are o%ten

observed in clinical practice



De&ciency and coldness of 'idney qi

)y(pto(s %re6uently urine leain$! lon$ and thin 5o* o% clear

urine! lo* spirit! aversion to coldness! tiredness! pale co(ple:ion!

sore *aist and nees *ith no stren$th! di;;y and tinnitus! cold

e:tre(ities! sper(atorrhea! pre(ature e3aculation or i(potence

8on$ue li$ht<colored! %at *ith teeth (arer! and thin and *hite

coat

/ulse thin! *ea and no stren$th

qi de&ciency of lung and spleen

)y(pto(s urinary incontinence *ith ur$ency a%ter the birth or

a%ter the disease! occasional urine lea! e:acerbatin$ *hen

cou$hin$! standin$ up! snee;in$! talin$ or lau$hin$! acco(panied

by cou$h! asth(a and tiredness! poor appetite or abdo(inal

bloatin$

8on$ue li$ht<colored *ith thin! *hite coat

/ulse *ea and no stren$th

(ot dominancy of )ladder

)y(pto(s urine drippin$ %re6uently! ur$ent and pain%ul urination!

yello* urine! burnin$ %eelin$ *hen urinate! heavy and

unco(%ortable %eelin$ in lo* abdo(en! bitter and dry (onth

8on$ue red *ith yello* coat /ulse strin$y! slippery and %ast

Yin de&ciency of lier and 'idney

)y(pto(s urinary incontinence! short and slo* 5o* o% yello*

urine! burnin$ %eelin$ in urinary tract! o%ten acco(panied by di;;y

and tinnitus! red chees! thirsty and %or$et%ul! sore *aist and no

stren$th in the le$s! ni$ht s*eatin$ or constipation

8on$ue red *ith scanty coat

/ulse strin$y! thin and %ast

Stagnation of *ia+Jao

)y(pto(s can not control urination! bloatin$! pain in lo*

abdo(inal area *ith so(eti(e detectable (ass

8on$ue dar! or petechiae *ith thin coat

/ulse strin$y! *ea and uneven

Clinical studies of acupuncture on urinary incontinence

=arious clinical studies have been per%or(ed and sho* that acupuncture

is e-ective in the treat(ent o% urinary incontinence 8he %ollo*in$ are

so(e o% studies



-.andomi/ed controlled clinical trials for electroacupuncture

treatment of urinary incontinence in stro'e patients01

-C%inese0 Chu >M .ao ?H @ou C @hao HL on$ ? +an$ CM Chen 8;u

?en Chiu Acupuncture Research BDEF"G<B"! "011 ,.>C8'= 8o

observe clinical e4cacy o% electroacupuncture DAE %or post<stroe

urinary incontinence in patients M8H,) A total o% 111 stroe

inpatients *ith urinary incontinence *ere rando(ly divided into A $roup

Dn I E and control $roup Dn I E /atients o% the control $roup *ere

treated by ad(inistration o% calciu( ion anta$on! an$iotensin<convertin$

en;y(e inhibitor! an$iotensin '' receptor anta$onist! co(pound thro(b<

clearin$ a$ent DivE! etc!and acupuncture o% >ianyu DL' 1E! Juehai D)/

10E! etc /atients o% the A $roup *ere treated by A o% bilateral )henshu

D.L "BE! Huiyan$ D.L BE! etc! co(bined *ith the treat(ent as the

control $roup 8he treat(ent *as conducted once daily %or F *ees

Croos D1KKE )cores o% the clinical sy(pto(s and clinical e4cacy

assess(ent *ere $iven be%ore and a%ter the treat(ent R)UL8) A%ter

the treat(ent! the severity o% urinary incontinence and sy(pto( scores

in both control and A $roups *ere decreased si$nicantly in co(parison

*ith pre<treat(ent D/ 001E ollo*in$ the treat(ent! o% the and

stroe patients in the control and A $roups! 0 and F D71E *ere cured

in the sy(pto(s o% %re6uent (icturition! ur$ency o% (icturition andincontinence o% urine! "0 DBFE and B D"E *ere e-ective! B

DBE and 17 DB0FE *ere invalid! *ith the e-ective rates bein$

BF and K! respectively 8he therapeutic e-ect o% A $roup *as

apparently superior to that o% the control $roup D/ 001E 'n addition!

