The prostate benign hyperplasia is caused by the imbalance of sex hormones in the body after men enter old age, and is also one of the common diseases in older men.
According to the survey, 45.6% of men over 50 years old have an enlarged anal finger, and 60% of men aged 50-70 years old have an incidence of prostate. Later, as age increases, almost 90% of 90-year-olds have hyperplasia.
I. Etiology.
The exact cause is not clear, more authors believe that due to the imbalance between androgens and estrogens, may be an important cause of its development
In addition, there is also a close relationship with the following factors.
1, indulgence in sexual desire. Because frequent sexual impulses cause repeated congestion of the sexual organs, over time, due to stasis and enlargement.
2, posterior urethritis, cystitis, vesiculitis and other organs around the prostate inflammation caused by passive congestion of the prostate, which in turn prompted the prostate fibrous tissue to proliferate.
3, chronic inflammation of the prostate is not completely treated well, so that the glandular tissue enlarges.
4, abnormal testicular function. If you have suffered from orchitis, cryptorchidism, etc., so that the testicular function early decline
5, urinary tract obstruction. Such as urethral strictures, bladder or urethral stones, lower urinary tract obstruction, excessive filling of the bladder with urine stimulates the prostate gland prompting hyperplasia.
6, frequent alcohol abuse or long-term alcohol consumption. The alcohol component can stimulate prostate enlargement.
7, addiction to pungent, spicy, acidic and other foods induce prostate congestion and hyperplasia.
8, lack of physical exercise. Can not improve the blood circulation of the prostate, and susceptible to arteriosclerosis affects the blood supply of the prostate nutrition.
The Chinese medicine believes that its location in the bladder, urethra, and is closely related to the kidneys, liver and spleen. It is also divided into deficiency and reality, with deficiency of kidney yin and kidney yang, imbalance of yin and yang, and unfavorable qi-chemistry as its root cause, and damp-heat, qi-stagnation and blood stasis, and phlegm-stasis as its symptoms.
Therefore, Chinese medicine suggests the following causes.
1. damp-heat injection 2. deficiency of kidney energy 3. internal injury to the seven emotions 4. spleen deficiency and qi stagnation 5. phlegm and deficiency of essence
Clinical symptoms
1, frequent urination: early symptoms are frequent urination, night urination is more obvious, with the development of the disease, the residual urine in the bladder gradually increased, the effective capacity of the bladder reduced, bladder mucosa congestion, urinary frequency is more obvious.
2. Difficulty in urination: prolonged urination time, weakness in urination, thin urine stream, shorter projection, dripping after urination, and gradually urinary retention and lower abdominal distension. Gradually urination to increase abdominal pressure to help urination, cold exertion, drinking alcohol and other triggers, can make the prostate and bladder neck congestion edema, so that patients suddenly occur acute urinary retention.
3.Other symptoms
(1) Hematuria is often caused by congestion and edema, and venous stasis and swelling.
②The increase of abdominal pressure in long-term urination can cause hemorrhoids, hernia, varicose veins of lower limbs, prolapse, blood in stool, etc.
③Infection factors, due to long-term bladder residual urine easy to cause urinary tract infection, causing back pain and fever and urethral irritation.
④The combination of renal impairment can cause anemia, loss of appetite, hypertension and other symptoms.
Diagnostic points
1, mostly seen in older men over 50 years old, early performance of urinary frequency and nocturia increased, difficult urination, weak urine flow, late stage can appear serious urinary frequency, urinary urgency, difficult urination, and even dribbling, small abdominal distension, touching the filling bladder presents filling incontinence.
2, rectal finger examination: prostate enlargement, hard texture, smooth surface, central groove disappears, pay attention to the examination after emptying.
3.B ultrasound: not only can the morphology, size and nature of the enlarged prostate be measured. The internal structure can be analyzed, and the transrectal ultrasound can be more correct. Transabdominal ultrasound can measure the residual urine.
The typical ultrasound presentation of prostate cancer is.
(i) enlarged prostate volume, asymmetric left and right, and inconsistent shape.
(ii) Rough thickening of the envelope, disruption of the connecting bright line with disruption of the local level.
③ Internal echogenicity is not uniform, irregular-shaped focal hypoechoic areas may appear, which may be accompanied by and light clusters, and there may be sound attenuation, and the lesions are often found in the posterior lobe or left and right lateral lobes, with unclear boundaries between internal and external membrane structures.
