Clinical Observation on Deep Acupuncture at Huantiao (GB 30) for Patients with Chronic Prostatitis

Yu Li-zhong, Zhang Zhi-hui, Sun Zuo-qian, He Tian-you, Yan Xing-ke

1 Zaozhuang Vocational College of Science and Technology, Shandong 277500, China

2 Gansu College of Traditional Chinese Medicine, Lanzhou 730000, China

Clinical Observation on Deep Acupuncture at Huantiao (GB 30) for Patients with Chronic Prostatitis

Yu Li-zhong1, Zhang Zhi-hui1, Sun Zuo-qian1, He Tian-you2, Yan Xing-ke2

1 Zaozhuang Vocational College of Science and Technology, Shandong 277500, China

2 Gansu College of Traditional Chinese Medicine, Lanzhou 730000, China

Objective: To observe the clinical efficacy of deep acupuncture mainly at Huantiao (GB 30) for patients with chronic prostatitis.

Methods: Forty-two cases of patients with chronic prostatitis were treated with deep acupuncture at Huantiao (GB 30) combined with adjunct acupoints on the base of syndrome differentiation. Ten times treatment was a course, and effects were evaluated after two courses.

Results: Among all the 42 cases, 29 cases were cured, 9 cases were improved and 4 cases were invalid, and the total effective rate was 90.5%.

Conclusion: It has good effect of deep acupuncture at Huantiao (GB 30) as major acupoint combined with adjunct acupoints on the base of syndrome differentiation for patients with chronic prostatitis.

Acupuncture Therapy; Prostatitis; Point, Huantiao (GB 30)

Chronic prostatitis is a common disease of adult male urinary system, its incidence rate is about 9% to 14%, and it mainly involves young adults aged 20 to 40 years old. Due to the complex etiology and unclear pathogenes, there is little reasonable and effective treatment and medicines. Antibiotics are commonly used in clinic, but they may cause bacterial resistance, resulting in a series of chronic refractory prostatitis cases. I had the privilege to learn from Professor He Tian-you who is a famous doctor in Gansu Province, using deep acupuncture at Huantiao (GB 30) as the major acupoint, and the report is given as follows.

1 Clinical Material

1.1 Diagnostic criteria

1.1.1 Diagnostic criteria of Western medicine

They are referred to diagnostic criteria for chronic prostatitis in Clinical Andrology[1]. ① Bearing down and distending, pain or sore pain in the perineum, pubic area, anus and lumbosacral areas, or pain, frequent urination, urinary urgency, and sense of inability to complete urination; ② microscopic examination of expressed prostatic secretions (EPS) shows that white blood cell (WBC) ＞10 (high power field), lecithin corpuscles reduce.

1.1.2 Syndrome differentiation in traditional Chinese medicine[2-3]

Heat-dampness syndrome: Frequent and urgent urination, dysuria, and a burning sensation when urinating or cloudy urine overflow when defecating, and bearing down and distending pain in the perineum, lumbosacral area and testicular, yellow greasy tongue coating, and slippery and rapid pulse.

Qi-stagnation and blood-stasis syndrome: Bearing down and distending discomfort in lower abdomen, perineum and testicular, or hematuria and hemospermia, purple and dark tongue with petechial and white or yellow coating, and deep uneven pulse.

Fire hyperactivity due to yin deficiency syndrome: Low back and knees lassitude, dizziness, blur version, insomnia, a lot of dreams, nocturnal emissions or hematospermia, frequent erections, cloudy urine overflow when defecating or urination, red tongue with little coating, and thin rapid pulse.

Kidney yang deficiency syndrome: Dizziness, lassitude, cold knee, impotence, premature ejaculation, cloudy urine overflow from urethra upon tiredness, a pale and swollen tongue with white coating, deep and thin pulse.

1.2 Inclusion criteria[4-5]

Those met the diagnostic criteria of Western medicine and the diagnostic criteria of traditional Chinese medicine syndrome; those aged 18 to 80 years old; those signed informed consent form and completed the treatment.

1.3 Exclusion criteria[4]

Those who had acute prostatitis, or benign prostatic hyperplasia, or prostate cancer, who had neurogenic bladder, urinary tract abnormalities or stenosis and severe neurosis; patients with local pain as the main symptom should exclude other diseases of lower abdomen, perineum and lumbosacral areas such as stones, bladder stones, inguinal hernia, inflammation of the pubic bone, varicocele, epididymitis, rectal colon disease, lumbar back myofascitis and so on; who were complicated with severe diseases of heart, lung, liver and hematopoietic system, and who were allergic constitution or allergic to multiple medicines; who could not cooperate, e.g. the mentally ill patients.

1.4 General data

There were 42 enrolled cases from clinics in Acupuncture Clinical Center in the Affiliated Hospital of Gansu College of Traditional Chinese Medicine from April 2011 to March 2012. And all the cases were diagnosed with chronic prostatitis. Their average age was 39.7 years, ranged from 28 to 71 years old. And their disease duration ranged 3 months to 7 years, with an average of 12.5 months. Most patients had received Western and Chinese medical treatment early before, but gotten poor efficacy.

2 Treatment Methods

2.1 Acupoints selection

Major acupoints: Bilateral Huantiao (GB 30).