the in%ection rate o% the A $roup *as striin$ly lo*er than that o% the

control $roup D/ 00E C,NCLU)',N A can lo*er the severity o%

urinary incontinence and i(prove clinical sy(pto(s o% (icturition in

stroe patients

-T%e study of electrical acupuncture stimulation t%erapy

com)ined "it% pelic !oor muscle t%erapy for

postprostatectomy incontinence01 -C%inese01 ?an$ .) ?e + ?ao

J /en$ >? @han$ )L ai . @han$ HL )hen ?> @hu ? @hu ?/ )hi H

Chun$<Hua +ai Oo 8sa Chih PChinese >ournal o% )ur$eryQ FGD17E1B"<7!

"010 ,.>C8'= 8o e:plore the e-ectiveness and si$nicance o%

*hether electrical acupuncture sti(ulation co(binin$ *ith pelvic 5oor

(uscle therapy D/M8E can i(prove the recovery o% urinary continence

M8H,) A total o% 10K patients too part in the study o% novel



co(bination treat(ent %or urinary continence %ro( )epte(ber "00G to

)epte(ber "00K /atients *ere divided into study $roup Dn I F0E and

control $roup Dn I KE 8he patients in study $roup received electrical

acupuncture sti(ulation therapy co(bined *ith /M8 one *ee a%ter

re(oval the catheter 8he patients in control $roup per%or(ed /M8 as

the only treat(ent %or post prostatecto(y incontinence 8he patients

*ere %ollo*ed up closely! *ith their clinical characteristics recorded!

6uestionnaires o% 'C'<<) lled up! and all the data %or statistical

analysis collected R)UL8) 8here *as a si$nicant di-erence bet*een

the study $roup and the control $roup in the urinary control curve D/ I

00"KE 8he di-erence o% continence probability bet*een these t*o

$roups beca(e $reater %ro( F *ees a%ter sur$ery! and the di-erence

reached the pea at *ees D/ I 00"BE 8hen the di-erence beca(e

s(aller! and there *as no di-erence at 1 *ees a%ter sur$ery 'C'<<)

6uestionnaires sho*ed the sa(e results C,NCLU)',N lectrical

acupuncture sti(ulation therapy co(binin$ *ith /M8 can i(prove the

recovery o% patients2 urinary continence a%ter radical prostatecto(y

O)seration on t%erapeutic e2ect of dog+day acupuncture and

mo$i)ustion com)ined "it% pelic !oor muscle e$ercises for

treatment of female stress urinary incontinence1 8an$ CLet al

@hon$$uo @hen >iu "00K9 "KD11EG7K<GB )eventy one cases *ererando(ly divided into t*o $roups 8hirty si: cases in the observation

$roup *ere treated *ith acupuncture on @hon$3i DC= BE! @i$on$ DJ<CA

1E! Chi;e DLU E etc and tortoise<shell (o:ibustion on )hen6ue DC=

co(bined *ith pelvic 5oor (uscle e:ercises9 *hile thirty ve cases in the

control $roup *ere treated *ith only pelvic 5oor (uscle e:ercises 8he

scores o% the 'nternational Consultation Co((ittee on 'ncontinence

uestionnaire )hort or( D'C'<<)E and the Medical ,utco(es )urvey

)hort or(<B D)<BE *ere evaluated be%ore and a%ter treat(ent! and

the scores o% )<B *ere also co(pared *ith B cases in nor(al $roup

R)UL8) 8he total e-ective rate o% K17 in the observation $roup *as

hi$her than that o% 771 in the control $roup D/ 00E 8he

di(ensions o% )<B o% stress urinary incontinence patients *ere

re(arably lo*er than those o% nor(al $roup Dall / 00E 8he scores o%

'C'<<) *ere decreased *hile the scores o% )<B *ere increased

obviously a%ter treat(ent in both the observation $roup and the control

$roup! there *ere pronounced i(prove(ents on physiolo$ical %unction!

