[Abstract] Objective
To observe the efficacy of self-prepared Tongluo Qingjie formula in the treatment of chronic prostatitis with damp-heat and stasis type.
Methods
One hundred and twenty patients diagnosed with chronic prostatitis were divided into 60 cases in the Western medicine group and 60 cases in the Chinese medicine group according to the random number table method, and the treatment course was 4 weeks, and the clinical efficacy was evaluated by observing the patients’ TCM symptoms, EPSRt, NIH-CPSI score and other indexes before and after 4 weeks of treatment.
Results
After treatment, the TCM symptom score, prostate fluid lecithin vesicles and total effective rate of the TCM group were significantly better than those of the Western medicine group, and the difference was statistically significant (P<0.05).
Conclusion
The treatment of chronic prostatitis with Tongluo Qingjie Formula in the damp-heat stasis type can significantly reduce prostate inflammatory irritation, significantly improve prostate gland patency, and relieve patients’ symptoms.
Chronic prostatitis is one of the common and frequent diseases in young and strong men. Clinical investigations have shown that the overall incidence of chronic prostatitis in men under 50 years of age is 25% to 30% [1, 2]. The etiology of this disease is still unclear, and in common epidemiological surveys in various cities and regions, prostatitis is prone to recurrent attacks, lingering and difficult to heal, and is at the top of the list of common diseases in young men, which is an important problem that seriously affects the quality of life of young men. Based on the principles of TCM identification, combined with the characteristics of CP pathogenesis and integrated various pathological factors, from February 2010 to December 2010. We used the self-prepared Tongluo Qingjie formula to treat the chronic prostatitis damp-heat stasis type with remarkable results, which are reported below.
1. Clinical data
1.1 General information
The 120 patients were all outpatients of the Department of Urology, Xuchang Central Hospital, and were diagnosed with chronic prostatitis by medical history, two-cup method, EPSRt and other examinations, which were in accordance with the Chinese medicine damp-heat stasis evidence type.
1.1.1 Comparison of age (years) situation
Among the 112 patients, the minimum age of the Chinese medicine group was 18 years old and the maximum age was 49 years old, with a mean of 33.5±8.2 years; the minimum age of the Western medicine group was 20 years old and the maximum age was 47 years old, with a mean of 34.7±7.9 years. By t-test of independent samples, P>0.05, the difference in age between the Chinese medicine group and the western medicine group was not statistically significant and was comparable.
1.1.2 Comparison of disease duration conditions
Among the 112 patients, the longest duration of disease in the Chinese medicine group was from 3 months to 12 years, with a mean of 4.6±2.1 years; the longest duration of disease in the Western medicine group was from 6 months to 12 years, with a mean of 4.8±2.0 years. By t-test of independent samples, P>0.05, there was no statistically significant difference in the disease duration between the Chinese medicine group and the western medicine group, which was comparable.
1.2 Diagnostic criteria
1.2.1 Western medicine diagnostic criteria
Referring to the Wu Jieping Urology (2004 edition) [3] and the Chinese Urology Association Urology Branch China Urology Chronic Prostatitis Treatment Guidelines (2007 edition) [4] were formulated.
1.2.2 Chinese medicine identification criteria
The criteria for identifying dampness, heat and stasis were formulated according to the Clinical Research Guidelines for the Treatment of Chronic Prostatitis with New Chinese Medicines (2002) [5].
Primary symptoms: ① frequent urination, urgent urination, ② dampness of scrotum, ③ red tongue with yellowish coating, ④ red or purple tongue or petechiae, slippery or astringent pulse. Secondary symptoms: ① burning in the urethra, painful urination, ② pain in the abdomen, testicles or lumbosacral region. Main symptoms ①, ③, ⑤ plus secondary symptoms ①, or secondary symptoms ②; or main symptoms ①, ④, ⑤ plus secondary symptoms ①, or secondary symptoms ②. This is the diagnosis of this type of evidence. Scoring criteria: 0 points for each main symptom without, 1 point for mild, 2 points for moderate, and 3 points for severe; 0 points for each symptom without, 1 point for severe; points ≤10 for mild, 11-18 for moderate, and >18 for severe.
1.3 Inclusion criteria
(1) Meet the diagnostic criteria of Western medicine prostatitis type II and III;
(2) Age between 18 and 49 years;
(3) Chinese medicine criteria of dampness, heat and stagnation;
(4) Duration of disease > 3 months.
