Objective To trace the history of TCM,its concept and the evaluate its role in the management of renal stones.Methods References were retrieved following a thorough bibliographic search using OVID Medline,EMBASE,Cochrane Database.Keywords used included ‘traditional chinese medicine’,‘urolithiasis’,‘calculi’,‘herbal medicine’,‘kampo’,‘kidney’.Relevant review articles,case reports,books were considered along with resources from the Wellcome Trust Collection,Royal Society of Medicine,London.Results TCM has been in existence for over 2500 years.It broadly consist of acupuncture,herbal medicine,tuina (massage) and qi gong.The earliest documentation of Chinese herbal medicaments is in the ‘Shen Nung Benchau Jing’,believed to be compiled during the Han Dynasty.Historically,it had an extensive role in treatment of chronic diseases,and has been widely used in China and Japan (known as Kampo) for 10 decades,until the introduction of Western medicine in the late 1800s.TCM is popular within urology,including herbal ‘ginseng’ for the treatment of erectile dysfunction,acupuncture and herbal therapy for overactive bladder and renal stones.In TCM,dysfunction of Qi in the bladder causes damp-heat to diffuse downward and accumulate in the urinary system,over time causing calculus formation.Urolithiasis causing obstruction is believed to block the flow of Qi and therefore result in pain.Haematuria is attributed to the calculus injuries to the meridian.Currently,there is limited but growing evidence based literature on the role TCM in the prevention and treatment of stones.The Chinese State Medicine Administration Bureau issued guidelines in 1994 for management of urolithasis.It categorized it into four syndromes,each with different modes of treatment (Damp heat retention syndrome,qi-stagnation blood stasis syndrome,kidney ying deficiency syndrome and kidney yang deficiency syndrome).Recent evidence showed that medicinal herbs are known to effectively increase the rate of calculus passage,decreased the complications of urolithasis,which indirectly reduces hospitalisation and cost.Conclusion From its primitive roots in China,TCM now has a global influence,and we need to recognise the complementary role it plays in urological practice.%目的 追溯中国传统医学的核心理念及其历史,评估其在治疗肾结石方面扮演的重要角色.方法 从以下几个数据库搜集相关所有文献资料:OVID Medline,EMBASE,Cochrane数据库.关键词包括“中国传统医学”、“尿石症”、“结石”、“中药”、“汉方医学”、“肾”.查找到的相关综述、病例报告和书籍均来源于英国伦敦皇家医学会的惠康基金会藏书资源.结果 中国传统医学已经存在了2500多年.它由针灸学、中药学、推拿学和气功学组成.现存最早的中药学专著是《神农本草经》,约成书于汉代.纵观中国历史,在治疗慢性病方面,本书扮演了极重要的角色,且在中国和日本(即“汉方医学”)广泛应用了数十年,直到18世纪后期西方医学的引入.中国传统医学在泌尿外科学方面广受欢迎,包括用中药“人参”治疗勃起功能障碍,用针灸和中药联合治疗膀胱过度活动症和肾结石.在中国传统医学的观点中,膀胱气化失调引起了湿热向下扩散并累积到泌尿系统,日积月累引起了结石形成.尿石症阻滞了气的流动,引起了疼痛.而血尿源于结石对经络系统的损伤.目前,中国传统医学在预防和治疗肾结石方面的文献证据虽说有限,但日益增长.1994年,中国国家医药管理局就治疗尿石症发布了指南,指南将尿石症分型为4种(湿热蕴结型,气滞血瘀型,肾阴不足型和肾阳不足型),每种症状的治疗方式都不同.近年来的证据表明中医药能有效增加结石排出率,减少尿石症的并发症形成,这些能间接减少住院时间及花销.结论 中国传统医学的根源来自于中国传统文化,现在逐渐有了世界范围内的影响力,我们要认可其在泌尿外科学临床实践过程中起到的重要补充作用.
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