Chronic Urinary Discomfort Due to Damp-Heat in the Lower Jiao: Effective Treatment with Zhibai Dihuang Pills

In this clinical case study, we explore the successful treatment of a 72-year-old female patient suffering from recurrent lower urinary tract discomfort, diagnosed in Traditional Chinese Medicine (TCM) as "Labor Dysuria" caused by downward infiltration of damp-heat. After a targeted 14-day course of Zhibai Dihuang Pills—a well-known herbal formula—the patient experienced complete symptom resolution and full recovery confirmed by follow-up examination. This article highlights the diagnostic process, integrative treatment approach, and lifestyle guidance that contributed to a positive outcome.

Patient Overview

Gender: FemaleAge: 72 years oldDiagnosis: Labor Dysuria – Damp-Heat Accumulation in the Lower Jiao (TCM); Recurrent Lower Urinary Tract Infection (Western Medicine)Hospital: The First Affiliated Hospital of Anhui Medical UniversityDate of Consultation: May 2022Treatment Plan: Oral administration of Zhibai Dihuang PillsTreatment Duration: 14 days at home, followed by outpatient follow-up visitOutcome: Complete remission of symptoms; no abnormalities detected upon re-evaluation

Initial Clinical Assessment

The patient presented with a history of recurrent lower urinary tract infections. Seven days prior to consultation, she began experiencing classic symptoms including frequent urination, urgency, and dysuria—initially dismissing them as fatigue-related. However, as her condition worsened over several days, significantly affecting her daily life, she sought medical attention.

Upon physical examination, key TCM indicators were observed: a dark-red tongue with slightly yellow and greasy coating, and a deep, fine, slightly slippery pulse—classic signs pointing toward internal heat and dampness. A urine test confirmed elevated white blood cells, supporting the diagnosis of an active infection. Based on both Western clinical findings and TCM pattern differentiation, the condition was identified as "Labor Dysuria due to Damp-Heat descending into the lower jiao"—a common syndrome among elderly women linked to declining immunity and hormonal changes.

Therapeutic Approach and Rationale

After explaining the diagnosis to the patient and her family, reassurance was provided regarding the manageable nature of the condition. Considering her age, overall health status, and symptom profile, a conservative yet effective treatment plan was chosen: oral therapy using Zhibai Dihuang Pills, a time-tested TCM formulation known for its ability to nourish yin and clear deficient fire.

Key Ingredients and Mechanism of Action

This herbal compound contains eight primary ingredients:

• Rehmannia glutinosa (Shu Di Huang) – Nourishes kidney yin and enriches essence
• Phellodendron amurense (Huang Bai) – Clears heat and dries dampness
• Anemarrhena asphodeloides (Zhi Mu) – Moistens dryness and reduces virtual heat
• Cornus officinalis (Shan Zhu Yu) – Tonifies liver and kidney
• Dioscorea opposita (Shan Yao) – Strengthens spleen and supports qi
• Paeonia suffruticosa (Mu Dan Pi) – Cools blood and resolves stagnation
• Poria cocos (Fu Ling) – Promotes diuresis and resolves dampness
• Alisma plantago-aquatica (Ze Xie) – Drains dampness and clears bladder heat

Together, these components work synergistically to clear heat, eliminate dampness, and restore balance in the genitourinary system—making it particularly effective for cases involving chronic or recurring urinary discomfort rooted in yin deficiency with heat accumulation.

The patient was instructed to take the medication twice daily for 14 days, with strict adherence to dosage guidelines. She was also advised to return immediately if symptoms escalated or new issues arose.

Follow-Up and Clinical Outcomes

At the 14-day follow-up appointment, the patient reported significant improvement starting around day 8, with marked reduction in urinary frequency, urgency, and pain. By day 12, all symptoms had completely resolved. Her energy levels and general well-being improved dramatically.

Physical examination revealed a normalized tongue appearance and pulse pattern. Urinalysis showed no presence of white blood cells or other abnormalities, confirming full recovery. Both the patient and her family expressed high satisfaction with the non-invasive, drug-free-of-side-effects approach and the rapid resolution of long-standing discomfort.

Patient Care Recommendations

On the evening following her initial visit, I conducted a follow-up phone call to reinforce care instructions and provide emotional support. Key recommendations included:

1. Dietary Modifications

Maintain a light, easily digestible diet rich in nutrients. Avoid spicy, fried, greasy, and overly processed foods, which can exacerbate internal heat and dampness. Increase fluid intake—especially water and mild herbal teas—to promote natural detoxification and healthy urinary flow.

2. Medication Adherence

Take the prescribed herbal medicine exactly as directed—timing and dosage are crucial for optimal absorption and efficacy. Do not stop or adjust the treatment without consulting a qualified practitioner.

3. Personal Hygiene Practices

Practice good genital hygiene by washing regularly and changing undergarments daily. Wear breathable cotton underwear and avoid tight-fitting clothing to reduce moisture buildup and prevent secondary bacterial growth.

Clinical Insights and Preventive Perspective

This case underscores the importance of early intervention in older adults, especially postmenopausal women who are more susceptible to urinary imbalances due to physiological changes such as reduced estrogen levels and weakened pelvic floor muscles. These factors contribute to decreased urethral resistance and increased vulnerability to infections and inflammatory conditions.

Labor Dysuria, while often overlooked in conventional settings, represents a clinically relevant TCM diagnosis that captures the subtleties of chronic, relapsing urinary symptoms not always fully explained by standard microbiological tests. Integrating TCM pattern recognition with modern diagnostics allows for a more personalized and holistic treatment strategy.

For individuals experiencing recurrent urinary discomfort—especially when culture results are inconclusive—herbal therapies like Zhibai Dihuang Pills offer a promising alternative or complementary option. With proper diagnosis, individualized care, and lifestyle adjustments, many patients can achieve lasting relief without reliance on repeated antibiotic use.