The most common disease in men’s medicine is chronic prostatitis, which causes physical pain and psychological disorders to patients. The most important thing is that it is not a simple disease, but a syndrome with its own specific manifestations. The main symptoms are discomfort in the perineum, pain in the penis, testicles and abdomen, frequent urination, urgent urination, painful urination, incomplete urination and sexual dysfunction. Most scholars believe that it is related to pathogenic infection, increased urethral resistance, autoimmune reaction, chemical factors and neuromuscular factors, and its treatment effect is not satisfactory. The Chinese medicine, which was born more than 2,000 years ago, has no record of prostatitis, and according to clinical symptoms and signs, it is generally classified as “gonorrhea”, “seminal turbidity” and “white prostitution”. The first of these is the “Prostatitis”. The first cause of this is that the consumption of tobacco, alcohol, spices, fat and sweet, damage to the spleen and stomach, breeding damp heat, flowing into the lower jiao; the second is indiscriminate sexual intercourse, direct poisoning, damp heat and poisonous evil retrograde, staying in the lower jiao; third is the influence of social and environmental factors, media stimulation, sexual desire is not normal drainage, frequent masturbation, indiscriminate sexual intercourse, sperm retention, resulting in repeated congestion of the prostate gland, defeat of sperm stagnation of the sperm chamber, containing a long time breeding poison, blocked in the meridians The disease is located in the lower jiao bladder and seminal chamber, and damp-heat, stagnant qi and blood stasis deplete the positive qi over time.
The results are similar in terms of the basic judgments on the level of Chinese medicine theory and method, regardless of whether the treatment is based on the identification of evidence or the addition or subtraction of specific prescriptions. The reason for the unsatisfactory results of chronic prostatitis is the variety of causes and the complexity of the pathogenesis. The author’s self-designed prostate soup is based on Dan Shen to invigorate blood circulation and resolve blood stasis as the monarch; Huang Qi to benefit Qi and move blood, together with Angelica, Red Peony and Chuan Niu Kne to strengthen Dan Shen’s effect of invigorating blood circulation and resolving blood stasis as the minister; Bian Cao, Qu Mai, Fructus Herba, Dandelion to clear heat, dampness and laxative, and Yan Hu Suo to invigorate blood circulation and relieve pain as the adjuvant; Chuan Niu Kne to induce the downward movement of the medicine, together with licorice to harmonize all the medicines in the formula as the making medicine. Modern pharmacological studies have proved that Dan Shen, Angelica, Radix Paeoniae, and Chuan Kuo Knee have obvious effects on improving microcirculation, promoting tissue healing, and resisting fibrosis in various organs; Bian Cao, Qu Quai Mai, Fructus Sanguisorba, and Dandelion have significant inhibitory effects on various pathogenic microorganisms; Yan Hu Suo has analgesic effects; Astragalus and Glycyrrhiza can regulate human immune functions. Despite this, some patients did not show significant improvement by the treatment of this formula. The reasons for this are certainly due to the complexity of the etiology and pathogenesis of the disease, and also related to whether the patients have standardized the decoction method of the herbal soup.
The actual fact is that you can have an acute period before the disease, but most of them do not have an acute process. The incidence of the disease is far more acute, generally accounting for about 30% of urological outpatients, but also reported to or more than 50%. The disease is characterized by complex symptoms, prolonged course, more complications, and easy recurrence. One of the typical symptoms is white dripping at the end of urine, the residual dripping after urination is not finished, and the urethral orifice is glued by secretions, similar to what is called “seminal turbidity” in ancient Chinese medical texts, such as “Internal Medicine Heart Dictionary”, which says: “Seminal turbidity is white and sticky like semen, flowing from the stem, not painful and not astringent, and there are traces of staining under the clothes.” The medical case of Zhang Iqing says: “The sperm is cloudy, and after the urination there is always a greasy substance stained in the mouth of the horse.” It has a great impact on the patient’s spirit, physical strength, work, study and life. Therefore, psychiatric treatment is as important as drug treatment. As for the relationship between chronic prostatitis and male infertility, it has attracted increasing attention and attention from the medical community at home and abroad. 1963, Shi Xien and Wu Jieping pointed out that when prostatitis is present, it can change the composition of semen and affect sperm vitality and lead to infertility. 1973, E.S.E. Hafetz of the United States believed that abnormal sperm morphology is closely related to inflammation of the reproductive tract such as prostatitis, and in 1986, Wang Shaojin In 1988, Xu Fusong counted 404 cases of male infertility, 113 cases (28%) were clearly caused by inflammation of the gonads (secondary gonads), while 77 cases (19%) were due to chronic prostatitis. It is stressed that the status of chronic prostatitis in male infertility cannot be ignored.
