Treating Male Breast Hyperplasia from the Perspective of Kidney Deficiency
Male breast hyperplasia falls under the TCM category of “Rubi” (breast nodules). Recently, its incidence has increased among males, especially middle-aged and older individuals. At this age, kidney essence gradually declines, qi and blood become deficient, often existing in a physiological state of kidney deficiency. With modern lifestyles accelerating work pace and intensifying competition, mental exhaustion, irregular diet, and disordered living habits damage organ functions. Over time, this affects the kidneys, depleting kidney essence and accelerating kidney deficiency. This disrupts the kidney’s functions of storing essence and regulating water metabolism and qi transformation, failing to nourish the liver and warm the spleen. Consequently, the liver loses its ability to regulate, the spleen fails to transport properly, dampness and turbidity accumulate internally, form phlegm, and combine with qi stagnation and blood stasis. Phlegm and stasis bind together, obstructing the breast channels and forming nodules—known as Rubi. The fundamental pathology is deficiency of righteous qi with lingering pathogenic factors. Phlegm-dampness, stasis-turbidity, and liver stagnation are merely surface manifestations; the core issue is kidney qi deficiency and lack of essence-blood. As Yu Tinghong stated in *Collected Cases of Surgical Medicine*: “Though breast nodules are said to originate from liver disease, the true source lies in the kidneys.” Thus, treating from the perspective of kidney deficiency yields good results.
1. Nourish Liver and Kidney, Tonify Yin and Essence
Damage to kidney qi leads to deficiency of essence and blood, disrupting mutual nourishment between liver and kidney, and inadequate Chong and Ren meridians. Common symptoms include dull breast lump pain, dry mouth and throat, soreness and weakness in waist and knees, irritability, forgetfulness, hot palms and soles, vague pain and distension in flanks, dizziness, tinnitus, dry eyes, red tongue with little coating, and fine rapid pulse. Treatment should nourish liver and kidney, with adjunctive liver-soothing and channel-opening herbs. Formula: Erzhi Wan or Zhibai Dihuang Tang with modifications. Ingredients: raw rehmannia, anemarrhena, phellodendron, cornus, ligustrum, echinacea, tortoise shell, poria, alisma, moutan, salvia, zhebei, curcuma, white peony, corydalis, prepared polygonum.
2. Strengthen Spleen and Kidney, Tonify Qi and Blood
Irregular lifestyle and poor diet damage both spleen and kidney, leading to deficiency in both congenital and acquired sources. This results in inadequate Chong and Ren meridians, qi and blood deficiency, impaired water metabolism, internal accumulation of phlegm-dampness, and obstruction of breast channels. Symptoms include breast lumps with pain or no pain, fatigue, poor appetite, nausea, abdominal distension, soreness and weakness in waist and knees, cold limbs, loose stools, breast distension and pain after exertion, or pain radiating to shoulders and back, pale tongue with thin white coating, pale tongue, deep string or slippery pulse. Syndrome: spleen-kidney yang deficiency. Treatment: regulate and tonify spleen and kidney, balance Chong and Ren meridians. Formula: Yougui Wan combined with Lu Jiao Jiao Wan with modifications. Common ingredients: lycium, rehmannia, deer antler gelatin, dodder seed, eucommia, cinnamon, cornus, yam, astragalus, tai zi shen, white peony, angelica, curcuma, chinquapin, corydalis.
3. Tonify Kidney Qi, Resolve Liver Stagnation
Accelerated lifestyle and intense competition lead to kidney damage from overwork and liver stagnation from emotional distress. Liver stagnation causes qi stagnation, injuring both liver and spleen, resulting in internal accumulation of phlegm-dampness and disruption of Chong and Ren meridians. Symptoms include breast distension and pain with movable lumps, flank pain and belching, weakness in waist and knees, or premature ejaculation, insomnia, nightmares, irritability or depression, loose or constipated stools, thin yellow or white tongue coating, string or slippery fine pulse. Syndrome: liver stagnation with kidney deficiency. Treatment: soothe liver and tonify kidney. Formula: Erzhi Wan, Liuwei Dihuang Tang combined with Chaihu Shugan San with modifications. Ingredients: ligustrum, echinacea, cornus, rehmannia, moutan, poria, alisma, cyperus, curcuma, bupleurum, chinquapin, zhebei, pangolin scale.
4. Tonify Kidney Qi, Expel Phlegm-Dampness
Excessive fatigue, inadequate postnatal nourishment, or indulgence in sex and alcohol damage the kidneys over time, impairing kidney qi, disrupting Chong and Ren meridians, causing qi stagnation, phlegm-dampness obstruction, and upward flow along the meridians to the breasts, causing this condition. Symptoms include breast distension and pain with lumps, possibly resembling beads, painful upon pressure, chest tightness, shortness of breath, heavy head, tinnitus, dizziness, nausea, poor appetite, fatigue, impotence, premature ejaculation, uncomfortable bowel movements, dry mouth and throat, but unable to drink much. Tongue coating thin and greasy or yellow-greasy, pulse deep and string or slippery. Syndrome: internal phlegm-dampness with weakened kidney qi. Treatment: tonify kidney and expel phlegm-dampness. Formula: Erchen Tang, Erzhi Wan, Shenqi Wan with modifications. Common ingredients: tangerine peel, pinellia, prens, poria, curcuma, tangerine red, ligustrum, echinacea, cinnamon, yam, alisma, mountain taro, red peony, radish seed, prepared polygonum, sargentia.
5. Tonify Kidney Essence, Resolve Blood Stasis
Various causes damage kidney qi, disrupting Chong and Ren meridians, causing qi stagnation. Long-standing illness affects blood, leading to blood stasis obstructing breast channels. Symptoms include hard breast lumps that don’t move, prolonged course, fatigue, blurred vision, dizziness, tinnitus, soreness and weakness in waist and knees, dull complexion, numbness in hands and feet, thin white tongue coating, dark purple spots on the tongue edges, dark purple sublingual veins, and fine, stagnant pulse. Syndrome: kidney deficiency with blood stasis. Treatment: tonify kidney essence and activate blood circulation to resolve stasis. Replenish kidney essence, resolve existing blood stasis, so that kidney qi becomes full, essence and blood flourish, Chong and Ren meridians harmonize, yin-yang balance, qi and blood flow smoothly, breast channels open, and nodules disappear. Formula: Erzhi Wan, Tao Hong Si Wu Tang with modifications. Ingredients: ligustrum, echinacea, peach kernel, safflower, red peony, chuanxiong, raw rehmannia, cooked rehmannia, prepared polygonum, lycium, dodder seed, zhebei, mountain taro, pinellia, corydalis, angelica.
Clinical Experience: For recurrent breast distension and pain linked to emotional fluctuations, psychological counseling is advised. For cases related to work stress, advise adjusting schedule for recovery. Most liver-soothing and qi-regulating herbs are aromatic and drying, consuming qi and yin—use only until symptoms improve. After recovery, avoid abrupt discontinuation; continue supportive care, primarily focusing on tonifying kidney and liver, with adjunctive herbs to unblock channels, resolve nodules, nourish blood, and harmonize blood.