Kidney qi insecurity pattern refers to the symptoms and signs caused by the deficiency of kidney qi, leading to the failure of its storage and consolidation functions, resulting in bladder incontinence and unsecured essence gate. It is often caused by factors such as aging or overstrain.

The main clinical manifestations include: frequent urination with clear urine, especially severe at night, dribbling after urination or incontinence, seminal emission, premature ejaculation, soreness and weakness in the lower back and knees, thin and clear leucorrhea in women, easy miscarriage, pale tongue with white coating, and deep, thin pulse.

Kidney qi insecurity pattern is commonly seen in diseases such as "seminal emission," "enuresis," "overstrain stranguria," "turbid urine," "leukorrhea," and "vaginal bleeding during pregnancy."

This syndrome should be differentiated from "kidney qi deficiency pattern" and "pattern of kidney failing to receive qi."

bubble_chart Differentiation and Treatment

The kidney qi insecurity pattern manifests differently across various diseases, each with distinct characteristics and treatment approaches.

1. For instance, in cases of seminal emission presenting with kidney qi insecurity pattern, symptoms such as frequent spermatorrhea, pale complexion, and mental fatigue are common. This is often due to early marriage in youth, excessive indulgence in desires, and kidney qi deficiency. As stated in "Zhengzhi Yaojue": "Excessive indulgence in desires leads to depletion of the lower origin, resulting in uncontrolled leakage." The treatment should focus on tonifying the kidney and astringing essence, with formulas such as Jisheng Secret Essence Pill (Jisheng Fang) and Megalosaurus Pill (Megalosaurus Pill) from "Yitong Fang".
2. In cases of enuresis with kidney qi insecurity pattern, symptoms include enuresis, clear and frequent urination, pale complexion, soreness and weakness in the lower back and legs, or delayed mental development. This is often due to congenital insufficiency, where kidney deficiency fails to control the water passages. The treatment should focus on warming the kidney and reinforcing astringency, with formulas such as Sangpiaoxiao Powder (Bencao Yanyi) combined with Gupao Decoction (Zabing Yuanliu Xizhu).
3. In cases of gonorrhea with kidney qi insecurity pattern, symptoms include persistent dribbling urination, intermittent episodes, and worsening with fatigue, often due to overindulgence in alcohol and desires or prolonged kidney qi deficiency. The treatment should focus on tonifying the kidney and reinforcing astringency, with formulas such as Dodder Seed Pill from "Shen's Life-Prolonging Book" and Pilose Antler Astringency Pill (Zabing Yuanliu Xizhu).
4. In cases of leukorrheal disease in women with kidney qi insecurity pattern, symptoms include white and thin leukorrhea, weak lower back and knees, pale complexion, delayed menstruation, or uterine cold infertility. The treatment should focus on tonifying the kidney and stopping discharge, with formulas such as Jingui Kidney Qi Pill (Jingui Yaolue) combined with Discharge-Ceasing Decoction (Discharge-Ceasing Decoction) from "Fuqingzhu Gynecology" (Fuqingzhu Gynecology). In cases of vaginal bleeding during pregnancy with kidney qi insecurity pattern, symptoms include persistent bleeding during pregnancy, pale color, soreness and weakness in the lower back, and mental fatigue. This is often due to excessive strain, kidney qi deficiency, and qi deficiency leading to uncontrolled bleeding. The treatment should focus on tonifying the kidney and qi, with formulas such as Qi-Tonifying and Bleeding-Stopping Decoction (Fuqingzhu Gynecology).

The occurrence of kidney qi insecurity pattern varies among individuals. For example, in children, it manifests as enuresis; in the elderly, as overstrain stranguria; in women, as leukorrhea or vaginal bleeding during pregnancy; and in men, as seminal emission or efflux diarrhea. Generally, it can be distinguished based on age characteristics.

In the disease mechanism evolution of kidney qi insecurity pattern, if it is not cured over time, or if the treatment is inappropriate, or if the regulation is improper, it may further develop into uncontrolled leakage, eventually leading to a critical state of collapse. Therefore, early diagnosis and treatment are essential.

bubble_chart Differentiation of Similar Patterns

1. Kidney qi deficiency pattern and kidney qi insecurity pattern: The disease causes of the two syndromes are similar, both belonging to kidney deficiency, but there are still certain differences. The causes of kidney qi insecurity pattern are mostly due to insufficient kidney qi in childhood, or congenital deficiency; or weakened kidney qi in old age; or prolonged illness leading to physical weakness; or early marriage and excessive indulgence in youth, or women having too many children, etc., which lead to insufficient kidney qi and loss of its sealing and consolidating functions. The essence gate is not firm, hence seminal emission and spermatorrhea; the kidney and bladder are internally and externally related, kidney deficiency leads to bladder incontinence, hence enuresis or frequent nocturia; kidney deficiency leads to insecurity of the thoroughfare and conception vessels, hence continuous leukorrhea, habitual abortion during pregnancy, etc. The pathological nature of kidney qi deficiency pattern is similar to that of kidney qi insecurity pattern, but the clinical manifestations of the latter focus more on the symptoms of an unsecured essence gate and bladder incontinence, while the former focuses more on general kidney deficiency symptoms such as dizziness, tinnitus, soreness and weakness of the waist and knees, deep pulse, white tongue coating, etc., which can be used for differentiation.
2. Pattern of kidney failing to receive qi and kidney qi insecurity pattern: Both syndromes belong to kidney qi deficiency pattern in nature, but the disease cause of pattern of kidney failing to receive qi is mostly due to a long history of cough and wheezing syndrome, repeated attacks, lung qi deficiency damage, "the lung being the dominator of qi, the kidney being the root of qi", prolonged lung deficiency affecting the kidney, the kidney losing its ability to receive and consolidate qi, and qi not returning to its root, with clinical manifestations characterized by wheezing and inability to lie flat, shortness of breath and weak respiration, inability to continue, especially worse with movement. The disease cause of kidney qi insecurity pattern is not from the lung to the kidney, but mostly due to congenital deficiency, or old age and kidney deficiency, or damage to kidney qi, with clinical manifestations characterized by an unsecured gate and symptoms of an unsecured vaginal orifice of a virgin. The two syndromes are not difficult to distinguish.

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bubble_chart Documentation

1. Renzhai Zhizhi Fang: "The kidney and bladder are both deficient, the internal qi is insufficient, hence the bladder naturally becomes slippery, the discharge is abundant and white in color, thus the yin deficiency worsens overnight."
2. Jingui Yi: "Although water is primarily governed by the kidney, the kidney ascends to the lung. If the lung qi lacks authority, then the kidney water ultimately cannot be retained."