抑郁癥合膀胱墜入陰道

初診：3.14.2016  女， 63歲， 體重：158lbs,

患抑郁癥，42年來，一直服用西藥和氨基酸“控制”。兩年前患膀胱墜入陰道，無法正常如廁，必須用手把膀胱從陰道托上去之後才能小便。醫生建議手術被拒絕。久之，又出現膀胱炎癥狀：每次小便很少，但十幾分鐘一次。以致無法正常工作。外出必須穿尿不濕。如此，加重精神抑郁癥狀。兩年前放棄任何抑郁藥物，只服用氨基酸類。無辜哭泣。曾作輸卵管結紮術和腰椎間盤切除術。每到下午後腰極度不適，需要坐下或躺下。花粉過敏證。燒心，難以深呼吸（氣下不去）。每夜必多次起來喝水。喜食辛辣。不能仰臥睡覺。有家族癌癥史，全家身上都有黴斑，認為是遺傳（這是典型的西醫結論）。雙膝極度難受，不良於行，需要帶護膝。

刻診：情緒緊張，極度敏感，易哭，神情痛苦，難寐，納可，便溏、身體各處布滿深褐色黴點、肝癍、黑斑、劍突凸出、桶狀胸，兩寸極弱，左尺沈弱。精力4級。飲多。清涕多。舌苔厚膩，裂痕。

此為肝氣抑郁，長期服用西藥，加劇體內陽虛，以致氣陷。

治則：柔肝提氣。 針灸j加中藥處方

3.22.2016 感到小便更勤、更難，大便糖稀、易怒頻繁。病人自稱：仍激動易哭，但感到深度壓抑減輕，易怒可能是以前壓抑的情緒在排出來，認為是身體在改善，所以，感到很舒服。

3.24.2016 體重158bls， 飛蚊癥消，視力好轉，黃帶消，燒心減輕，大便成形，下午腰痛減輕，

3.25.2016 血壓：130/69, 脈搏80. 睡眠稍好，尿出稍暢，

3.26 夜尿一次，尿量增加兩倍，仍需用手幫助小便。

3.29.2016 沒有夜尿，可不用手幫助小便。跑廁所次數減少70%。精力提高。仍感尿難

3.30.2016 必須要帶護膝了。面色佳，屁多，極臭，臀部起皰疹（排西藥毒），有需要用手幫助小便。

4.2. 諸癥回來：膀胱膨出，抑郁，關節痛，情緒低落，精力差，很緊張怕抑郁癥又回來。

4.5 諸癥消，血壓：133/79， 脈搏70次/分，膀胱回去了，沒有遺尿，一滴也沒有。陰部腫脹瘙癢消。乳下棗子大小的結節消。

4.8 陰天、小雨，但精力仍感覺達到6，頭爽。以前這是會很難過。

4.16  血壓：134/75， 脈搏：74，無夜尿，睡8小時，

4.17. 精力9級，神爽，血壓：114/70， 脈搏：70次/分，無夜尿，自動排尿。有信心再找工作了。暫停密集治療，改為保健治療。

Clinic visit: Mar 14, 2016, 63 years old female

Suffering Depression for 42 years. has taken Antidepressant for 40 years and quitted medication 2 years ago. At the same time diagnosed prolapsed bladder into Virgina, a suggestion of surgery rejected due to no insurance, urinary incontinence, wearing dipper year-round, unable to urinate normally, have to use hand to help to urinate. Frequent and less-quantity urinations, always feels like to cry. very nervous. Has family cancer history. Knee dislocation, need support by copper fit knee brace.  Lower back pain after Discectomy, Magnetic lumbar support belt would help., but still has uneasiness increased in the afternoon, have to sit down or lie down, poor sleep, thirsty and drank lot of water at night, 50 ounces, so frequent urination at 24/7, that unable to undertake work normally. 1985 Tubal ligation, 2001 discectomy on L3/4. 

Currently: nervous very sensitive, feel like to cry for no reason, gloomy, insomnia, dark mole over the body, low energy, self-graded 4. Running nose heavily, cracks in tongue. Bladder bulging from Virgina.

Impression: weak liver Qi and Qi stagnation in lungs.

Herbal therapy and acupuncture

This is a case of liver qi stagnation, exacerbated by long-term use of Western medicine, which worsened the body's yang deficiency, leading to qi sinking.

Treatment principle: Soothe the liver and boost qi. Acupuncture combined with a Chinese herbal prescription.

March 22, 2016: The patient experienced more frequent and difficult urination, loose stools, and frequent irritability. The patient stated that while still easily agitated and prone to crying, there was a reduction in deep repression. The irritability was attributed to the release of previously repressed emotions, which the patient interpreted as a sign of bodily improvement, hence the feeling of comfort.

March 24, 2016: Weight 158lbs. Floaters resolved, vision improved, jaundice subsided, heartburn lessened, stool formed, afternoon back pain lessened.

March 25, 2016: Blood pressure: 130/69, pulse 80. Sleep slightly better, urination slightly smoother.

March 26: Nocturia once, urine volume doubled, still need manual assistance to urinate.

March 29, 2016: No more nocturia, no need to manual assistance to urinate. Urinary trips reduced by 70%. Energy improved. Still experiencing difficulty urinating.

March 30, 2016: Knee braces necessary now. Complexion good, excessive flatulence, extremely smelly, herpes on buttocks (expelling toxins from Western medicine), need manual assistance to urinate sometimes.

4.2. Symptoms returned: cystocele, depression, joint pain, low mood, poor energy, and anxiety about a relapse of depression.

4.5. Symptoms subsided. Blood pressure: 133/79, pulse: 70 beats/min. The bladder returned to normal, with no urinary incontinence. Vaginal swelling and itching subsided. The nodule the size of a date under the breast disappeared.

4.8. Cloudy, light rain, but energy level still felt like 6, and the head felt refreshed. This used to be very distressing.

April 16th: Blood pressure: 134/75, pulse: 74, no nocturia, slept 8 hours.

April 17th: Energy level 9, feeling great, blood pressure: 114/70, pulse: 70 bpm, no nocturia, urinates spontaneously. Confident in finding another job. Temporarily suspending intensive treatment and switching to preventative care.