Guidelines for Integrated Traditional Chinese and Western Medicine Prevention and Treatment and Lifestyle Management of Chyluria and Acute Cystitis

159. Turbid Urine and Its Prevention and Treatment Turbid urine, also known as milky urine, is characterized by cloudy, white urine resembling milky chyle or swill, caused by chylous urine flowing into the urinary system. It is a common symptom of filariasis, primarily caused by *Filaria canis*. The main symptoms of turbid urine are: milky white urine, similar to milk or soy milk, sometimes containing chyle deposits; pink or dark red urine, caused by blood in the urine, characterized by fat droplets on the surface; and lymphuria, where the urine is clear, sometimes accompanied by transparent gelatinous substances in addition to surface fat droplets. It is often complicated by urinary tract infections, with symptoms of bladder irritation such as urinary frequency, urgency, and dysuria; chyle obstructing the urinary tract can lead to difficulty urinating, urinary retention, and renal colic. Systemic manifestations include weight loss, anemia, malnutrition, low-grade fever, cough, and lower back pain. Urine tests show red blood cells, white blood cells, protein, and fat, and the chyle test is positive. (1) Prevention of cloudy urine: The source of infection should be controlled. General surveys and treatments should be carried out in endemic areas; mosquito prevention and control work should be actively carried out to eliminate the transmission vector. During the attack, bed rest should be taken, sexual activity should be restrained, water should be drunk more, the intake of fat and oily foods should be limited, and alcohol and spicy and irritating foods should be avoided. During the remission period, attention should be paid to reasonable diet and care, avoiding overwork, regulating emotions, restraining sexual activity, and avoiding spicy and irritating foods. (2) Comprehensive treatment of cloudy urine: ① Western medicine treatment: ● Ethylamine sulfadiazine (Hydroxyfenozide), 200 mg each time, 3 times a day, orally, 7 days is one course of treatment, and generally 3 courses of treatment are taken; 1 to 1.5 grams can also be taken at once, continuously for 2 to 3 days. It is not suitable for women with active pulmonary tuberculosis, severe heart, liver and kidney disease, acute infectious diseases and menstruation. ● Furazolidone, 20 mg per kilogram of body weight per day, 3 times a day, orally, 7 days is one course of treatment. ② Traditional Chinese Medicine Treatment: ● Modified Buzhong Yiqi Decoction, suitable for spleen deficiency and qi sinking syndrome. Formula: Astragalus membranaceus 20g, Atractylodes macrocephala 15g, Ginseng 10g, Cimicifuga foetida 6g, Bupleurum chinense 6g, Angelica sinensis 15g, Poria cocos 15g, Nelumbo nucifera 10g, Euryale ferox 10g, Lindera strychnifolia 10g, Citrus reticulata 10g, Glycyrrhiza uralensis 6g. ● Modified Zhibai Dihuang Decoction, suitable for kidney yin deficiency syndrome. Formula: Rehmannia glutinosa (raw and prepared) 15g each, Cornus officinalis 12g, Dioscorea opposita 12g, Alisma plantago-aquatica 10g, Poria cocos 10g, Paeonia suffruticosa 10g, Anemarrhena asphodeloides 10g, Phellodendron chinense 6g, Lycium barbarum 12g, Ligustrum lucidum 10g, Euryale ferox 10g, Nelumbo nucifera 10g, Glycyrrhiza uralensis 6g. ● Modified Yougui Wan, suitable for kidney yang deficiency syndrome. Prescription 1: Prepared Rehmannia Root 15g, Cornus Fruit 12g, Dioscorea Rhizome 12g, Eucommia Bark 12g, Lycium Fruit 12g, Cuscuta Seed 10g, Angelica Root 12g, Alpinia Oxyphylla Seed 10g, Euryale Seed 10g, Astragalus Seed 10g, Prepared Licorice Root 6g, Astragalus Root 15g. ● Hawthorn Honey Paste: Grind hawthorn into powder. Take 30g of hawthorn powder, add 200-300ml of water, simmer over low heat until it becomes a paste, add 30g of raw honey, and take it all at once, 2-3 times daily. Suitable