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Kidney deficiency is a term that many in the pharmacy industry are familiar with. Some customers come in and immediately say: "I feel like I have some kidney deficiency; what should I take to adjust?" How do we differentiate between kidney yang deficiency, kidney yin deficiency, kidney qi deficiency, and both kidney yin and yang deficiency? How should we advise customers?
First, clarify what "kidney deficiency" means.
In clinical expressions and literature, kidney deficiency often refers to kidney qi deficiency. According to various sources, the meaning of kidney qi deficiency is not entirely consistent. The TCM Terminology Approval Committee defines kidney qi deficiency as the deficiency of both kidney yin and kidney yang, which is also known as both kidney yin and yang deficiency. However, the "Encyclopedia of Traditional Chinese Medicine" states that since qi is yang, kidney qi deficiency is equivalent to kidney yang deficiency, also referred to as the decline of the fire of the life gate (mingmen huo).
Thus, when discussing "kidney qi deficiency" in clinical practice, it often has two meanings: one refers to both kidney yin and yang deficiency, and the other refers to kidney yang deficiency. The remaining term, "kidney yin deficiency," is the opposite of kidney yang deficiency.
Identifying symptoms before prescribing medication
1. **Kidney Yin Deficiency**: Nourish yin and reduce fire
- Symptoms: Dizziness, tinnitus, weakness in the lower back and knees, tidal fever, night sweats, and seminal emission, with tidal fever and night sweats as key distinguishing features;
- Chinese patent medicines: Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill), Zhi Bai Di Huang Wan (Anemarrhena and Phellodendron Pill), Qi Ju Di Huang Wan (Goji and Chrysanthemum Pill), Mai Wei Di Huang Wan (Ophiopogon and Rehmannia Pill), Zuo Gui Wan (Left Restore Pill), Er Zhi Wan (Two Ultimate Pill), Da Bu Yin Wan (Great Tonifying Yin Pill), etc.;
- Medication note: Patients with hypertension or diabetes should avoid Da Bu Yin Wan. Patients with spleen and stomach deficiency and cold should avoid Qi Ju Di Huang Wan.
2. **Kidney Yang Deficiency**: Warm and tonify kidney yang
- Symptoms: Coldness and weakness in the lower back and knees, aversion to cold, impotence, frequent night urination, and limb edema, with aversion to cold and frequent night urination as key distinguishing features;
- Chinese patent medicines: Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pill), Qiang Shen Pian (Strong Kidney Tablets), You Gui Wan (Right Restore Pill), Gui Fu Di Huang Wan (Cinnamon and Rehmannia Pill), Qi Wei Du Qi Wan (Seven Flavor Capital Qi Pill), Zhi Bao San Bian Wan (Precious Three Whip Pill), Wu Zi Yan Zong Wan (Five Seeds to Nourish Offspring Pill), Shen Xiong Wen Yang Jiao Nang (Ginseng and Heroic Warm Yang Capsules), Gui Lu Bu Shen Wan (Tortoise and Deer Kidney Tonifying Pill), etc.
3. **Both Kidney Yin and Yang Deficiency**
- Symptoms: Sometimes tidal fever and night sweats occur, while also being very sensitive to cold; sometimes yin deficiency leads to yang excess, and sometimes yang declines while yin is abundant, with the presence of symptoms of both kidney yin deficiency and kidney yang deficiency as key distinguishing features;
- Chinese patent medicines: Gui Lu Er Xian Gao (Tortoise and Deer Two Immortal Paste), Bu Pi Yi Shen Kou Fu Ye (Spleen and Kidney Nourishing Oral Liquid), Bu Shen Yi Nao Jiao Nang (Kidney and Brain Nourishing Capsules), Jia Rong Pian (Jia Rong Tablets), Li Bu Jin Qiu Jiao Nang (Li Bu Jin Qiu Capsules), Suo Quan Wan (Suo Quan Pill), Sheng Jing Pian (Semen Nourishing Tablets), Bu Shen Qiang Shen Pian (Kidney Strengthening Tablets), Shen Rong Wan (Ginseng and Deer Pill), Shen Rong San Bian Wan (Ginseng and Deer Three Whip Pill), Shen Lu Fu Zheng Jiao Nang (Ginseng and Deer Supporting Correct Capsules), Tian Qi Bu Shen Jiao Nang (Heavenly Qi Kidney Nourishing Capsules), Hai Ma Qiang Shen Wan (Seahorse Kidney Strengthening Pill), Suo Yang Bu Shen Jiao Nang (Suo Yang Kidney Nourishing Capsules), Shen Rong Bian Wan (Ginseng and Deer Whip Pill), Yao Tong Pian (Back Pain Tablets), Yang Chun Kou Fu Ye (Yang Chun Oral Liquid), Gui Lu Bu Shen Pian (Tortoise and Deer Kidney Tablets), etc.
- It is important to note: TCM theory holds that yin and yang support and complement each other; damage to yin affects yang, and damage to yang affects yin. Whether it is kidney yin deficiency or kidney yang deficiency, it can ultimately develop into both kidney yin and yang deficiency.
4. **Kidney Qi Deficiency**
- If kidney qi deficiency is identified as both kidney yin and yang deficiency, refer to the treatment methods for "both kidney yin and yang deficiency." If kidney qi deficiency is identified as kidney yang deficiency, refer to the treatment methods for "kidney yang deficiency."
5. **Kidney Deficiency**
- Semantically, kidney deficiency encompasses various types of kidney deficiency. However, if kidney deficiency is identified as kidney qi deficiency, refer to the treatment methods for "kidney qi deficiency."
Common misconceptions about kidney deficiency
Even if customers exhibit symptoms such as "weakness in the lower back and knees," "cold hands and feet," "frequent and urgent urination," "fatigue," "dizziness and tinnitus," or "spontaneous sweating and night sweats," it does not necessarily indicate kidney deficiency; it may be one of the following three situations:
1. **Lower Back Pain and Leg Pain**
- Distinguishing features: Kidney deficiency-related weakness in the lower back and knees generally accompanies other symptoms, such as cold limbs with kidney yang deficiency or tinnitus and night sweats with kidney yin deficiency. If it is purely lower back and leg pain, consider lumbar muscle strain and related lumbar diseases; pharmacy staff can suggest that customers seek further examination at a hospital.
2. **Dizziness and Tinnitus**
- Distinguishing features: Dizziness and tinnitus caused by kidney yin deficiency are due to insufficient kidney yin filling the ear orifices. In contrast, insufficient blood supply to the vertebrobasilar artery has a much more complex etiology, with both physiological and pathological factors potentially causing it, including dizziness caused by cervical spine diseases compressing the vertebral artery. The severity of symptoms between the two conditions is markedly different; if symptoms are severe, pharmacy staff should prioritize considering causes other than kidney deficiency and suggest that customers seek medical attention promptly.
3. **Frequent and Urgent Urination**
- Distinguishing features: Frequent and urgent urination due to kidney deficiency is often caused by kidney yang deficiency or kidney qi's inability to secure water and fluids, accompanied by symptoms such as cold limbs and aversion to cold. In contrast, urinary tract infections may present with reduced urine volume, painful urination, burning sensations, or even hematuria. Therefore, the volume of urine and accompanying symptoms are clear distinguishing points.
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Warm reminder: The various prescriptions and remedies mentioned in this article are for informational sharing only and do not constitute medical advice, recommendations, or guidance. If needed, please consult a professional doctor for differential diagnosis and treatment.
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