(iv) Invasion of adjacent tissues section in the seminal vesicle, bladder, vesicorectal fossa or rectal wall detecting masses and echogenicity.
⑤ Lower urinary tract obstruction is found: hydronephrosis, residual urine, etc.
4.Urodynamic examination can determine the existence and degree of lower urinary tract obstruction.
At 20ml.
Normal people with prostatic hypertrophy
① Initial urination time 10-20s 30-40s
②Maximum urine flow rate 20-25ml/s ≤15ml/s
③Maximum urine flow time 7-8s 10-20s
④Average urine flow rate 15-20s 10ml/s
⑤ Urination time about 20s 30-60s
5.Intravenous renal monsinogram, whether there is lower urinary tract obstruction causing hydronephrosis ureteral dilatation and estimation of renal function.
6.Cystoscopy To understand the cause of hematuria and to observe the enlarged prostate.
7.Laboratory focus on PSA (prostate-specific antigen)
PSA is the most sensitive marker of prostate cancer
①PSA in 4-20ng/ml PSAD>0.45 Highly suspicious of cancer
②PSA at 4-10ng/ml PSAD <0.05 Called gray stage, observable
0.05＜PSAD＜0.45 Follow-up observation
③FPSA＞0.45 Cancer suspected
FPSA＜0.16 or >10ng/ml with case indication
IV. Treatment methods
1.Pharmaceutical treatment
Western medicine treatment
5α reductase inhibiting enzyme can inhibit the production of dihydrotestosterone in human body, which can inhibit hyperplasia and make it shrink. The brand name is Pauliji 5mg qd × 6 months, domestic have blue music.
②α receptor blocker
Non-selective α1 receptor blocker Jurinamide 5-10mg 1/day No longer used
Second-generation α1 receptor blocker Gottlieb (Terazosin Mashani) 2mg qd
Third-generation alpha 1 receptor blocker Harle 0.2mg 1/day Better performance than the first two Nissan for Zithromax
③Pollen type
Schenectady (Pulsatilla) is a rye pollen extract that inhibits the binding of dihydrotestosterone to its receptor 375mg/tablet Bid In addition, there are also prostacom and urethra.
Chinese medicine treatment
The purpose of Chinese medicine in the treatment of prostate
To cut off the source and remove the symptoms, by warming the kidney yang, activating blood circulation, improving the absorptive capacity of the body and improving sexual function, so that the secreted androgens are widely absorbed and no longer accumulate in the prostate.
By activating blood circulation and removing blood stasis, clearing heat and detoxification, softening and dispersing knots, and facilitating urination, the androgens, cholesterol, waste and toxins that have accumulated in the prostate are discharged from the body.
The company’s main goal is to improve the quality of its products, improve blood viscosity and enhance immune function, and nourish the yin and tonify the kidneys. Promote the secretion function of glandular cells, so that the evil can be removed and the positive can flourish.
This can not only remove malaria but also make the disease go away by promoting lymphatic support, so that the urinary and sexual functions can be effectively adjusted and the whole body can be in an overall benign balance.
2.Physical therapy
The first of these is the use of a fixed microwave heat source to heat the prostate, which can cause cellular degeneration, necrosis and vascular atrophy within a 2cm radius. Its energy enters the tissue field and interacts with each other, causing ionic oscillations and increasing the local temperature to 45℃-47℃. The treatment modalities are transrectal, urethral and extracorporeal. The recent effect is good, 1-2 times a week × 3-5 weeks
② radiofrequency heat therapy, which has been basically rarely applied
③Energy treasure, combined with acupuncture treatment
④Isotope therapy
3.Surgical treatment
Indications.
①Urinary retention (unable to urinate at least once after removal of catheter)
②Recurrent episodes of hematuria
③Renal failure due to prostatic hyperplasia
④Recurrent urinary tract infection
⑤ Combined bladder stones and large bladder chambers with residual urine over 100ml
Surgical approach.
① suprapubic transcystic prostatectomy
②Postpubic prostatectomy
Trans-perineal prostatectomy
④Transurethral electrodesiccation of the prostate
⑤ Double orchiectomy
Five, prostatic hyperplasia patients how to carry out self-care
1. The diet should be light and easy to digest. The actual fact is that you will be able to get a lot more than just a few of the most popular and popular items.
