Post Date December, 02 2023
There are no red blood cells or only occasional individual red blood cells in the urine of normal people. If the urine enters the blood and is centrifuged and precipitated, there are more than 2 red blood cells per high-power field of vision under the microscope, which is called hematuria.
What is blood in urine usually related to
Patients with hematuria accompanied by longer term frequent urination, urgency, and pain in urination are more likely to have renal tuberculosis; "Symptoms such as hematuria with swelling of the eyelids, face, or body, elevated blood pressure, and fever may be acute nephritis or kidney disease.";
If hematuria is accompanied by severe frequent urination, urgency, or pain in urination, most cases are acute cystitis; "Prostatitis is most common in patients who have poor urination, no pain in the urethral orifice, but light red urine visible to the naked eye, or microscopic traces of red blood cells.";
In patients with hematuria and low back pain, sometimes severe paroxysmal low back pain occurs - renal colic may be caused by kidney or ureteral stones;
Hematuria with no obvious symptoms and pain and over 40 years of age may have urinary system tumors, of which bladder cancer may not be ruled out;
If hematuria and low back pain are significantly related to posture and daily activities, if symptoms improve after bed rest and physical activity increases, there is a greater likelihood of nephroptosis; If hematuria is accompanied by bleeding from other parts of the body, it may be caused by a blood disease.
What is the reason for urinating blood? To sum up, it is the reason for urinating blood. Blood in urine is similar to but different from blood drench. If there is no pain during urination, it is blood in urine. If there is a slight pain during urination, it is blood drench. If there is pain, it is difficult to endure.
What methods can be used to identify hematuria
First, distinguish different types of hematuria based on the accompanying symptoms of hematuria. If hematuria is accompanied by frequent urination, urgency, or pain in urination, especially pain in urination, it is often caused by urinary tract infections, stones, etc., and is called painful hematuria; "If hematuria is not accompanied by painful urination, it is called painless hematuria, which is common in nephritis, renal tuberculosis, and urological tumors. Especially in older patients, macroscopic hematuria appears painless, and attention should be paid to conducting various examinations to exclude malignant lesions.".
Other systemic symptoms associated with hematuria can also be analyzed to distinguish the causes of hematuria. Currently, the examination of urine red blood cell morphology is used to determine the source of hematuria, with a coincidence rate of about 90%. The specific method is to take urine sediment after centrifugation, place it on a glass slide, and observe the morphology of red blood cells in urine using a phase contrast microscope. Glomerulogenic hematuria, in which the red blood cells in the urine are deformable red blood cells, that is, red blood cells present in various forms, such as doughnut like, strawberry like, water droplet like, and even broken red blood cells, suggesting that hematuria is caused by pathological changes in the glomerulus. In non glomerular hematuria, red blood cells in the urine are mostly in normal or approximately normal morphology.
In addition, gross hematuria should also be distinguished from hemoglobinuria. Hemoglobinuria is caused by hemolytic diseases, where the content of free hemoglobin in plasma increases, crossing the renal threshold, filtering through the glomerulus, and entering the urine. The color of hemoglobin urine can be red, brown, or even black. Differentiation from hematuria mainly relies on microscopic examination. The urine of hematuria contains a large number of red blood cells, while the urine of hemoglobin contains no red blood cells, which is the fundamental difference between the two.
Traditional Chinese medicine can treat hematuria
1. Wind evil invades the lung
Main syndrome: Urinary bleeding begins with fever due to bad wind, edema of the eyelids, accompanied by sore throat, cough, thin and white tongue coating, and floating or floating pulse.
Treatment principle: expelling wind, promoting lung function, clearing heat and stopping bleeding.
Prescription: Yue Mai Jia Shu Tang ("Synopsis of the Golden Chamber") plus or minus. In the prescription, Mahuang diffuses lung qi, emits sweat, and relieves external symptoms; Gypsum production, muscle relieving and heat clearing; Atractylodes macrocephala, licorice, ginger, jujube invigorate the spleen and dissipate dampness. Add honeysuckle and purified forsythia to clear heat and promote swallowing; Baimao root, raw rehmannia root, and artichoke root are used to clear heat, cool blood, and stop bleeding. Cough with white mulberry and light scutellaria. If the disease occurs during the midsummer heat, Yiyuan Powder can be added and Coptis chinensis can be used to clear the heat.
2. Heat knot bladder
Main symptoms: bloody urination, bright red blood color, aversion to cold and fever, frequent short and astringent urination, unpleasant dripping, less abdominal distension, thin and painful waist, red tongue and yellow fur, and pulse count.
Treatment: clearing heat and diuresis, cooling blood and stopping bleeding.
Prescription: Modified Bazheng Powder. Fang Zhong Bian Zhu, Qu Mai, Tong Cao (instead of the original Fang Mu Tong), plantain seed, talc, and licorice shoots can clear and relieve bladder heat nodules; Rhubarb relieves heat, reduces fire, dissipates blood stasis, and stops bleeding; Raw gardenia can clear heat and stop bleeding, and less wick ignition can be added from the urine. Internal heat can be added to anemarrhena, phellodendron, and gentian grass to clear and relieve the heat of the lower energizer.
"The amount of blood in urine can be increased by adding diyu charcoal, typha, lotus root nodes, and amber to cool the blood and stop bleeding without leaving blood stasis.". Reduce abdominal distension and pain, add black beard, golden bell, and cumin to regulate qi and relieve pain. Lumbar pain can be added with Eucommia ulmoides and Chuanduan to tonify the kidney and strengthen the waist. Frequent, short, astringent and painful urination can be added with viola, dandelion, and light bamboo leaves to clear away heat and diuresis. If there is severe pain in the waist and abdomen and there is sand and stone in the urine, it can be added with Lysimachia, Sea Gold Sand, and Chicken Inner Gold to clear and remove the stone.
3. Fire Poison Forces Blood
Main syndrome: At first, it is common to see aversion to cold and fever, followed by high fever and headache, aching joints, irritability, thirst, and preference for drinking, mental fatigue, fatigue, blood in urine, and bright red blood color. It can be accompanied by epistaxis, bloody stool, muscle bleeding, red tongue, yellow and greasy fur, and a number of pulse strings.
Treatment principle: purging fire and detoxifying, cooling blood and stopping bleeding.
Prescription: Modified Huanglian Jiedu Decoction. "In the recipe, scutellaria baicalensis can clear the fire of the upper energizer, coptis chinensis can clear the fire of the middle energizer, cypress can clear the fire of the lower energizer, and gardenia can clear the fire of the three energizers from the bladder.". It is an antidote to fire and poison. Hot and toxic, with a large amount of epistaxis, can be added to buffalo horn, raw rehmannia, powdered paeonia, red peony, and shicao to clear heat and detoxify; Cool the blood and stop bleeding.
Dry mouth and drinking can be paired with black ginseng, ophiopogon japonicus, and dendrobium to nourish yin and promote fluid production. "For those with deficiency of both qi and yin and fatigue of the spirit, it is recommended to add radix pseudostellariae, ophiopogon japonicus, and schisandra chinensis to replenish qi and nourish yin.". If the disease lasts for a long time with blood stasis and internal obstruction, if there are blood sticks in urine and urine, and if the urine dries poorly, it can be added with polyporus umbellatus, white fescue root, hedyotis diffusa, amber, etc. to clear heat, detoxify, cool blood, and stop bleeding; Add elephant fritillaria, mountain conch, prunella vulgaris, purple salvia miltiorrhiza, and dragon's blood to clear away heat and disperse nodules.