I. Etiology
(a) Physical deficiency is an important, intrinsic and essential factor causing chronic prostatitis. There are two kinds of situations due to deficiency and deficiency due to disease. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. It is true that frequent sexual intercourse is an important factor that causes prostate congestion, but the large consumption of prostate fluid can cause a significant drop in prostaglandins. It is believed that prostaglandin has a strong physiological, has the function of regulating renin secretion, can diastolic blood vessels, inhibit platelet agglutination, inhibit norepinephrine release, etc., so excessive consumption, is an important cause of premature physical weakness. In addition, autoimmune factors, etc., can also be classified as such.
(ii) Infection
Most of them are caused by infection with pathogenic microorganisms. The common pathogenic bacteria are of two types.
(i) Bacillus category: Escherichia coli is the most common; followed by Aspergillus, Klebsiella and rare gram-negative bacilli.
②Cocci: Staphylococcus aureus is the most frequent, followed by Enterococcus and Streptococcus, etc. In recent years, there are signs of gonorrhea infection. In addition, fungi, viruses, trichomonas, mycoplasma, etc. are also seen. The route of infection are.
1, bloodstream infection 95% have a primary infection foci, such as oral, upper respiratory tract inflammation, bacteria into the blood circulation, to reach the prostate and cause inflammation. This is a good way to get the most out of your life.
2, urinary tract infection.
3, genital tract infection seminal gland, epididymis inflammation, itself often coexist with chronic prostatitis, and interact with each other. In Chinese medicine, those with genitourinary tract infections are said to have “damp heat down the liver meridian”.
4. Intestinal tract infections. It is not uncommon for inflammation of the colon to spread directly or via the lymphatic channels to the prostate.
5. Hematoma infection. The perineal injury, urinary tract injury, large and small hematoma combined with infection, etc.
There are many causes of prostate congestion, the common ones are as follows.
1, abnormal sexual affairs. Unmarried men often sexual action, genital erection, masturbation too often, can cause chronic congestion of the prostate; married men have sexual intercourse too often, or long-term interrupted intercourse, or interrupted intercourse before ejaculation. One is the chronic congestion of the prostate, the other is the increase and accumulation of prostatic fluid, causing excessive expansion and congestion of the prostate.
2, diet. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
3, physical stimulation.
(iv) Other
Autoimmune factors, allergic reactions, physical and mental factors (some emphasize up to 50% of those), etc.; some of the causes are unknown. In general, infection and congestion are the external conditions for the onset of the disease, while physical deficiency is the root cause of the disease. Here is a quote from the “Caveman’s Aoji” that says: “Qi and blood are vigorous and external evil cannot dry up, and Qi and blood are deficient and internal positive cannot reject”.
