Abstract: The application of the method of warming the meridians and dispersing cold in the treatment of chronic pelvic pain syndrome (CPPS) can reduce or eliminate pain, improve symptoms and enhance patients’ quality of life. Due to the long-term entrapment of dampness in the sperm chamber, Yang energy is gradually depleted and cold is generated from within, coupled with factors such as overuse of antibiotics and cold drugs, cold evidence is not uncommon in the middle and late stages of the disease. We applied the method of warming the meridians and dispersing cold, and used the three basic formulae of Tiantai Wu Yao San, Dang Gui Si Wei Tang and Shao Abdominal Expelling Blood Stasis Tang with focus and reduction to obtain satisfactory results. Key words: chronic pelvic pain syndrome; warming the menstruation and dispersing cold; Tiantai Wu Yao San; Danggui Sihui Tang; Shao Abdominal Expelling Blood Stasis Tang C.I. Classification number: R271.9 Document identification code: B Article number: 1007-4813(2010)06-0863-02 Chronic pelvic pain syndrome (CPPS) is a common and difficult disease in urogynecology, and its incidence accounts for 90%-95% of all prostatitis. The incidence of CPPS accounts for 90% to 95% of all prostatitis. In the past, treatment was mostly based on clearing heat and dampness, activating blood circulation, draining the liver, tonifying the kidneys and opening the ligaments, while the method of warming the meridians and dispersing cold was often not taken seriously in treatment. In the author’s opinion, due to the long-term entrapment of dampness in the seminal chamber, the gradual depletion of Yang energy, cold from within, coupled with the use of antibiotics and cold drugs and other factors, cold evidence is not uncommon in the middle and late stages of the disease, the application of warming and dispersing cold method of treatment, can quite reduce or eliminate pain, improve symptoms and improve the quality of life of patients, the results are more satisfactory. Now, without trying to be superficial, the superficial application experience is introduced as follows. The liver meridian follows the lesser abdomen and surrounds the yin apparatus. If the evil of yin and cold visits the liver vein, the liver loses its drainage and the qi is blocked. On the one hand, because the qi stagnation is not pass, not pass is pain, can cause less abdominal traction perineum, lumbosacral and other parts of the cold pain; on the other hand, the qi stagnation can not dredge water channels, water channels through the blocked, can cause adverse urination. Therefore, cold condensation in the liver and Qi stagnation is an important pathogenic mechanism causing local pain and discomfort and urinary symptoms in chronic pelvic pain syndrome. Tiantai Wu-yao San is published in “Medical Inventions” by Li Dong-yuan, and is composed of Tai Wu-yao, Mu Xiang, Cumin, Qing Pi, Gao Liang Jiang, Betel nut, Neem, and Ba Dou, etc. It was originally used to treat painful small intestinal hernia caused by Qi stagnation and cold condensation. According to the mechanism of “treating different diseases together”, it can also be used to treat chronic pelvic pain syndrome with Qi stagnation and cold condensation. Liu, male, 42 years old, a driver, was first diagnosed on October 18, 2008. 6 years of discomfort in the lower abdomen, lumbosacral region, perineum and testicles, accompanied by poor urination, incomplete dripping and occasional white drops at the end of urination. In a hospital diagnosed as “chronic prostatitis”, before and after iterative use of antibiotics, alpha-blockers and other western drugs and clearing heat and dampness, blood circulation and blood stasis Chinese medicine treatment, but failed to obtain satisfactory results. The present evidence: the less abdomen leads to control the testicles and pain, and radiates to the right groin and the root of the thigh, when cold pain, slightly relieved by warmth, urethra burning, ants feeling, urinary residual drip, sweating, mouth is not thirsty, tongue light coating white, pulse string thin. Anal finger examination: the central sulcus of the prostate becomes shallow, the left lobe has a nodular sensation and is painful to touch. Prostate fluid examination: lecithin vesicles (+), WBC 4-6/HP. Consider that the Yang deficiency in the body or excessive use of cold, resulting in cold condensation of the liver veins, liver loss of drainage, Qi blockage and pain. The main treatment is to warm the menstruation and disperse cold, move Qi and relieve pain. Prescription: 15g of Tai Wu Yao, 6g of Guang Mu Xiang, 6g of Xiao Xiao Xiang, 6g of Qing Pi, 6g of Gao Liang Jiang, 10g of Betel nut, 12g of Chuan Guo Zi, 12g of Yan Hu Suo, 15g of Wei Ling Xian, 6g of Fang Feng, 10g of Gui Zhi, 12g of Ze Lan, 6g of Soapberry. take 1 dose daily with water. After taking 14 doses, the pain was greatly improved and the burning and itching in the urethra basically disappeared. The symptoms disappeared after 21 more doses. No recurrence was seen during the follow-up period of 3 months. 