2, the sexual life is neither indulgence nor abstinence. But for those who have a history of urinary retention, you should be careful.
3, as far as possible less cycling, compression of the prostate, aggravating the disease
4, do not hold urine for a long time, so as not to damage the function of the forced urinary muscle, aggravating the disease
5.Treat genitourinary infections in a timely manner and actively prevent the occurrence of urinary retention
6.Keep your mood relaxed, avoid worry and anger, avoid overworking
7, moderate physical activity, improve the resistance to improve the local blood circulation of the prostate
8, every night before going to bed for acupressure (Chung Quan, perineum, Guan Yuan, Zhong Ji, Qu Bone, etc.), and repeatedly make anal lifting exercise
A brief discussion on the treatment of prostate enlargement and prostatitis views
It is well known that the prostate is a difficult disease to treat, as discussed in detail earlier. The reason for this is that the anatomical location is above the perineum with poor blood supply. It has three layers of envelope, which makes it difficult for drugs to enter and has poor permeability. Only fat-soluble drugs can enter the envelope, and protein-bound drugs cannot enter, plus it is adjacent to the opening of the seminal vesicles and posterior urethra. Once these organs are diseased they can also affect prostatitis. In addition, bad habits such as smoking, alcohol, irritating foods, irregular sexual life and frequent masturbation are all reasons why it is difficult to treat. Therefore, it is very difficult to make use of a single treatment method. In the absence of a special effective method, a variety of effective means to treat a disease should be used to complement each other’s strengths and complement each other’s weaknesses. Chinese herbal medicine as the main, antibiotics as a supplement, and then can be combined with acupuncture, physical therapy and qigong treatment. Antibiotics, Chinese herbal medicine, improve the body’s immune function, adjust the balance, change the symptoms of Chinese herbal medicine with acupuncture and physical therapy, in consolidating the effect of treatment, improve the physical quality of qigong (spring back), and return bad habits to good habits, combined with psychological control, so that both the symptoms and the root cause to achieve the purpose of cure.
Now we focus on the experience of Chinese medicine treatment
In terms of identifying the cause of the disease, it is located in the lower jiao, on the perineum, under the pubic bone, with a thick perineum and a thin pipeline, poor blood supply, and often impulsive congestion, so there is easy stasis and easy to cause deficiency. In terms of TCM etiology, deficiency of spleen and kidney qi, long deficiency will lead to stasis. In order to solve the problem of Qi deficiency, blood stasis and elimination of bacteria, we propose to benefit the Qi, tonify the kidneys and invigorate the blood. We propose the method of benefiting Qi, tonifying the kidney, activating blood circulation and removing stasis, clearing heat and dampness, and promoting lymphatic flow.
In terms of benefiting qi, ginseng, astragalus and rhodiola can be used heavily
For tonifying the kidney, it should be combined with the addition of Xian Ling Spleen, Locked Yang, and Puzzle Nut for those with kidney yang as the mainstay.
For kidney yin predominantly, it is advisable to reuse, Lycium barbarum, Fubenzi, Jinzhuzi, Fructus chasteensis
Activating blood circulation and resolving blood stasis: Salvia miltiorrhiza, Peach kernel, Safflower, Wang Bu Liu Xing Zi, White Flower and Snake Tongue Herb, Bai Ying, Leech
Inducing herbs (penetrating the envelope): Gunnera, Saponaria (heaviest), Dried General, Tu Fu Ling (middle), Boneset, Mountain Cichlid (partial Yang deficiency)
Lymphatic: plantain, red poria, q cunningham, zedoary
heavy urinary discharges: Xian Ling Spleen, Liu Yao Nu, Di Shen Zi, Mao Dong Qing, Yi Mu Cao, Red and White Peony
For people with low immunity, use: ginseng (white ginseng or ginseng powder), yellow essence, reishi
For those with yin deficiency and fire: Radix et Rhizoma, Phellodendron, Radix et Rhizoma, Radix et Rhizoma, Radix et Rhizoma, Radix et Rhizoma
For those with urinary frequency and urgency: gorgonian, locking yang, calcined dragon peony, wu wei zi, wu mei, panax quinquefolium powder
In the process of identifying evidence
1, we should pay attention to the deficiency of spleen and kidney qi, and the stagnation and obstruction of blood stasis and defeated essence as its symptoms
2. The deficiency involves yin and yang, and yang must be supplemented with yin nourishment. Such as ginseng and rhodiola, etc., to strengthen the spleen and benefit the qi, consolidate the essence and cultivate the yuan, so that the positive qi is enriched, and at the same time with wolfberry and raspberry, flattening the liver and kidney, nourishing the yin and helping the yang, nourishing the positive yin, producing sperm and shrinking urine.