Second, the pathology
The inflammatory response of chronic bacterial prostatitis is lighter than that of acute prostatitis, with less exudation. The majority of the inflammatory changes are in the peripheral zone (i.e. posterior lobe) of the prostatitis and rarely in the central zone (i.e. middle lobe). The seminal vesicle gland and vas deferens are involved in about 80% of patients, and the posterior urethra is almost inevitably invaded. The gland is narrowed, resulting in pus cells and epithelial cells not easily discharged and blocking the tubules, causing the gland to dilate and the gland to be surrounded by round cell infiltration, and the gland may shrink and harden due to fibrous changes. Chronic aseptic prostatitis is visible on light microscopy as dilated alveoli of the prostate, cellular components such as erythrocytes and leukocytes in the lumen of the seminal vesicle gland, and edema of the interglandular tissue. Although the gland is enlarged, unlike prostatic hyperplasia where there is significant hyperplasia of the smooth muscle and fibrous tissue of the gland, no inflammatory cell infiltration is seen if the aseptic prostatitis is not full and infected.
In patients with chronic prostatitis, there is a large amount of inflammatory secretions mixed into the semen, which affects the sperm activity, especially when there are changes in the biologically active substances in the prostate, such as prostaglandins and hyaluronidase, which under normal circumstances can assist in the union of sperm with the egg and participate in the reproductive process. However, in the case of prostate and seminal vesicle gland inflammation, endocrine disorders and changes in the quality and quantity of bioactive substances occur, which affect male fertility. In some patients with infertility, chronic prostatitis is a very important factor. As inflammation destroys the fibrinase in the prostate fluid, it affects the liquefaction of the semen, thus greatly limiting sperm motility and hindering the possibility of combining sperm with eggs. In addition, the anti sperm antibodies in patients with prostatitis lead to loss of sperm motility and difficulty in conception. Treating these men with antibiotics can help reduce antibody titers and conception. Therefore, it is of great practical importance to raise awareness of chronic prostatitis and to actively prevent and treat it in order to gain fertility.
The common causes are “sperm retention” and “infection”. The former is mostly caused by the young and the strong being easily moved by the phase fire, the wish is not fulfilled, the sperm has not been out for a long time; or intercourse, spermatorrhea, masturbation, fright, etc., the sperm is not ejaculated, the defeated sperm is injected, the sperm pass is not fixed, thus becoming sperm turbidity. The latter is mostly due to deficiency of the spleen and lungs, easy to catch a cold, leading to damp heat in the lower body, or overcircumcision, hiding dirt, or unclean sexual intercourse, damp heat invasion, staying in the seminal chamber, confusing the seminal turbidity, seminal away from its position, and in this disease. The transformation of the pathogenesis is: long injury to the spleen and kidneys, spleen qi deficiency is more difficult to wet, kidney qi injury is easy to drain, this is the general process of the disease from real to deficiency. Kidney deficiency is the root, damp-heat is the symptom, long-term disease into the ligament, ligament stagnation, is the pathological response to enter the chronic process. Kidney stores sperm and is the main reproductive agent. Kidney deficiency results in less sperm, so fertility is low; damp-heat fumigates the sperm chamber and obstructs the sperm duct, so there is a decrease in the number of sperm, lower activity rate, semen is not liquefied, sperm agglutination and other manifestations.
Clinical manifestations
The clinical manifestations of this disease are quite inconsistent, with some asymptomatic and some with various manifestations.
(The actual fact is that you can find a lot of people who are not able to get a good deal on this. The actual fact is that there are 8 asymptomatic cases of infertility due to chronic prostatitis in 77 cases. The actual fact is that there are a lot of people who are not able to get a good deal on a lot of things.
There is a great deal of individual variation. Even the same individual has different symptoms at different stages.
1. Changes in reproductive and sexual function No epidemiological statistics have been seen. Xu Fusong in a group of 457 patients with chronic prostatitis (married), combined with infertility in 83 cases, accounting for 18%. The preliminary indication is that most patients with chronic prostatitis have children as usual and do not affect fertility. As for the changes in sexual function, due to chronic inflammatory stimulation, and excitement stimulation, generally manifested as hypersexuality, easy erection of the penis and premature ejaculation (premature ejaculation), dream emission, slippery semen, etc.. However, many patients seen clinically are seen with hypogonadism and impotence as the reason for consultation, which is due to mental depression and low mood due to men’s infertility; or recognize the recognition of urine not dripping white as sperm leakage and kidney deficiency. These inhibiting factors, resulting in sexual dysfunction. 1981, Wang Shaojin statistics 232 cases of chronic prostatitis, there are 62% of sexual dysfunction of varying degrees.