1.4 Exclusion criteria
(1) Males under 18 years of age and over 50 years of age;
(2) Combination of severe neurosis, urethral stricture, prostate tumor;
(3) Allergy and allergy to various drugs;
(4) Combination of serious cardiovascular and cerebrovascular diseases, liver and kidney insufficiency, hematopoietic system and other serious primary diseases, psychiatric patients;
(5) Those who do not belong to dampness, heat and stagnation evidence in Chinese medicine.
2.Methods
2.1 Treatment methods
2.1.1 Chinese medicine group.
Damp-heat stasis type is treated with Tongluo Qingxie Fang (self-prepared formula), the drugs are Dioscorea Z 20g, Fructus septica 30g, Plantago ovata (package) 30g, Salvia miltiorrhiza 20g, Paeonia lactiflora 20g, leech 3g, Lychee kernel 10g, Boswellia serrata 6g, Myrrh 6g.
2.1.2 Western medicine group: type II and IIIA used levofloxacin mesylate tablets (Lifoxin) (produced by Beijing Shuanghe Pharmaceutical Co., Ltd., approval number: State Drug Quantification H10980067) 0.2g, taken orally twice a day, and terazosin hydrochloride tablets (Mashani) (produced by Beijing Saike Pharmaceutical Co., Ltd., approval number: State Drug Quantification H10970081) 2mg, taken orally once a night; type III used levofloxacin mesylate tablets (produced by Beijing Saike Pharmaceutical Co., Ltd., approval number: State Drug Quantification H10970081) 2mg, taken orally once a night. 1 time, taken orally; Type IIIB select Terazosin Hydrochloride Tablets 2mg, 1 time per night, taken orally.
Note: The following therapeutic measures and precautions are allowed along with drug treatment: (1) urination training; (2) abdominal and perineal massage or physiotherapy with prostate massage or magnetic heat therapy; (3) avoid spicy and thick diet.
2.2 Treatment course
Both the Western medicine group and the Chinese medicine group were treated for 4 w. The relevant results before and after treatment were recorded.
2.3 Efficacy evaluation criteria
The efficacy evaluation criteria in the “Clinical Guidelines for New Chinese Medicines for the Treatment of Chronic Prostate Inflammation” [5] were referred to the “Clinical Guidelines for New Chinese Medicines” (issued in 2002), and were changed according to the specific observation indexes. Clinical recovery: symptoms disappeared, EPS examination was normal for more than 2 consecutive times, anal pain disappeared, texture was normal or close to normal, and ultrasound examination was approximately normal. Effective: symptoms basically disappeared, WBC value decreased by 1M2 or <15 MHP for more than 2 consecutive times in EPS examination, palpation pain and texture improved, ultrasound examination improved. Effective: symptoms decreased and EPS examination improved compared with the previous one. Ineffective: no improvement or worsening of symptoms, signs and EPS examination.
2.4 Statistical treatment
The spss13.0 software was used to statistically analyze the data information. χ2 test was used for the count data; t test was used for the measurement data.
3, Results
A total of 120 cases were included in this study, and 112 cases finally met the protocol, 57 cases in the Chinese medicine group and 55 cases in the Western medicine group. There were 8 cases of failed and rejected cases (see Table 1), and the proportion of rejected cases was 6.7%, which could meet the quality control requirements in the case-control study.
3.6 Adverse reactions and adverse events
There were 2 cases of nausea in the Chinese medicine group and 3 cases of nausea in the Western medicine group, all of which were relieved after taking the medicine after meals. There was no significant effect of drugs on liver and kidney function in both groups.
4. Discussion
The name “chronic prostatitis” does not exist in ancient Chinese medical texts, but according to its clinical manifestations, it should be classified as “essence turbidity”, “gonorrhea”, “white turbidity” and “white prostitution” in Chinese medicine. The actual deficiency is mainly reflected in the spleen and kidneys, while the actual deficiency is mainly reflected in dampness and heat, qi stagnation and blood stasis, and dampness and heat injection. The disease occurs mostly in young people, who are prone to over-eating spicy and thick flavors, stagnation of damp-heat, which then develops into qi deficiency and blood stasis or qi stagnation and blood stasis, with phlegm, dampness, stasis and deficiency interacting with each other, resulting in local swelling and inflammation.
In line with the pathogenic mechanism of spleen and kidney deficiency, phlegm, stasis and deficiency are mutually glued together, and the nature of the disease is originally deficient and symptomatically real. In addition, dampness has a unique pathogenic characteristics, easy to tend to the lower jiao yin position, dense and sticky, lingering and hidden, and easy to hold evil, heat and toxicity, etc. latent in the body, mixed in the blood, and hurt the internal organs of yin and Yang.