for various weakness syndromes related to chyluria. ● Chyluria Decoction (Kidney Yin Deficiency Syndrome): Glycyrrhiza Fruit 10g, Lygodium Spores 15g, Pyrrosia Rhizome 15g, Polygonum aviculare and Phellodendron Bark 12g each, Safflower 10g, Poria 10g, Rehmannia Root 10g, Ligustrum Fruit 10g. ● Lotus Seed Decoction (for Qi and Blood Deficiency): Lotus seed 12g, Poria 15g, Plantago seed 15g, Alisma rhizome 10g, Dioscorea rhizome 10g, Rehmannia root (charred) 10g, Angelica sinensis 15g, Donkey-hide gelatin pearls 10g, Typha pollen (charred) 10g, Licorice root 6g. ● Cuscuta Seed Decoction (for Kidney Deficiency): Cuscuta seed (fried) 10g, Mantis egg case 10g, Tortoise shell 30g, Deer antler gelatin 12g, Daylily flower 30g, Codonopsis root 12g, Poria 18g, Licorice root 10g, Angelica sinensis root 10g, Calcined clam powder 30g, Tangerine peel 6g. ③ Acupuncture Treatment: ● Select Guanyuan (CV4), Qihai (CV6), Zusanli (ST36), Shenshu (BL23), and Pangguanshu (BL28). Use tonifying needling technique, retain needles for 30 minutes, and add moxibustion, once daily. ● Ear acupuncture block: Select Kidney, Bladder, Subcortex, and Shenmen (HT7) acupoints. Mix vitamin B₁ and vitamin B₁₂ injection solutions and inject 0.1 ml subcutaneously into each acupoint. ④ Surgical treatment: Depending on the condition, appropriate procedures such as renal pelvis irrigation, electrocoagulation, renal pedicle lymphatic ligation, and lymphatic/venous shunt surgery may be performed.

Clinical Manifestations and Prevention of Acute Cystitis Acute cystitis is an acute infection caused by bacteria invading the bladder. It is often secondary to other diseases, such as acute prostatitis, benign prostatic hyperplasia, kidney infection, stones, urethral stricture, etc. (1) Clinical Manifestations: Burning sensation in the urethra during urination; severe urinary frequency, urgency, and dysuria; hematuria, pyuria, and urge incontinence may occur; tenderness in the bladder area, increased white blood cells in the urine, and red blood cells may be present. (2) Prevention and Treatment Plan: ① Western Medicine Treatment: ● Ciprofloxacin, 0.4g each time, twice a day, orally; or ofloxacin, 0.2g each time, twice a day, orally. ● Penicillin 8 million units added to 250 ml of 10% glucose injection, intravenous drip, for 7 consecutive days. ② Traditional Chinese Medicine Formula: ● Modified Xiaoji Yinzi, suitable for heat injury to blood vessels syndrome. Prescriptions: 25g Rehmannia glutinosa, 15g Cirsium japonicum, 12g Talcum, 10g stir-fried Typha orientalis pollen, 10g Nelumbo nucifera rhizome, 6g Lophatherum gracile, 10g Angelica sinensis, 20g Imperata cylindrica root, 10g Rubia cordifolia, 10g stir-fried Gardenia jasminoides, 6g Tetrapanax papyriferus, 6g Glycyrrhiza uralensis. ●A modified version of Chenxiang San combined with Chaihu Shugan San, suitable for liver qi stagnation syndrome. ●Huhuang Daochi Tang, suitable for bladder damp-heat syndrome: 15g Polygonum cuspidatum, 20g Taraxacum mongolicum, 6g Lophatherum gracile, 6g Akebia quinata, 15g Rehmannia glutinosa, 6g Glycyrrhiza uralensis. ③Single-herb prescriptions: ●20g Polygonum cuspidatum and Litchi chinensis, decocted in water. ●20g Taraxacum mongolicum, 20g Plantago asiatica, 10g Commelina communis, decocted in water. ●20g Eclipta prostrata, 15g Gardenia jasminoides, 15g Talcum, 20g Imperata cylindrica root. ④Acupuncture treatment: ●Select Jingmen, Shenshu, and Sanyinjiao acupoints. Use the reducing method for acupuncture, and retain the needles for 20-30 minutes. ● Ear acupuncture points: Kidney, Sympathetic, Shenmen, Bladder. (3) Preventive measures: ① Pay attention to regulating emotions and eliminating various external pathogens and factors related to internal damp-heat. ② After contracting this disease, pay attention to rest, drink plenty of water, eat a light diet, avoid greasy, spicy and other irritating foods, and abstain from sexual activity.