Sometimes painless terminal carnal hematuria or terminal hematuria is seen; occasionally there are those who have painless hematuria as the only complaint symptom of the disease, after excluding other factors of systemic or local, doing prostate examination will help clinical diagnosis.
This is an extremely common symptom, mainly pain (vague pain), swelling or burning sensation in the perineum, which is aggravated after drinking, sitting for a long time or riding a bicycle, and feels relaxed after getting yawning or taking a hot water bath; sometimes there is an unexplainable discomfort; there is a sensation similar to the perineum in the penis, urethra, testicles or perhaps the pubic symphysis, and radiates to one or both groins, abdomen and lower back. lumbar region. Of course, there are also patients with pain in these areas as the main complaint. In some patients, the pain is particularly pronounced before or after ejaculation. Those who have pain before ejaculation have the feeling of wanting to ejaculate and having pain after ejaculation, which is mostly caused by actual pain and heat; those who have pain after ejaculation are called “ejaculation pain”, which is called “empty pain” and “deficiency pain” in Chinese medicine. In individual cases, there are pain in the colon and anus, or the urethra is raised, or there is a feeling of water flowing in the small abdomen, etc.
4. Neurological and mental symptoms are universal, and the pain in this area far exceeds the pain of the disease itself. Patients are emotionally depressed, worried about the impact on fertility and sexual function, and some are afraid of turning into cancer, showing pessimism and disappointment, fatigue, dizziness, memory loss, difficulty in concentration, and even imagination, with various hallucinations and fantasies and other symptoms of neurasthenia, and some have sexual neurasthenia. For this reason, seek medical help everywhere, did not achieve the desired purpose, in turn, the disease is considered to be serious, further aggravating the burden of thought, the two as a cause and effect, forming a vicious circle, difficult to extricate themselves.
IV. Diagnosis
1, medical history and symptoms. There is a history of urethritis, acute prostatitis and lower urinary tract obstruction or urinary tract infection. Residual draining after urination, white dripping at the end of urination, perineal distension or cramping pain, or urinary tract irritation micro, sexual function changes, etc.
2, rectal finger diagnosis. Prostate hardness normal or increased, or nodules, gland size can be normal or reduced or larger, its surrounding more fixed, no pressure pain or light pressure pain.
3.Prostate fluid routine. Massage the prostate and collect its secretions for picture examination, which is decisive for diagnosis. Light microscopy shows that normal prostate fluid has very few white blood cells and a lot of lecithin. If there is an increase in leukocytes in the secretion, more than 10 per high-powered view and a decrease in lecithin, the diagnosis of chronic prostatitis is established. If the lecithin vesicles are below 50%, there are often clinical abnormalities in sexual function of varying degrees; if they are below 30%, there is definitely sexual dysfunction, such as impotence and premature ejaculation. The normal pH of prostate fluid is 6.3 to 6.5, which is acidic. The degree to which prostatitis is cured and the pH of the prostate returns to normal is directly proportional to that of chronic prostatitis.
4, urine examination. The prostate massage off should be a routine urine examination. If you can’t get prostate fluid, collect 13-15mL of urine after massage for routine microscopy; if the number of white blood cells in the urine increases compared to before the massage, it has diagnostic significance.
5, prostate fluid bacterial culture. It is important to identify bacterial prostatitis and congestive prostatitis. Toyota Qin reported a positive rate of 65%. The infecting bacteria are mostly white staphylococcus, followed by staphylococcus aureus, bacillus-like, pseudomonas aeruginosa, and E. coli. It is important to know that the diagnosis is unreliable based on history or rectal examination alone, without prostate fluid or urine examination.