pain! physical activity! social %unction and a-ection %unction in the



observation $roup Dall / 00E C,NCLU)',N the do$<day acupuncture

and tortoise<shell (o:ibustion co(bined *ith pelvic 5oor (uscle

e:ercises can i(prove the sy(pto(s o% urinary incontinence and

increase the 6uality o% li%e o% patients

T%e e3cacy of acupuncture in treating urge and mi$ed

incontinence in "omen a pilot study1 n$ber$ ) et al > +ound

,sto(y Continence Nurs "00K9BDE1<70 8his study consisted o% K

*o(en bet*een the a$es o% FF and years *ith ur$e or (i:ed ur$e

and stress U' at least t*ice a *ee %or a (ini(u( o% B (onths

MA)UR) )ub3ects co(pleted a 1<*ee bladder diary at baseline and

at 1 and F *ees postacupuncture to assess the i(pact o% acupuncture

on incontinence episodes uality o% li%e *as (easured at baseline and

at 1 and F *ees postacupuncture usin$ the Medical ,utco(es )hort<

or( D$eneral health< related 6uality o% li%eE and the 'ncontinence '(pact

uestionnaire and Uro$enital istress 'nventory Dincontinence<specic

6uality o% li%eE R)UL8) 't *as %easible to recruit sub3ects and per%or(

the planned study procedures )ub3ects rando(i;ed to the true

acupuncture $roup had a (ean BB0 D(edian I KKE reduction in

dayti(e accidentsSday at 1 *ee postacupuncture and 7F7 reduction

D(edian I 77E at F *ees postacupuncture 'n contrast! the (ean

reduction in dayti(e accidents *as 1GGG D(edian I 1KFE at 1*ee and 17 D(edian I 0E at F *ees post<sha( acupuncture

8here *ere no si$nicant $roup di-erences in chan$es in the scores on

the 6uality<o%<li%e (easures )ub3ects2 perceptions about *hether they

had received the true or sha( acupuncture *ere not si$nicantly better

than one *ould e:pect by chance C,NCLU)',N) 8he ndin$s o% this

pilot study support the need %or additional research e:a(inin$ the

e4cacy o% acupuncture in the treat(ent o% U' in *o(en! the %easibility o%

per%or(in$ study procedures! and the use o% a sha( needle as placebo

in acupuncture studies

4cupuncture in t%e treatment of dia)etic )ladder

dysfunction1 8on$ ? et al > Altern Co(ple(ent Med "00K91DGEK0<K

8his study co(pared B0 cases in the acupuncture $roup *ith 1 cases in

the sha( acupuncture $roup Dn I F totalE 8he e-ects o% acupuncture

*ere observed on urodyna(ic (easure(ents! as *ell as a variety o%

sy(pto(s associated *ith . R)UL8) 'n the acupuncture $roup! ve

o% the si: urodyna(ic (easures D(a:i(al detrusor pressure! bladder

co(pliance! (a:i(al bladder capacity! bladder volu(e at desire to void



and ur$e to voidE de(onstrated si$nicant i(prove(ent Dp 00! 001E

over the 1<day treat(ent period ,nly one (easure Dbladder volu(e at

ur$e to voidE *as si$nicantly i(proved Dp 00E in the sha(

acupuncture $roup 8here *ere si$nicant di-erences a%ter therapy in

%our (easures Dbladder co(pliance! (a:i(al bladder capacity! bladder

volu(e at desire to void! and ur$e to voidE bet*een the $roups Dp

00! 001E A si$nicant di-erence o% the chan$es in sy(pto(s

co(pared *ith pretreat(ent in the acupuncture $roup *as observed Dp

00! 001E 'n " sub3ects in the acupuncture $roup! incontinence

i(proved %ro( "F to 1F 'n the sha( acupuncture $roup! incontinence

deteriorated %ro( "" to "B C,NCLU)',N) ,ur pilot study has provided

evidence that acupuncture (ay be clinically use%ul %or the radical

treat(ent o% .

52ects of electroacupuncture on urinary )ladder function after

radical %ysterectomy1 ?i +M et al @hon$$uo @hen >iu

"00G9"GDKEB<

,ne hundred and ten cases *ere rando(ly divided into an

electroacupuncture DAE $roup and a control $roup! cases in each

$roup 'n the control $roup! the urinary tube *as placed and ept *ith

routine (ethod and the urinary bladder *as rinsed! and %ro( the ei$hth

day the abdo(en *as radiated *ith 8/! B0 (in each day! %or days 'nthe A $roup! on the basis o% treat(ent in the control $roup A *as

$iven at )anyin3iao D)/ E! @usanli D)8 BE! +ai$uan D8 E! )huidao D)8

"GE! uilai D)8 "KE! etc %ro( the ei$hth day to t*el%th day a%ter

operation 8he recovery ti(e o% urinary bladder %unction a%ter radical

hysterecto(y! urine dyna(ic inde:es and hospitali;ation days *ere

co(pared bet*een the t*o $roups R)UL8) 8he cases o% the bladder

%unction recovery! retention o% urine! urinary incontinence *ere

1D1SE! FDFSE! 0 on the 1F th day a%ter operation and BDBSE!