Adjunct acupoints: Pangguangshu (BL 28), Yinlingquan (SP 9), Sanyinjiao (SP 6), and Weizhong (BL 40) were added for heat-dampness syndrome; Xuehai (SP 10) and Geshu (BL 17) were added for qistagnation and blood-stasis syndrome; Shenshu (BL 23), Ganshu (BL 18), Taixi (KI 3) and Taichong (LR 3) were added for fire hyperactivity due to yin deficiency syndrome; Mingmen (GV 4), Shenshu (BL 23), Pishu (BL 20) and Zusanli (ST 36) were added for kidney yang deficiency syndrome.

2.2 Operation

In a prone position, the local skin in the acupoint area was routinely disinfected with 75% alcohol. Huantiao (GB 30) was punctured by a needle of 0.3 mm in diameter and 100 mm in length. Insert the needle quickly into the subcutaneous tissue with hand-holding needle insertion method, and make the tip toward the prostate obliquely, and then insert it slowly about 80 to 90 mm. After arrival of qi, use even reinforcing-reducing manipulation till sore and distended sense in perineum, penis and testicle. And then, insert needles of 0.3 mm in diameter and 40 mm in length into other acupionts perpendicularly, conduct lifting-thrusting and twirling method till producing local numbness and distention sense, and then conduct even reinforcing-reducing manipulation. Retain the needles for 30 min every time and manipulate the needles once during retaining.

The above operation was performed every 2 d, 10 times constituted a treatment course, with a rest of 2-3 d between 2 courses, and the therapeutic effect was evaluated after 2 courses.

3 Therapeutic Effect observation

3.1 Therapeutic effect criteria[4-6]

Recovery: The symptoms disappear, EPS culture shows negative, microscopic examination (high power field) shows WBC ＜10, and lecithin corpuscles return to normal.

Improvement: The symptoms relieve, EPS culture microscopic examination (high power field) shows WBC ＞10, but ＜20, and lecithin corpuscles are smaller.

Invalid: There is no significant change in the symptoms and EPS examination.

3.2 Results

After two courses of treatment, 29 cases were cured, 9 cases were improved, 4 cases were invalid, and the total effective rate was 90.5%.

4 Discussion

Chronic prostatitis belongs to ‘Long Bi (retention of urine)’ and ‘Lin Zheng (strangury disease)’ in traditional Chinese medicine[7-8]. It is usually caused by improper medication and treatment for acute prostatitis. It’sconsidered in traditional Chinese medicine that the root cause of chronic prostatitis is kidney-deficiency, and its manifestation is heat-dampness, and long duration induces qi-stagnation and blood-stasis. The majority of patients have a history of long-term and large-dose exposure to antibiotics; thus the pathogen bacteria have a strong resistance to the medication, which is why the therapeutic effect is not satisfactory.

The ancient book Su Wen (Plain Questions) records that ‘the diseases may locate at the surface or in the depth, while piercing includes shallow piercing and deep piercing, thus we need to always proceed to the respective structure’. Mr. He holds that deep puncturing Huantiao (GB 30) toward the prostate can not only guide vital qi to illness area directly and produce strong acupuncture sensation, but also clear heat-dampness as well as promote blood circulation for removing blood stasis. Therefore, the prostate secretion function is strengthened, which is conducive to drain inflammatory excretion and promote inflammation absorption, resulting in rapid relief of the symptoms including bearing down and distending discomfort in the lower abdomen and perineum, and enhancing the body's immune function. From anatomy perspective, all the innervation nerves of prostate deep area are the branches of sacral plexus including pelvic plexus, prostate nerve and sciatic nerve. Thus deep acupuncturing Huantiao (GB 30) can enhance the regulatory function of the prostate plexus in order to promote local blood circulation and inflammation absorption. Adding Pangguangshu (BL 28), Yinlingquan (SP 9), Sanyinjiao (SP 6), and Weizhong (BL 40) for heat-dampness syndrome can clear heatdampness to improve qi transformation and movement, and drain the pathogen by urination; and reducing method aims at enhancing the power of expelling pathogen. Adding Xuehai (SP 10) and Geshu (BL 17) for qi-stagnation and blood-stasis syndrome can promote qi movement and blood circulation so as to achieve free flow of qi and blood and uninhibited urination. Adding Shenshu (BL 23), Ganshu (BL 18), Taixi (KI 3) and Taichong (LR 3) for fire hyperactivity due to yin deficiency syndrome can nourish yin to remove heat on the base of tonifying the root[9-11]. And adding Mingmen (GV 4), Shenshu (BL 23), Pishu (BL 20) and Zusanli (ST 36) for kidney yang deficiency syndrome can warm and tonify kidney yang; besides, conducting reinforcing method during manipulation can enhance the power of the tonify. Deep puncturing Huantiao (GB 30) combined with syndrome differentiation for chronic prostatis can both tonify the deficiency and clear pathogen, so that vital qi cannot be harmed by eliminating pathogen, and both superfacial and root causes of disease are treated. That is why it achieves a good clinical effect and is worth further application.

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Translator: Deng Ying

R246.2

B

Date: February 25, 2013

Author: Yu Li-zhong, M.M., lecturer, attending physician

Yan Xing-ke, M.D., professor.

E-mail: yanxingke@126.com