6. Immunoassay. The specific antigen, agglutination test is applied to 82% of chronic E. coli prostatitis patients with elevated E. coli antibodies in the serum, while only E. coli urethritis and normal serum have low E. coli antibodies. In chronic prostatitis, the serum and anterior dementia fluid immunoglobulin content is elevated, especially IgA and IgM, while complement C3 content is reduced.
7. Semen examination. In chronic prostatitis, in addition to abnormal sperm count, motility and activity, Kuznik (1966) emphasized that pus cells and bacteria in semen have practical significance. In clinical cases with purulent semen as a feature of chronic prostatitis, the disappearance of pus spermatozoa is the aim of treatment.
8. Ultrasound examination. In chronic prostatitis, the envelope reflection is not smooth due to local exudation, fibrosis, adhesions, and in severe cases, the envelope boundary is not clear, the gland shape is irregular, left and right asymmetry, and limited reflection reduction is seen internally.
9, prostate biopsy. The actual biopsy can be used to identify granulomatous prostatitis and prostate cancer in some cases that are difficult to diagnose. The specimens are taken with certain limitations, and the presence of cancer cannot be completely ruled out in negative cases, so this test is less used.
The differential diagnosis
1.Prostate overflow. It is also called “prostate leakage”. The main symptom is white sticky discharge from the urethra after urination and defecation, and the liquid is easy to drip out when the prostate is massaged.
2, prostate pain. It is only the pain or pressure in the perineum or suprapubic area, with urinary symptoms such as urinary tract obstruction, normal prostate fluid and sterile growth in culture. In fact, the prostate is not diseased, but often misdiagnosed chronic prostatitis.
3, prostate abscess. Severe perineal or rectal pain, with urinary symptoms, aspiration of pus and finding purulent bacteria by perineal skin puncture.
4, prostate gonorrhea infection. Gonococcus was found in the pus, but no other bacteria.
5, prostate tuberculosis. Prostate nodules proliferate and may find Mycobacterium tuberculosis.
6, prostate stones. The pelvic radiograph or B-mode shows a stone shadow.
7, prostatic hyperplasia. Increased residual urine, cystoscopic examination of the bladder neck bulge, anal examination or ultrasound prostate enlargement.
8.Prostate cancer. The diagnosis can be confirmed by perineal or rectal prostate puncture biopsy, or by urethroscopy, or by rectal prostate ultrasound or tomography. The blood PSA value is significantly elevated.
9. Chronic vesicovaginal adenitis. The main feature of this is visual or microscopic hematospermia, which can be differentiated from chronic prostatitis. If necessary, perform a seminal vesicle gland imaging line to clarify the diagnosis.
10. Other. The symptoms of chronic urethritis, cystitis and certain anal diseases such as anal fissure are similar to those of chronic prostatitis, but it is not difficult to differentiate them as long as the prostate fluid is examined carefully.
Sixth, treatment
The Chinese medicine is more targeted and effective, so it can be the first choice; western medicine can be used during acute attacks, and chronic treatment is supplemented by symptomatic treatment, and attention should be paid to spiritual treatment.
(A) Identification and treatment
The disease is complex, generally can be divided into damp-heat, blood stasis, deficiency, kidney deficiency four evidence of the first two are real, the last two are deficiency, but the clinical appear alone less, deficiency and deterioration of mixed more, generally more deficiency in the chronic period, less deficiency in the acute phase of the real more deficiency.
1, damp-heat evidence
The main symptoms: younger age, shorter duration of the disease, or a history of prepuce, urethritis, glansitis, orchitis and other blame, urine yellow less, turbid or precipitated, urinary frequency, urinary urgency, urethral burning stabbing front, perineal and abdominal distension, dry stool, force defecation urethral drip white amount, mouth dry and bitter and sticky, tongue coating yellow greasy, pulse string slippery with number. The prostate gland is swollen, the pressure pain is more obvious, the prostate fluid is full of pus cells ++, the prostate fluid culture has bacterial growth.
