Professor Liu Youfang's Empirical Formula "Huayu Niaoshi Tang" for Kidney Stones Using the Method of Activating Blood and Resolving Stasis

Professor Liu Youfang (1927- ) was a renowned Chinese clinician in integrated Chinese-Western urology and a founder of the specialty. He graduated from the Medical School of Shandong University in 1952, originally trained in Western medicine, and later turned to integrated Chinese-Western research. From 1962 he worked at the Guang'anmen Hospital of the China Academy of Chinese Medical Sciences; he served as director of urology at Guang'anmen Hospital from 1973 to 1994, and in 1995 led the founding of the Urology Professional Committee of the Chinese Association of Integrative Medicine, serving as its chairman. Professor Liu had rich clinical experience and made many achievements in urology.

In operating on kidney-stone patients, he found that larger stones that had resided for a long time were surrounded by edematous tissue with inflammatory fibrous scarring and sclerosis, which bound the stone in place and made it hard to move. For such patients, the traditional TCM treatment principle of promoting urination and draining stones was difficult to use to expel the stone; worse, because diuretic formulas were used, the patient's hydronephrosis was worsened and renal function damaged.

He therefore proposed that such stone patients should be treated by activating blood and resolving stasis, combined with an appropriate amount of diuretic stone-draining herbs. Following this line of thinking he created Huayu Niaoshi Tang (Stasis-Resolving Urinary-Stone Decoction), composed as follows: Sanleng (Sparganium) 9 g, Ezhu (Curcuma zedoaria) 9 g, Zaojiaoci (Gleditsia spine) 9 g, Ruxiang (Olibanum) 6 g, Moyao (Myrrh) 6 g, Chishao (Paeonia rubra) 15 g, Niuxi (Achyranthes) 12 g, Baizhi (Angelica dahurica) 12 g, Qingpi (Citrus reticulata peel) 12 g, Yiyiren (Coix) 20 g, Zhiqiao (bitter orange) 12 g, Houpo (Magnolia bark) 12 g, Cheqiancao (Plantago) 20 g, Jinqiancao (Lysimachia) 20 g.

Professor Liu Youfang's Huayu Niaoshi Tang mainly treats kidney stones of the qi-stagnation and blood-stasis pattern, presenting with lower-back distending pain or dull pain in the lower back and abdomen, blood clots in the urine or dark-red urine, and difficult urination. The tongue coating is normal or dark red with stasis spots, and the pulse is deep-wiry or wiry-tight. Professor Liu used Huayu Niaoshi Tang to loosen the scar tissue around the stone so as to facilitate downward movement and expulsion of the stone, markedly raising the stone-expulsion rate and achieving good clinical results.

Later, under the active advocacy and support of Health Minister Qian Xinzhong, Professor Liu Youfang promoted this treatment approach and empirical formula nationwide through academic reports and papers. In September 1976 a national training class on integrated Chinese-Western prevention and treatment of urinary stones was even held in Beijing; through it he spread the method to urologists in more than ten provinces and cities nationwide, attracting wide attention. This treatment approach and method then became popular nationwide, and urology departments in many places conducted research on this basis, achieving good academic results.

Professor Liu Youfang's formula-design approach is a typical example of drawing on Western medical technology and pathological knowledge to improve TCM pattern differentiation and treatment. Traditional TCM holds that "prolonged illness necessarily involves stasis," so in treating chronic diseases with a long course, the blood-activating and stasis-resolving method is often used moderately. Professor Liu's idea in creating Huayu Niaoshi Tang is also consistent with this traditional TCM concept.

By analogy, we should realize that gallstones present the same problem: simple diuretic stone-expelling drugs will not work well for any long-standing, larger stones. One should follow Professor Liu's approach to formula design and add a sufficient amount of blood-activating and stasis-resolving herbs.

In Professor Liu's formula, Sanleng, Ezhu, Ruxiang, Moyao, Zaojiaoci, Chishao and Niuxi are all blood-activating stasis-resolving herbs, so the stasis-resolving strength of his formula is considerable. Jinqiancao and Cheqiancao are traditional TCM diuretic stone-draining herbs, used in not large amounts; but aided by the full dose of blood-activating herbs, the effect is remarkable.

The author himself has also combined the patent medicine Yaotongning Jiaonang (Lumbar-Pain-Relaxing Capsule) with Paishi Chongji (Stone-Expelling Granules) to treat kidney-stone patients; the effect was indeed better than using Paishi Chongji alone. Yaotongning Jiaonang is a typical blood-activating stasis-resolving formula, and this treatment idea coincides with Professor Liu's approach; although the drugs differ, because the treatment principle is the same, it also takes effect quickly.

Thus it can be seen that whether based on the traditional TCM idea that "prolonged illness necessarily involves stasis" or on modern medical pathology, for such "blood-stasis" syndromes caused by chronic illness, the method of activating blood and resolving stasis is the key to treatment.