3, due to the thickening of the three-layer envelope, the drug is difficult to enter, as a pioneer, it is necessary to apply priming drugs, so that the effective concentration of drugs directly to the lesion, to improve the efficacy.
4, pay attention to both attack and supplement, improve the body’s immune function, ginseng, rhodiola, yellow essence, astragalus.
5, play the body’s potential to improve the body’s initiative, physical and mental self-regulation ability. Eliminate germs, qigong (rejuvenation) plus psychological regulation.
We know that the treatment of prostate hyperplasia, there are currently three main drugs, namely 5α-reductase inhibitors, represented by Paulownia, adrenal alpha-blockers, Marsellitis, as well as botanicals represented by sernitone. I would like to focus on the botanical medicine class of pure Chinese medicine preparation, the retention of urine Shu capsule produced by Shijiazhuang Kedi Pharmaceutical Co., Ltd. was applied in 1996 in the clinical 1998 in Shanghai Huashan, Changhai, Ruijin, Shiyi, Jingzhong five hospitals for clinical observation for 138 cases for three weeks, the results of the study suggest that both subjective symptoms (IPSS score), or objective indicators residual urine, urinary The results of the study indicated that there were very significant differences (p<0.01) in both subjective symptoms (IPSS score) and objective indicators such as residual urine, fluid dynamics, and pre- and post-drug control, and the improvement rates of the three were observed to be 39.42%, 35.66% and 24.26%, respectively. And the side effects are extremely low and can be taken for a long time.
The composition of Retention of urine capsule.
King: Psoralen Mainly contains psoralen, which significantly reduces the weight of the prostate induced by dihydrotestosterone and makes it reduce the volume of the prostate, and has the effect of warming the kidney and transforming the qi
Mainly contains flavonoids, which can enhance the peristalsis of the ureter and contraction of the bladder muscles, strengthen the urinary power of the bladder, have a diuretic and laxative effect, disperse nodules and relieve pain.
2, motherwort mainly contains motherwort alkaloids, can inhibit platelet thrombosis, nourish the myocardium, activate blood circulation, remove blood stasis, clear heat and laxative effects
Zuo: 1, sea gold sand, mainly containing sea gold sand, can enhance the contraction force of the bladder force urinary muscle, strengthen the bladder urinary power, improve the urinary flow rate, has a diuretic and laxative, disperse nodules and relieve pain
2, amber: the main succinic acid, with inhibitory effect on the central nervous system, with blood circulation, diuretic and laxative effect.
Make: Mountain cichlid Mainly contains colchicine, can effectively inhibit cell division, has clearing heat and detoxification, subduing swelling and dispersing nodules
Dosage: 0.3g x 3 capsules, 2 times daily. Three weeks is a course of treatment, also can be taken for a long time.
From 10 years of clinical application, we have the following experiences.
1, retention of urine Shu does improve the obstructive symptoms of prostate urine, such as urinary frequency, urinary urgency, incomplete urination, nocturia, increased urinary pain, thin urinary drainage and weakness of urination, which is better than other drugs of the same kind.
2. Retention of urine has a dual role, on the one hand, it can improve the symptoms of urinary tract obstruction by inhibiting prostate enlargement and reducing the volume of prostate, and at the same time, it can also have the effect of α1-blocker drug. It can relax the smooth muscle of bladder neck and smooth muscle of urethra prostate to make the urinary tract unobstructed and relieve the symptoms of urinary tract obstruction.
3, can improve the force of the muscle of the force of the urinary muscle (the role is unique to this product, other similar products do not have) can increase the power of urination, improve urodynamics, improve the patient’s maximum urinary flow rate, so that the prostate enlargement. The most symptoms, weakness of urination, can be significantly improved. For patients with a large amount of residual urine due to the obvious weakness of the bladder forced urinary muscle, patients who cannot undergo surgery and patients who need long-term urethral tube insertion, Chinese herbal medicine treatment has a solution, and retention of urine can be used as an important adjunctive treatment medicine.