Main method: Clearing heat and inducing dampness.
Main formula: Dioscorea, Poria, Che Qian Zi, Salvia, Phellodendron, Atractylodes, Chuan Pu Hua, Coix seeds, Acorus calamus, Biyu San. Addition and subtraction: add Chai Hu and Baicalin for cold and heat, Phellodendron and Mouton for yellow urine, Xiaosu and Baimao Root for blood in urine, Raw Rhubarb and Xuanming Powder for constipation, Scutellaria and Huang Lian for loose stool, Citrus aurantium and Chuan Dongzi for bloating, Chuan Park and Atractylodes for red tongue with little coating, Shengdi and Guiban.
Note: It is generally believed that this disease is difficult to cure, easy to recur, so we need to pay attention to prevention work. The author summarized a group of 80 cases of this disease, 48 cases of healing, follow-up six months to 2 years, only 8 cases of recurrence, recurrence is mainly due to drinking, cycling, colds or urinary tract infections, etc., by the identification and treatment of 1 to 2 months and was cured. It can be seen that Chinese medicine has great potential for the treatment and prevention of this disease.
2. Blood stasis type
The main symptoms: long duration of the disease, or perineal injury, small amount of final urine dripping white, painful urine dripping, or see the flesh blood sperm, stabbing pain in the perineum is obvious, pain leads to the testicles, penis, abdomen or waist, sallow eyes, purple tongue or petechiae, astringent pulse, anal examination of the prostate hard texture, or nodules, prostate fluid central red cells.
Main method: Invigorate blood circulation and resolve stasis.
Main formula: Wang Bu Liuxing Tang.
The main medicine: Wang Bu Liuxiang, Yan Huosuo, Dan Pi Shen, Saponaria spinosae, Peach kernel, Prunus Curculio, Cow’s knee, Panax notoginseng, Safflower, Sumac, Chuanxiong, Red peony.
Add and subtract: if local pain is obvious, add Lost Smile San; for hematospermia, add Radix et Rhizoma Ligustrum and Radix et Rhizoma Mori; for dyspareunia, add Radix Zeleniae and Radix et Rhizoma Yi.
Note: It is sometimes difficult to tell whether sallow eyes and face are due to stagnation of blood stasis or kidney deficiency with its color exposed. In cases of kidney deficiency, the makeup is accompanied by evidence of yin deficiency and fire; in cases of blood stasis, the tongue has petechiae, or there is a history of trauma, which is the main point of differentiation. However, sometimes the treatment of stasis of blood or kidney deficiency alone has very little effect. At this time of suspicion of deficiency and reality, it is possible to invigorate the blood and tonify the kidneys at the same time, eliminating and tonifying at the same time.
3.Medium deficiency type
The main symptoms: long duration of the disease, vegetative spleen deficiency, terminal urine dripping white, incomplete urination, residual dripping after urination, aggravated after exertion, steady pain in the perineum, a feeling of falling, clear and long or frequent urination, fatigue, less color, no Xin of the grain, cold and awe, palpitation and sweating, light and fat tongue, thin and soft pulse; anal finger examination of the posterior door can continue for several days with a feeling of swelling.
Main Approach: Tonifying the middle energy.
Main formula: tonifying the middle energy with addition and subtraction.
Main herbs: roasted astragalus, angelica, poria, gorgonian, bupleurum, forged oyster, atractylodes, Chen Pi, roasted asclepias, roasted grass.
Addition and subtraction: loose stools to Angelica sinensis, plus roasted internal gold, white peony; five-shift diarrhea plus bone marrow, Wu Wei Zi; pain that want to diarrhea plus white peony, wind; less nasal to roasted grass, plus grain and wheat to bud; frequent urination plus Xuan Mu Gua, sangzhi; dyspareunia plus talcum, Tong Cao; insomnia plus jujube, Fu Shen.
