Clinical Research Of Embedded Needlle Acupuncture Therapy In Treating BPH

With the advent of an aging society and more importance being placed on health concerns of the elderly, from the perspective of incidence rate and waste of medical resources, benign prostatic hyperplasia (BPH) is a disease of geriatric medicine that cannot be ignored. According to the report of Dr. H. Nakajima, General Director of the World Health Organization, in men over the age of 50 there is about a 50-75% occurrence of BPH. In the process of diagnosis and treatment, on average every patient spent nearly 5000USD. In Taiwan BPH is Urology's most commonly seen disease. The medical community worldwide has invested a lot of man hours and resources specializing in the research and treatment of BPH.Part I Literature SurveyObjectiveTo understand BPH pathogenesis, etiology, and corresponding treatment as recognized by Traditional Chinese Medicine (TCM). Make use of fundamental theory and origin of embedded needle stimulation of acupoints. To become familiar with Western medicine's related pathogenesis, risk factors, and treatment of BPHMethodsReference TCM documents related to benign prostatic hyperplasia and embedded needle acupuncture technique. Perform a search of any data related to BPH over the past ten years. And finally compile, arrange, and summarize all information.ResultsA. The pathogenesis of benign prostatic hyperplasia as understood by TCM, is a discourse of external and internal causes, and once again relies on the dual principles of the developmental process of both internal and external causes. Etiology is believed to be related to qi, blood, dampness, phlegm, heat, and/or stasis. As far as treatment, TCM uses methods such as supplementing the kidney and boosting the qi, and quickening the blood and relieving stasis. Some more unusual treatment methods that have also been preserved include herbal enemas, patches, and suppositories. And acupuncture makes use of needling, moxibustion, acupoint injection therapy, combined needle and herbal therapy, and embedded needle therapy as the main forms of treatment.B. Embedded acupuncture needle therapy gradually developed from a guiding theory that reads, "Its intake from the deep and long term retention, is used to treat an obstinate disease. " Initially it is believed that embedded acupuncture needle therapy is a collective name for one type of theoretical system, not just simply pointing to any concrete acupoints or needle stimulation methods.C. Western medicine has more thorough research of benign prostatic hyperplasia. Its occurrence must fulfill two fundamental requirements, that is testicular function and age, which are very closely related. Current treatment mainly relies on medications, such as Type A Sympathetic nerve blocker [118] [119] [124] (alphal-adrenergic blockers), anti-acetylcholine (Anti-cholinergic), hormone suppression therapy, and so on…At this stage surgery is still a viable treatment option. Surgical treatment options include: transurethral resection of the prostate (TURP) which is a traditional open abdominal surgery, microwave heat therapy, focused ultrasound thermal treatment, radio wave heat therapy, and the newest form of treatment Green light laser PVPTM.ConclusionsA. With regards to benign prostatic hyperplasia TCM is in the process of gradually developing more understanding of the pathogenesis and etiology, and thus treatment is progressively becoming more thorough and complete. Acupuncture as a part of TCM, has a well established history in the treatment of BPH. All related domestic and international clinical and experimental research has confirmed that to a certain degree acupuncture treatment can improve the prognosis for BPH patients.B. The majority of literature showed that: using "GuanYuan" "QiHai" "ShenShu" "ZuSanLi" "SanYinJiao" and "TaiChong" as the main acupoints, assisted by complimentary acupoints as derived from the TCM pattern identification system. And the use of embedded needle acupuncture showed even better efficacy in treating BPH.C. Western medicine has a clearer understanding of BPH pathogenesis and correspondingly a more comprehensive treatment, which is still being perfected, and can offer patients yet another treatment option.Part II Clinical ResearchObjectivePatients suffering from benign prostatic hyperplasia will be the target of this research. Different types of embedded needle therapy and traditional acupuncture treatment will be used, and a comparative study of the prior and post treatment situation will be carried out. The aim is to: examine the healing effectiveness of different types of therapies in treating BPH, and to conduct an evaluation of the healing effectiveness of clinical acupuncture treatment.MethodsCases collected from January 2006 through February 2008 at Taipei TaiYiTang TCM Clinic and ShengChang Modern Chinese Medical Hospital of BPH patients were used for clinical observation. A group of 60 patients suffering from BPH and ranging in ages from 50-80 were selected. "GuanYuan" , "QiHai" , "ShenShu" , "ZuSanLi" , "SanYinJiao" , and "TaiChong" were the main acupoints used and were assisted by complimentary acupoints as derived from the TCM pattern identification system. The clinical study used randomized single blind method. The patients were randomly divided into two test groups: 30 in the embedded needle group (treatment group) and 30 in the traditional acupuncture group (control group). The prior and post treatment comparison made use of IPSS and QQL scores, residual urine volume in the bladder, prostate volume, maximum flow rate, sex hormones and other indicators for observation of BPH patients.ResultsEmbedded needle therapy showed significant clinical efficacy in treating BPH, and it was additionally discovered that it improved both physical characteristics of the body and strengthened the immune system. Pre-treatment and post-treatment observation of clinical research was based on: International Prostate Symptom Score (IPSS), Quality of Life Score (QQL), residual urine volume (RU), prostate volume (PV), maximum urinary flow rate (Qmax) and sex hormones. The resulting evaluation after three months of treatment showed: the embedded needle group (treatment group) had 20 cases of marked effectiveness, 6 cases of effectiveness, and 4 cases showing no effect, an overall efficacy rate of 86.67%; the acupuncture group (control group) had 4 cases of marked effectiveness, 18 cases of effectiveness, and 8 cases showing no effect, an overall efficacy rate of 73. 33%. The results show that: the treatment group's marked efficacy rating of 66.67% clearly surpasses that of the control group 13.33%, P<0.01.ConclusionsIn accordance with the theory of "its intake from the deep and long term retention, is used to treat an obstinate disease, " the fundamental techniques of traditional acupuncture and the creative use of modern technology have led to the development of the TCM and Western Medical Integration point of view and method. The World Federation of Acupuncture has pointed out that development of long-term effectiveness, less traumatic acupuncture therapy, and improved treatment for difficult-complex diseases is the major direction of acupuncture for the 21st century. Therefore as the advantages of embedded needle acupuncture are increasingly pointed out, there is great significance in going one step further and continuing to promote its application.The use of embedded needle therapy and traditional acupuncture therapy in treating mild to moderate BPH, have different degrees of efficacy. However, in cases of severe BPH the use of embedded needle therapy showed marked improvement in pre-treatment and post-treatment IPSS, QOL, RU, and Qmax scores. Although the number of cases was too few, treatment of prostate volume (PV) is also seen to be effective.Achieved results of embedded needle therapy in treating BPH are: improvement of symptoms (from IPSS International Prostate Symptom Score), improvement in quality of life, reduction in frequency of nocturia, an increase in the maximum urinary flow rate, control of enlarged prostate volume (partial reduction in prostate volume), control of worsening in patient' s condition, leading to stabilization in quiescent period, protection from and prevention of detrusor myopathy, and quickly achieving a painless and healthy state of body.