QIAN LIE XIAN WAN BP078 Rubus, Rosa & Rehmannia Formula TCM ACTIONS ACTIONS OF THE MAIN HERBS Nourishes the Kidney Yin and enriches the Kidney Essence, activates the Blood and resolves stasis, clears Heat and relieves stranguria Rubus fruit is used orally in formulas for the treatment of impotence, spermatorrhea, premature ejaculation, urinary incontinence, frequent urination, and blurry vision. It has been shown to have an antibacterial and oestrogen-like action. TCM SYNDROMES Rosa fruit is used orally in formulas for the treatment of nocturnal seminal emission, leukorrhea, urinary frequency and diarrhoea. It has been shown to have antiviral, antibacterial, digestive stimulant and astringent actions. Kidney Yin deficiency Blood stasis Heat or Damp-Heat (residual) DOSAGE & COURSE OF TREATMENT INDICATIONS 8 - 12 pills, 3 times daily, half to one hour away from food. Benign prostatic hyperplasia (or benign prostatic hypertrophy), chronic prostatitis. In severe cases and in the early stages of treatment (first 1 – 3 weeks) the dosage may be increased by 50 - 100%. Course of treatment: 2 to 6 months. SIGNS & SYMPTOMS (key clinical features in bold) CAUTIONS & CONTRAINDICATIONS Urinary frequency, difficulty (delayed initiation), hesitancy (weak interrupted stream), urgency and pain Terminal dribbling None noted. COMBINATIONS Nocturia Benign prostatomegaly on digital examination The tongue is red and dry and may have speckles, macules or a purple hue and a scanty yellow coat The pulse may be thready, choppy and slightly rapid • With Qi deficiency: + Bu Zhong Yi Qi Wan (Ginseng & Astragalus Combination BP005) • With Kidney Yang deficiency: + Fu Gui Ba Wei Wan (Rehmannia Eight Formula BP011) • Urinary tract infection: + Ba Zheng San (Dianthus Combination BP040) + Si Miao Yong An Wan (Lonicera & Scrophularia Formula BP059) INGREDIENTS Each pill contains extract equiv. to dry: Rehmannia glutinosa, root (sheng/shu di huang) 93.8 mg Rubus chingii, fruit (fu pen zi) 46.9 mg Rosa laevigata, fruit (jin ying zi) 46.9 mg Paeonia veitchii, root (chi shao) 37.5 mg Salvia miltiorrhiza, root (dan shen) 37.5 mg Lindera strychnifolia, root (wu yao) 28.1 mg Curcuma zedoaria, rhiz. (e zhu) 28.1 mg Mentha haplocalyx, leaf (bo he ye) 28.1 mg Polygonum aviculare, herb (bian xu) 28.1 mg 1 BP078 QIAN LIE XIAN WAN CLINICAL GUIDE – Black Pearl® Pill Range www.sunherbal.com 4th Edition • Urolithiasis (kidney stones, bladder stones): + Yin Chen Hao Wan – Jia Wei (Artemisia & Rhubarb Combination BP065) COMMENTS QIAN LIE XIAN WAN BP078 This is a modern empirical formula that has been developed to treat benign prostatic hyperplasia (prostatic hypertrophy) as well as chronic non-bacterial prostatitis. Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland that generally restricts the flow of urine from the bladder. It is a common problem affecting the quality of life for approximately one third of men older than 50 years. Histologic evidence of benign prostatic hyperplasia occurs in up to 90% of men by age 80 years. Prostatitis is an infection or inflammation of the prostate gland that presents as several syndromes, with varying clinical features, the most common of which are acute bacterial prostatitis, chronic bacterial prostatitis, non-bacterial prostatitis, and prostatodynia. Patients with non-bacterial prostatitis have signs of prostatic inflammation but no signs of bacterial infection. Prostatodynia is characterized by clinical features consistent with prostatitis but without signs of prostatic inflammation; it is usually classified together with non-bacterial prostatitis. While prostatitis affects approximately 10% of men aged 20-74 years, it is most commonly chronic non-bacterial prostatitis or prostatodynia (90%). In TCM these conditions are categorised under stranguria syndrome (lin zheng). The specific types of stranguria that concern us here are turbid stranguria (gao lin), Blood stranguria (xue lin), Qi stranguria (qi lin) and strain stranguria (lao lin) – deficiency presentations only. Stranguria syndromes have three basic underlying causes: Damp-Heat in the Bladder, Liver constraint with stagnant Heat; and deficiency of the Spleen and Kidney. The first two lead to excess syndromes that manifest as acute disorders. Over time they may develop into deficiency syndromes, manifesting as chronic conditions. At this stage there is only a residual component of the original pathogen, i.e. Heat or Damp-Heat. Because prolonged retention of pathogens obstructs the movement of Qi and Blood – in addition to depleting the health Qi – chronic stranguria is generally complicated by the presence of Blood stasis. This formula targets Kidney Yin deficiency together with Blood stasis as the predominant disease mechanisms. In addition it clears any residual Heat or Damp-Heat from the lower Jiao, and facilitates the flow of urine. The presence of two astringing herbs helps to improve the bladder’s capacity to store urine, thus reducing urinary frequency. The synergistic actions of the ingredients are as follows: • Rehmannia root (sheng/shi di huang): (combined raw and prepared herb) nourish the Kidney and enrich Essence, nourish the Blood and replenish the Body Fluids, cool the Blood and clear Heat • Rubus fruit (fu pen zi); Rosa fruit (jin ying zi): astringe the lower Jiao to reduce urinary frequency • Rehmannia root (sheng di huang); Paeonia root (chi shao); Salvia root (dan shen); Polygonum herb (bian xu): clear Heat and cool the Blood • Paeonia root (chi shao); Salvia root (dan shen); Curcuma rhiz. (e zhu); Lindera root (wu yao): activate the Blood and dispel stasis to reduce prostate swelling and alleviate pain • Lindera root (wu yao); Mentha leaf (bo he ye): regulate the Qi • Lindera root (wu yao): guides the actions of the Qi and Blood regulating herbs to the lower Jiao • Polygonum herb (bian xu), Mentha leaf (bo he ye): clear Damp-Heat to alleviate stranguria 2 BP078 QIAN LIE XIAN WAN CLINICAL GUIDE – Black Pearl® Pill Range www.sunherbal.com 4th Edition