The main focus should be to grasp the perineum (or small abdomen, waist) swelling and pain and fistula with a feeling of falling. This is because there is a tonic in elimination, so it will not attack the vital energy; do not worry about increasing dampness and heat.
4.Kidney deficiency type
The main symptoms: long duration of the disease, a history of masturbation and overwork, dripping white at the end of the urine, mucus and mucous at the urethra, urine dripping, lumbar acidity and weakness, dreams and loss of blood, reduced sexual function, or blood sperm in the eyes, dark complexion, five heartburn, low heat in the afternoon, red cheek, dry stool, yellow urine, insomnia and dreaminess, red tongue with little coating, cracked or peeling coating, thin pulse with a number. There is a marked decrease in lecithin vesicles in the prostatic fluid, or there are red blood cells.
Main method: Tonifying the kidney and astringent essence.
Main formula: Cuscuta seeds pill with addition and subtraction.
Main herbs: Cuscuta sinensis, Poria cocos, Wai Shan yam, Tong Sha Yuan, Plantago ovata, Dendrobium spp.
Add and subtract: add Dioscorea, Wu Wei Zi; add Jin Ling Zi, Yan Hu Suo; add Gorgonian, Coix Seed, Nian Nei Jin; add Smilax, Dendrobium, Mai Dong for constipation and thirst; add Dao Chi San for frequent, urgent and painful urination; add Yin Tonic Pill and Huang Jing for hypogonadism; add Er Zhi Wan for red blood cells in prostatic fluid or semen, or even hematosperm; add Li Zhi Cao, Dandelion and Daidai Pill for yellow urine or pus cells in prostatic fluid or semen. If there is a decrease or disappearance of phospholipid vesicles, add Radix et Rhizoma Polygonati and Rhizoma Polygonati.
Note: The disease is always characterized by a mixture of deficiency and actuality. The deficiency is based on kidney deficiency, or is accompanied by spleen deficiency, or by blood stasis, or by damp heat. The most common type is kidney deficiency with damp-heat. The combination of Dioscorea and Cuscuta Pill is a wonderful formula for treating this disease, one by tonifying the kidney and the other by directing dampness.
(B) Identification and treatment of disease
1, prostate soup (Beijing: Liu You Fang) Danshen, Ze Lan, red peony, peach kernel, safflower, Wang Bu Liu Xing, Qing Pi, dahurica, Chuan Neem, cumin, sorrel, roasted milk not, dandelion. A total of 154 cases were treated, 102 cases (66.2) were cured and 77.3% were basically cured (Journal of Traditional Chinese Medicine Surgery, 1980;18(3):250).
2, compound Dilongpo (Jilin: Wang Shaojin) Dilong, tiger scepter, lycopodium, perforated root, mucuna pruriens, psyllium, licorice, astragalus, snake tongue grass. 1 dose per day, decoction with water. A total of 232 cases were treated, 128 cases (55.2%) were cured, 62 cases (26.7%) were improved, and 42 cases (181%) were delayed (Jilin TCM, 1981;3:31).
3. Qing kidney soup with added flavor (Fujian: You Kaihong) Zhi Bai, Huang Bai, Long Bone, Oyster, Xie Cao, Hang Shao, Wai Shan Yao, Hai Mantis, Ze Di. 1 dose per day, divided into 2 doses with water decoction, 20 days as a course of treatment. During the period of medication, hot water sitz bath after stool every day. There were 24 cases treated, of which 16 were cured, 5 were effective, 1 was ineffective, and 2 were interrupted, with a minimum of 1 course of treatment and an average of 1.6 courses (Shanghai Journal of Traditional Chinese Medicine, 1986;1:7:34).