"D"SE! 0 on the "G th day in the A $roup! and "7D"7SE! "D"SE!

BDBSE on the 1F th day and FBDFBSE! 11D11SE! 1D1SE on the "Gth

day in the control $roup! respectively! *ith a very si$nicant di-erence

bet*een the t*o $roups D/ 001E9 the A $roup in residual urine

volu(e! bladder volu(e! (ean urinary 5o*in$ rate *as better than the

control $roup on the 1F th day a%ter operation D/ 001 or / 00E9 the

hospitali;ation days a%ter operation *as D"11 TS< BBE days in the A

$roup and D" TS< BE days in the control $roup! the %or(er bein$

shorter than the later D/ 001E C,NCLU)',N A can pro(ote recovery



o% bladder %unction! shorten the eepin$ ti(e o% urinary tube a%ter radical

hysterecto(y! *hich is benet to decreasin$ incidence rate o% urinary

syste( in%ection and shortenin$ hospitali;ation days

4cupuncture for oeractie )ladder a randomi/ed controlled

trial1 ((ons )L and ,tto L ,bstet ynecol "00910D1E1BG<FB

i$hty<ve *o(en *ere enrolled in this rando(i;ed! placebo<controlled

trial +o(en *ere rando(ly assi$ned to either receive an acupuncture

treat(ent e:pected to i(prove their bladder sy(pto(s! or a placebo

acupuncture treat(ent desi$ned to pro(ote rela:ation 8hey under*ent

cysto(etric testin$! co(pleted a B<day voidin$ diary! and co(pleted the

urinary distress inventory and incontinence i(pact 6uestionnaire!

validated 6uality<o%<li%e inventories! be%ore and a%ter F *eely

acupuncture treat(ents 8he pri(ary endpoint *as nu(ber o%

incontinent episodes over B days )econdary endpoints included voidin$

%re6uency and ur$ency! cysto(etric bladder capacity! (a:i(u( voided

volu(e! and the urinary distress inventory and incontinence i(pact

6uestionnaire sy(pto( scores R)UL8) )eventy<%our *o(en

co(pleted all aspects o% the study +o(en in both treat(ent and

placebo $roups had si$nicant decreases in nu(ber o% incontinent

episodes DK %or treat(ent! F0 %or placeboE *ithout a si$nicantdi-erence in the chan$e bet*een the $roups +o(en in the treat(ent

$roup had a 1F reduction in urinary %re6uency D/ I 01BE! a B0

reduction in the proportion o% voids associated *ith ur$ency D/ I 01E!

and a 1B increase in both (a:i(u( voided volu(e and (a:i(u(

cysto(etric capacity D/ I 01E .oth $roups also had an i(prove(ent in

the urinary distress inventory and incontinence i(pact 6uestionnaire

scores DF decrease %or treat(ent! B0 decrease %or placebo! / 001

%or the di-erence in chan$e bet*een the $roupsE C,NCLU)',N +o(en

*ho received F *eely bladder<specic acupuncture treat(ents had

si$nicant i(prove(ents in bladder capacity! ur$ency! %re6uency! and

6uality<o%<li%e scores as co(pared *ith *o(en *ho received placebo

acupuncture treat(ents

4cupuncture on clinical symptoms and urodynamic

measurements in spinal+cord+in6ured patients "it% detrusor

%yperre!e$ia1 Hon3o H et al Urol 'nt "0009DFE1K0< A total o% 1B

patients D11 (ales! " %e(alesE su-erin$ %ro( urinary incontinence due to

spinal cord in3uries *ere treated by acupuncture! *hich *as carried out



*ith disposable stainless steel needles inserted into the bilateral .L<BB

D@hon$liaoE points on the sin o% the third posterior sacral %ora(ina

Urodyna(ic studies *ere also per%or(ed be%ore acupuncture!

