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30.03.2014, admin
Hunner's ulcerations or glomerulations (mainly seen with hydrodistention), scarring; rule out cancerous lesions and other diseases. Practitioners of Chinese medicine who receive patient reports of characteristic symptoms, triggers of exacerbation, and accompanying syndromes, should refer the patient to a urologist for confirming diagnosis by manual and cytoscope exams as well as blood tests (see Table 1).
A possible scenario for cause of IC is an autoimmune response that develops in susceptible individuals as a result of an earlier infection, perhaps by bacterial strains that have become more prevalent in recent decades.
IC research has been hampered by the difficulty in defining the syndrome more precisely and by the difficulty of getting sufficient numbers of cases at one site where studies could then be conducted. Due to their limited satisfactory treatment options, patients with IC often seek out alternative therapies to find relief from their syndrome and hope for a possible cure. While Chinese medicine has a long history of application to numerous diseases, during recent decades, it has been applied to conditions never before experienced in its history. In the case of IC, the symptoms of urinary urgency, urinary frequency, and bladder pain are not different from those of some other bladder disorders, such as urinary tract infections. The severity of pain, and its persistence, in IC indicates to Chinese doctors that a blood stasis syndrome is involved.
The cytoscopic finding of hemorrhagic spots is consistent with a Chinese syndrome of blood stasis.
One cannot know if such considerations will result in successful therapy, but they can be a basis for applying traditional Chinese medicine principles and experience to the treatment of the new disorder. Chinese herb books that make reference to treatment of urinary bladder syndromes usually give special attention to a traditional formula of the Taiping Huimin Hejiju Fang (ca.
For abdominal pain due to blood stasis, commonly used herbs include: pteropus (weilingzhi) with typha (puhuang), myrrh (moyao) with frankincense (ruxiang), and corydalis (yanhusuo).

In proposing any formulation for IC, reference to commonly used treatments is helpful, and herbs may be included or excluded based on their applicability to the specific presentation of IC compared to the disorders treated by the other herbs.
These herbs could be provided in the form of decoction or dried decoction, with san-chi (sanqi; tien-chi ginseng) powder and succinum powder provided separately (these herbs are usually not decocted, and are instead given as powder or tableted powder). Her theoretical basis for the formulation, which is claimed to provide relief to many patients (significant improvement to just over half of them in an uncontrolled evaluation), is that IC occurs when the kidney qi is weak, hence the emphasis on kidney tonification therapy.
Perhaps to a greater extent than with herbs, acupuncture therapy is not specific to the disease being treated but is suited to treating the manifestations, which may be similar for different diseases. Training in acupuncture therapy includes learning of certain points that can treat pain in the lower abdomen, as well as selection of meridians for therapy aimed at alleviating bladder disorders. In a study of acupuncture and moxibustion for female urethral syndrome (3), the authors indicated that the basis of the disease being treated was persistent urinary tract infection that was resistant to treatment by antibiotics. For patients with damp heat syndrome, SP-9 (yinlinguqan) and KI-8 (jiaoxin) could be added to either group. Acupuncture was administered every other day, with ten treatments making a course of therapy, and patients were treated for one to two courses (hence, about 1-2 months total duration of treatment based on three treatments per week). As part of the study, the researchers evaluated the urination flow rate, intrabladder pressure, and urethral pressure.
In essence, the symptoms are alleviated because pressure in the bladder and urethra is reduced by an action of the acupuncture needles on blocking excessive nerve impulses. The two points of specific concern, BL-35 and BL-29, had been used previously by the authors to treat urinary disturbances that were complications of diabetes. Both huiyang and zhonglushu are acupoints of the bladder meridian of foot-taiyang located in the sacral region.

Their stratified anatomy is: skin, subcutaneous tissue, greatest gluteal muscle [gluteus maximus]. The author then gives a case example of urethral syndrome that seems consistent with IC, though it may simply present similar symptoms. In needling huiyang, oblique insertion of 3-4 cun was performed with the needle tip pointed toward the pubic symphysis, and in needling zhonglushu, oblique insertion of about 3 cun alongside the margin of the sacral bone was performed.
Thus, a course of 25 treatments was used (during a period of about two months) to resolve this disorder. A therapy developed in 1981 called sacral nerve root stimulation has been evaluated for treatment of interstitial cystitis (6, 7), and has been applied as a treatment for other lower abdominal disorders, including regulating bowel function and alleviating vulvadynia and vulvar vestibulitis (8), with positive results. The points CV-6 and GV-4 were treated by acupuncture and moxibustion, the other points were treated by acupuncture only, using the tonification procedure for manipulating the needles at all points. In a prior report, huiyang had been used as a single point for treatment of postpartum inhibited urination (5). The number of people affected by IC is unknown; it has been suggested that most cases still go undiagnosed, but there are about 100,000 diagnosed cases at any given time (precise statistics are not available), and it has been claimed that this may be only 20% of the actual cases.
Distal points are utilized to regulate overall circulation of qi and blood to affect the bladder region; in particular, SP-9 (yinlingquan) is needled to promote free urination.

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