The Treatment of Modern Western - Biblio.nhat-nam.ru

8BENIGN PROSTATICHYPERTROPHYAlso called benign prostatic hyperplasia, this is a benign adenomatoushyperplasia of the periurethral prostate glandcommonly seen in men over 50 years of age. In fact, one outof four men will eventually require treatment for BPH atsome point in their life, and congestion and overgrowth ofthe prostate gland is virtually universal in men over the ageof 60. This hyperplasia causes variable degrees of bladderoutlet obstruction. Recent endocrine research has discoveredthat the male hormone dihydrotestosterone (DHT) isinvolved in the development of BPH, with levels of DHTincreasing with age. Bladder outlet obstruction symptomsinclude progressive urinary frequency, urgency, and nocturiadue to incomplete emptying and rapid refilling of the bladder.Hesitancy and intermittency with decreased size andforce of the urinary stream occur. Sensations of incompleteemptying, terminal dribbling, almost continuous overflowincontinence, and complete urinary retention may ensue.Episodes of acute complete urinary retention may followprolonged attempts to retain urine, immobolization, exposureto cold, anesthetic agents, anticholinergic and sympathomimeticdrugs, and ingestion of alcohol. Prolonged urinaryretention, whether partial or complete, may cause progressiverenal failure and azotemia.The Western medical diagnosis of BPH is based on the signsand symptoms and a rectal digital exam. Other tests includecatheterization after voiding to measure residual urine andcystoscopy to estimate gland size. When BPH is complicatedby secondary chronic bacterial prostatitis, antibiotics maybe used to treat bacterial infection. Catheter drainage,whether urethral or suprapubic, may be used to treat acuteurinary retention. Although new drugs (finasteride, Proscar)have shown some success in shrinking enlarged prostates, tillrecently, surgery (transurethral resection of the prostate) hasbeen the definitive treatment. There are approximately400,000 surgical operations each year in the U.S. for thiscondition. Though the prognosis after surgery is usuallyexcellent, 18% of men experience complications, such asinfection, bleeding, incontinence, and impotence.CHINESE DISEASE CATEGORIZATION: Benignprostratic hypertrophy falls under several different categoriesin Chinese medicine depending on each patient’s main clinicalsymptoms. Nocutria is called ye niao or ye niao zeng duozheng. Urinary obstruction is referred to as niao bi, urinaryimpediment, and long bi, dribbling urinary block. If there ismarked urinary urgency and polyuria, this is referred to as linzheng, strangury condition.DISEASE CAUSES: Aging, enduring disease, internaldamage by the seven affects, and unregulated eating anddrinkingDISEASE MECHANISMS: This condition is associatedwith three main disease mechanisms. First, there may bespleen and/or kidney vacuity. It is the qi which moves theexcess fluids outside the body as well as keeps righteous fluidsinside the body. Therefore, either spleen or kidney qivacuity may cause lack of force to discharge the urine and/orleakage and incontinence. Spleen and kidney vacuity in oldermiddle-aged and elderly patients are the result of a lifetimeaccumulation of damages and detriments. Secondly, theremay be something blocking the yin orifice. This may beeither or any combination of qi stagnation, blood stasis, orphlegm obstruction. And third, damp heat may cause urinaryurgency, frequency, burning, and pain.Because the lungs also play a role in water metabolism in thebody, there is one other disease mechanism which may playa part in this condition. If phlegm heat obstructs the diffusingand downbearing of the lungs, the lungs may lose controlover the water passageways. In that case, fluids will notflow to and be discharged from the bladder. This diseasemechanism helps explain why the symptoms of BPH often