i((ediately a%ter the 1st acupuncture and 1 *ee a%ter the Fth

acupuncture 'n patients! these urodyna(ic studies *ere per%or(ed

a$ain 1 (onth a%ter the Fth acupuncture R)UL8) No side e-ects *ere

reco$ni;ed throu$hout the treat(ent period ,% the 1B patients!

incontinence disappeared in " D1E and decreased to 0 or less

co(pared to baseline in a %urther DFE Ma:i(u( cysto(etric bladder

capacity increased si$nicantly %ro( 7" TS< "B to 1FG1 TS< G1 (l 1

*ee a%ter the Fth acupuncture Dp 001E 'n the patients in *ho(

cysto(etry *as repeated 1 (onth a%ter the Fth acupuncture! bladder

capacity decreased %ro( 1G7 TS< K0F (l 1 *ee a%ter the Fth

acupuncture to 1"GB TS< KBF (l C,NCLU)',N 'n spinal cord in3ury

patients acupuncture could represent another valuable therapeutic

alternative to the treat(ent o% urinary incontinence caused by detrusor

hyperre5e:ia

Improement of urge+ and mi$ed+type incontinence after

acupuncture treatment among elderly "omen 7 a pilot

study1 .er$str( O! et al > Auton Nerv )yst "00097KD"<BE17B<G0 8he

ai( o% this study *as to investi$ate i% sensory sti(ulation in the %or( o%(anual acupuncture could in5uence ur$e< or (i:ed<type incontinence

a(on$ elderly *o(en *ho *ere not satis%actorily relieved by standard

phar(acolo$ical and non<phar(acolo$ical treat(ents $iven at a

speciali;ed incontinence unit 8he study is an open clinical %ollo*<up

study 8he study included 1 elderly *o(en *ho *ere treated *ith

(anual acupuncture 1" ti(es .oth sub3ective scorin$s and ob3ective

(easure(ents in the %or( o% leaa$e in $ra(s DFG h 'nco<testE *ere

used valuations *ere per%or(ed at dischar$e and 1 and B (onths

therea%ter Al(ost all outco(e (easure(ents *ere si$nicantly

i(proved even at %ollo*<up B (onths a%ter the last treat(ent lobal

scorin$s sho*ed that 1" o% the 1 *o(en considered the(selves

i(proved even at the %ollo*<up B (onth a%ter treat(ents *ere

co(pleted 8he possible (echanis(s o% action are discussed! as is the

*ay to per%or( (ore studies in this eld

4cupuncture for urinary incontinence in patients "it% c%ronic

spinal cord in6ury1 4 preliminary report1 Hon3o H et al Nippon

Hinyoia aai @asshi 1KKG9GKD7E<K A total o% G (ale chronic



spinal cord in3ured patients *ith urinary incontinence *ere treated by

acupuncture 8heir a$es ran$ed %ro( "0 to BB years D(ean "7E 8he level

o% lesion *as cervical in F and thoracic in F etrusor hyperre5e:ia *ith

uninhibited bladder contraction *as conr(ed by urodyna(ic studies in

all o% the( Acupuncture *as per%or(ed usin$ a disposable stainless

needle D0B (( in dia(eter! 0 (( in len$thE! *hich *as inserted into

bilateral .L<BB D@hon$liaoE points and *as rotated (anually %or 10

(inutes 8he treat(ent *as conducted every *ee %or F *ees

Urodyna(ic studies *ere repeated! i((ediately a%ter the be$innin$ o%

and a *ee a%ter the co(pletion o% the treat(ent Urinary sy(pto(s

*ere also checed be%ore and a%ter the treat(ent R)UL8) No side

e-ects *ere reco$ni;ed throu$hout the treat(ent period A(on$ G

patients! incontinence *as controlled co(pletely in B DBGE and partially

in B DBGE 8he avera$e (a:i(u( cysto(etric bladder capacity

increased si$nicantly! %ro( F"B TS< B7K (l to 1FG1 TS< 101" (l by

the treat(ent Dp 00E! *hile the avera$e (a:i(u( bladder pressure

*as not chan$ed C,NCLU)',N) 8hese data su$$est that acupuncture

could be a pro(isin$ alternative %or conventional therapies %or urinary

incontinence caused by detrusor hyperre5e:ia in patients *ith chronic

spinal cord in3uries

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Explicação Def Yin Yang Urinary Incontinence