Kidney qi not firm is the pattern name used when the holding and storing function attributed to the kidney is described as weakened, so that the things classical texts say should be retained are not retained.
The recorded features are: passing urine often and urgently; urine passed in small amounts; dribbling after the stream has finished; incontinence, or bed-wetting in a child; loss of urine on coughing, laughing or lifting; in men, seminal emission or ejaculation earlier than wanted; in women, a thin, watery vaginal discharge; together with a sore and weak lower back and knees, a sense of cold, tiredness, a pale tongue with a white coating and a deep, weak pulse. The classical texts attribute the picture to a weak constitution from birth, to ageing, to prolonged illness, and to exhaustion through overwork.
Two different kinds of loss are described under this one name and they do not share a cause: the leak that happens on effort is usually pelvic floor and sphincter mechanics, while the constant urge with a bladder that never feels empty is usually detrusor overactivity. The same list of symptoms also comes from urinary tract infection, an enlarged prostate with overflow, poorly controlled diabetes, diabetes insipidus, pregnancy and childbirth, pelvic surgery, neurological disease, and common medicines - diuretics, SGLT2 inhibitors, lithium, some antihypertensives and sedatives.
Where this library stops describing and says see someone now: new loss of bladder or bowel control together with severe back pain, numbness around the sitting area and the genitals, or weakness in the legs can be cauda equina syndrome and is an emergency; being unable to pass urine with a painful, distended lower abdomen is an emergency; fever with flank pain and vomiting suggests infection reaching the kidney; blood in the urine is assessed even when it stops by itself; passing large volumes of urine with thirst and losing weight is checked for diabetes. In a child, bed-wetting is usually not regarded as a problem before about five years of age.
Whether the approaches described as firming the kidney qi change any of these outcomes is not established.
肾气不固是古典术语，指与肾相关的封藏与固摄作用被描述为减弱，于是文献认为应当守住的东西守不住。
记载中的表现包括：小便频数而急、量少、尿后余沥；失禁，或小儿遗尿；咳嗽、大笑、用力时漏尿；男性遗精或早泄；女性带下清稀；伴腰膝酸软、畏寒、疲乏、舌淡苔白、脉沉弱。古典文献归因于禀赋不足、年老、久病，以及劳倦内伤。
同一个名字底下其实是两类不同的失守，原因并不相同：用力时漏尿多属盆底与括约肌的力学问题；而尿急却总觉得没尿净，多属膀胱逼尿肌过度活动。同样的表现也来自尿路感染、前列腺增生导致的充盈性溢出、血糖控制不佳、尿崩症、妊娠与分娩、盆腔手术、神经系统疾病，以及常见药物——利尿剂、SGLT2 抑制剂、锂盐、部分降压药与镇静药。
本库停止描述、转为要求就医的地方：新出现的大小便失控，若同时有剧烈背痛、会阴与外生殖器麻木、双腿无力，可能是马尾综合征，属急症；尿不出来伴下腹胀痛也属急症；发热、腰痛、呕吐提示感染累及肾脏；尿血即便自行停止也要评估；尿量很大伴口渴与体重下降要查血糖。小儿遗尿在五岁前通常不被当作异常。
所谓固摄肾气之法是否改变上述任一种结局，未被证实。
49 related entries.