4, ascending clearing and descending turbidity soup (Jiangxi: Hong Guanghuai) Chai Hu, Sheng Ma, Mandarin, Poria, Poria, Ze Di, Che
Mucuna pruriens. A total of 43 cases treated, 27 cases (63%), effective 1 case (30%), ineffective 3 cases (7%), the total effective rate of 3%. Generally, the effect was seen in 1-3 weeks, and the effect was obvious in 2-4 weeks (Jiangxi Traditional Chinese Medicine, 1986; 5: 27).
5.Tonic kidney and conductive turbidity soup (Jiangsu: Xu Fuying). Cuscuta seeds Sha Yuan Zi Fu Ling Tai Wu Yao Shi Calamus Psyllium Psyllium raw herb tips, etc.. Treatment of 133 cases, healing 50 cases (37.6%), clinical cure 42 (31.5%), improvement 36 cases (27.1%), invalid 5 cases (3.8%), the cure rate of 69.1%, the total effective rate of 96.2%. The shortest duration of treatment was 10 days, the longest was 1 year and 6 months, and the general duration was 2.4 months. It is also pointed out that the principle of action of this disease to take effect may be related to the coordination of body balance, elimination of harmful substances and restoration of local functions (Journal of Traditional Chinese Medicine, 1988;9:41).
(III) Exploration of the mechanism of action Through clinical systematic observation and analysis of relevant laboratory tests, it was tentatively concluded that the principle of the effectiveness of tonifying the kidney and conducting turbidity soup in treating this disease might be related to the following aspects.
In order to explore the relationship between this disease and the humoral immune system and the changes after the treatment with Kidney Conduit Tang, we measured the immunoglobulin and complement C3 content of serum and prostate fluid of some patients and used the control before and after treatment. The results showed that the serum IgA content before treatment was higher than normal in patients with chronic prostatitis (P < 0.01) while the complement C3 content was lower than normal (P < 0.05); the IgG content in the prostatic fluid was significantly higher than in the control group before treatment (P < 0.01). This suggests that the patient has some abnormal immune function, which may be the root cause of the long-term failure to heal and recurrent attacks of the disease. After a period of treatment with this drug, the above-mentioned immune indicators increased and improved, and there was no significant difference compared to the control group (P>0.05). It is presumed that this drug has a two-way regulation effect on the immune function (mainly humoral immunity) of patients with chronic prostatitis.
The pH value decreased significantly (P < 0.01) with the improvement of the condition after one stage of treatment with Kidney Conduit Tang, and the recovery time was faster than that reported by Paul 1978, where the pH returned to acidity only after two years of prostatitis treatment. We also found that the degree of cure of prostatitis is directly proportional to the return of normal prostatic fluid pH. This is why we suggest that checking the pH of prostate fluid can be used as a reference indicator for diagnosis and determining the effectiveness of treatment.
The results of the bacterial culture of prostate fluid before and after treatment of 35 patients with this disease show that the basic formula has a certain antibacterial and anti-inflammatory effect. Recent experiments have proved that the formula has obvious inhibitory effects on Staphylococcus aureus, Staphylococcus albus, S. typhi, E. coli and B. fowleri; it has antibacterial and anti-inflammatory effects on S. aureus, S. typhi and B. fowleri, and the formula has better efficacy on both. It is also a good way to enhance or adjust the immune function of the patient, in addition to the direct inhibition or killing effect of the pathogenic microorganisms.
Clinical observation shows that after treatment with this formula, local drainage can be unblocked, drainage of turbid rot, thus reducing tissue damage and restoring its normal function. If some patients start with more urethral discharge, as the treatment progresses, the discharge gradually decreases or even disappears; while some patients start with no discharge and little discharge overflow from prostate massage, but after a period of treatment, they can successfully obtain prostate fluid. It is presumed that this formula can relieve the obstruction of the prostate ducts, remove the accumulation of secretions, smooth the drainage, promote blood flow, flourish local metabolism, and restore local function, thus causing the clinical symptoms to diminish or disappear.
In addition, we also found that this formula has a good effect on improving the sexual function and infertility of patients with this disease.