2, blood deficiency and cold clotting type, choose Angelica Sinensis Four Reverse Soup. Blood deficiency, blood deficiency and cold, blood cold clotting, blockage of the meridians, and pain if not pass, can also cause the typical symptoms of chronic pelvic pain syndrome, such as less abdominal traction perineum, lumbosacral swelling and cold pain and urinary inconvenience. Angelica Sinensis Four Reverse San was first published in Han Zhang Zhongjing’s Treatise on Typhoid, and consists of Angelica Sinensis, Gui Zhi, Paeonia lactiflora, Radix et Rhizoma, Glycyrrhiza glabra, Tong Cao and Dazao. Since the basic effect of this formula is to warm the menstruation and disperse cold, nourish blood and open the veins, it can also be used to treat chronic pelvic pain syndrome caused by blood deficiency and cold condensation. The combination of the herbs can warm the blood vessels in the lower jiao, so as to dispel the cold evil in the meridians and smooth the blood flow, thus achieving the purpose of relieving local pain and urinary discomfort. Xiao, male, 37 years old, a civil servant, was first diagnosed on December 21, 2009. He has been suffering from lumbosacral and perineal swelling and pain for more than 2 months. He had a history of chronic prostatitis for many years. The onset of the disease was due to cold and flu two months ago and he felt cold pain and discomfort in the lumbar region, which gradually worsened and led to double femur, less abdominal distension and fullness, accompanied by frequent urination, bifurcation, incomplete dripping, and white turbid drops at the end of urination. At the time of consultation, the patient looked distressed, the localized distension and pain remained, but the pain was reduced with warmth, the hands and feet were cold, the mouth was not thirsty, the tongue was lightly coated with white fur, and the pulse was sunken and thin. The prostate gland is asymmetrical, tough and nodular. This is due to blood deficiency and cold, cold condenses the meridians and causes pain. The main treatment is to warm the menstruation and disperse cold, nourish the blood and promote blood circulation. Prescription: Angelica Sinensis 12g, Gui Zhi 10g, Paeonia Lactiflora 15g, Hossein 3g, Tong Cao 6g, Shi Calamus 6g, Wu Yao 10g, Fei Ren 10g, Fu Ling 15g, Jujube 10g, Roasted Licorice 6g. Decoction with water, 1 dose daily. After taking 2 doses, the patient called to say: “after taking this medicine, sweating all over the body, the body is also warm, the feeling of swelling seems to have been reduced, but feel tired and weak”. He was told not to worry about it and to continue taking it. After taking 5 doses of this medicine, the pain and swelling in the lumbosacral and perineal areas was significantly reduced and the urine started to flow smoothly. At the third consultation (January 12), the pain and urinary tract irritation had basically disappeared and he was sleeping peacefully, except for occasional white turbidity at the end of urination. The original formula was added and reduced, and the symptoms were all removed after more than 1 month of consolidation. 3, blood stasis and cold clotting type, choose Shao Abdominal Evacuating Stasis Tang The Ren and Chong veins both originate from the uterus, go down from the perineum, and run along the front abdomen, while the foot Turk’s Yin vein follows the lesser abdomen and surrounds the Yin apparatus. If the cold clotting and blood stasis occlude the meridians, the above-mentioned meridians may have stabbing pains and do not move; if the blood stasis blocks the Qi-transformation of the Sanjiao, and Qi-transformation is unfavorable, then there may be unfavorable urination, bifurcation of urine, waiting for urine, and incomplete draining after urination. Shao Abdominal Expelling Stasis Soup is originally published in Qing Dynasty’s Wang Qingren’s “Medical Lin Correction” and is composed of cumin (fried), ginger, yanhuosuo, myrrh, angelica, chuanxiong, guan gui, red peony, pu huang, and wuling fat (fried). We borrowed its function of activating blood stasis, warming menstruation and relieving pain, and moved it for the treatment of chronic pelvic pain syndrome of blood stasis and cold condensation. Guo, male, 29 years old, a reporter. was first diagnosed on March 6, 2009. He has been suffering from lumbosacral and perineal soreness and swelling with unfavorable urination for more than 3 years, aggravated for 1 week. He complained that he had suffered from chronic prostatitis, which had been delayed and often recurred, but the lumbosacral pain was usually tolerable, and in the past week, his condition had worsened due to work strain and sedentary work. Now, the lumbosacral and perineal areas have persistent pain and soreness, which can’t be named, unfavorable urination, bifurcation of urine, waiting for urine, incomplete dripping after urination, wet and cold scrotum, poor night sleep, cold and cold form, no thirst, dull red tongue, thin white fur, sunken and astringent pulse. Anal finger examination: prostate slightly enlarged, painful to touch (+), surface not very smooth. Prostate fluid examination: lecithin vesicles (++), leukocytes 10-15/HP. evidence of cold condensation of the meridians, Qi stagnation and blood stasis, the development of pain. The treatment is to warm the menstruation and disperse cold, activate blood circulation and eliminate blood stasis. Prescription: 10g of cumin, 6g of ginger, 12g of neem, 12g of yanhuosuo, 10g of myrrh, 15g of angelica, 6g of Chuanxiong, 3g of cinnamon (later), 10g of red peony, 10g of pu huang, 10g of fried ling lai, 10g of daidai wu yao, 15g of wei ling xian, 15g of dong quai zi. take 1 dose daily with water. After 1 week of taking the medicine, the pain was slightly relieved and the urine was gradually cleared. After 14 doses, the pain was significantly relieved, the urine was basically normal, the tongue improved, and the pulse was smooth. The patient was instructed to strengthen exercise and avoid sedentary and strenuous work.