4.Less side effects, can be applied for a long time
Because it is composed of Chinese herbs, and the formula is based on tonifying the kidney and then combined with the method of activating blood stasis, dispersing nodules and softening hardness, clearing heat and detoxifying, and relieving spasm and lymphatic flow. It contains the principle of both attacking and tonifying. There is no obvious damage to liver and kidney, except for a few patients with thirst, nasal congestion and mild gastrointestinal reactions, it can be taken for a long time and is safer and more effective than other western medicines.
We then introduce my common treatment of prostatitis Chinese patent medicine – prostate detoxification capsule
Ingredients: leech, rhubarb (made with wine), motherwort, dandelion, safflower, dirong, astragalus, angelica, paeonia lactiflora, chickweed, chai hu
Monarch: Leech, Rhubarb – anti-inflammatory
Minister: motherwort, dandelion, safflower, dilong – anti-inflammatory
Adjuvant: White peony, Astragalus, Angelica sinensis, Radix et Rhizoma cocklebur – analgesic
Make: Chai Hu – antibacterial
Leech: This formula reuses leech, the key ingredient is leechin, which is the strongest thrombin inhibitor with powerful anticoagulant and antithrombotic effects. And it does not induce thrombocytopenia.
Secondly, it contains heparin, which also has the effect of carrying coagulation and can prolong the coagulation time, prothrombin time and prothrombin time. leech for chronic prostatitis is to lift blood coagulation through the seminal tract and increase the early and full opening of the prostate ducts, reduce the rate of re-occlusion, blood stasis in the seminal tract to form dead blood and defeat sperm, causing the prostate to become congested and enlarged, stimulating the sympathetic nerve excitability within the envelope, which is causing abnormal urination and pelvic area
Rhubarb: rhubarb phenol has antibacterial and anti-inflammatory effects.
Paeonia lactiflora: Paeonia lactiflora has a strong antispasmodic effect, analgesic and sedative effect.
Radix Bupleurum: Radix Bupleurum Saponin: has a good sedative and analgesic effect on the central nervous system and antipyretic effect, with significant anti-inflammatory effects.
Efficacy and main treatment: detoxifying and relieving dampness, promoting lymphatic flow and resolving stasis Used for chronic prostatitis with dampness and heat and stasis
Symptoms: frequent and urgent urination, residual draining after urination, white dripping after urination, astringent pain in the urethra, pain in the abdomen, perineal discomfort, lumbosacral pain, scrotal dampness and testicular pain, etc.
Dosage: Take orally, 4 capsules once, 2 times a day.
In the course of a long engagement with prostate disease, it is felt that the most difficult to treat is aseptic prostatitis, laboratory tests of normal white blood cells (prostate fluid), lecithin ++ no need for anti-inflammatory. The actual “three pains” (pain in the abdomen, lower back, and testicular pain) are obvious when there is. The actual “three pains” (pain in the abdomen, pain in the waist, pain in the testicles) and “one urgency” (frequent and urgent urination).
In short, the treatment of prostate disease, first of all, we must play both sides of the positive, the patient to take the initiative physical and mental self-regulation fully mobilize their own potential to fight the disease. The second is that the doctor should realize that this disease is a difficult disease, there is no special medicine, need to be patient, subtle use of Chinese and Western medicine and other means, phased use, and combined with exercise therapy such as back to spring. It is believed that with joint efforts, a successful outcome will be obtained.
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 this. 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. This kind of negative disappointment from the psychological, thus affecting the vicious circle in terms of physical disease, further causing a long time to cure.
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. I think that prostate disease should be curable. 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. This is also the case with prostatitis, once the personal life is confused (such as cold, drinking and smoking, excessive sex, unclean sex, excessive masturbation, excessive fatigue, etc.), these are the reasons that trigger the recurrence of prostate disease. The actual fact is that there are a lot of people who are not able to get a good deal on this. “The actual fact is that you will find a lot of people who are not able to get a good deal on this kind of things. This is my good hope for the majority of prostatitis patients.
The contribution of the Spring Festival to the development of the body’s physical and mental potential, the improvement of the body’s immune function, anti-aging, and the treatment of the untreated disease will be published in a separate article.