| ObjectiveChronic prostatitis(CP)is a widespread urogenital disease in the andrology department.It has the characteristics of being difficult to heal and prone to attacks.In recent years,the incidence has remained high.The clinical manifestations are abnormal urination,local pain and discomfort,sexual dysfunction.Severe cases can cause infertility,long-term mental depression and anxiety,affecting physical and mental health.At present,the treatment of CP with western medicine is mainly comprehensive treatment,and there is no specific treatment method.Most of them are anti-bacterial,anti-inflammatory,analgesic,or supplemented with anti anxiety drugs.These treatment methods often have large side effects,the curative effect is not ideal and easy to cure,but also bring certain economic burden and mental pressure to individuals and families.The treatment of this disease in traditional Chinese medicine is guided by the holistic concept and based on syndrome differentiation.The main therapeutic methods are clearing away heat and dampness,promoting blood circulation and removing blood stasis,tonifying kidney and benefiting essence,including Decoction of traditional Chinese medicine,acupuncture,embolism of traditional Chinese medicine,retention enema of traditional Chinese medicine(TCM),sitting bath of traditional Chinese medicine,fumigation and washing therapy,etc.Combining multiple treatment methods according to the patient’s condition to formulate an appropriate treatment plan can effectively improve clinical discomfort and the overall effect is often satisfactory.Acupuncture,as a traditional Chinese medicine treatment method,has been widely used in various diseases.The analgesic effect of acupuncture has been confirmed by numerous studies.As the main symptom that troubles CP patients,it can be seen that acupuncture has unique advantages in treating CP.Warm acupuncture combined with acupuncture and moxibustion has certain curative effect on various kinds of pain diseases caused by wind chill,cold dampness and blood stasis.There is also an objective theoretical basis for the treatment of chronic prostatitis.Professor Tang Chunzhi concluded that the pathogenesis of CP patients lies in kidney deficiency.The TCM symptoms of CP of kidney yang deficiency type are drips after urine,turbid after labor,chilly limbs,sore waist and knees,mental depression,impotence,premature ejaculation or low sexual desire.It should be treated by warming and dispersing cold,promoting blood circulation and removing blood stasis.Warming kidney yang is the key to treatment,so warm acupuncture is also used by doctors to treat kidney yang deficiency CP.To date,large sample clinical trials are needed to prove that warm acupuncture can effectively treat this disease.Therefore,based on the theory of traditional Chinese medicine,this study uses warm acupuncture to treat CP of kidney yang deficiency through clinical randomized controlled study.To observe the effect of warm acupuncture on the clinical symptoms,mental anxiety and depression,prostate palpation,inflammation level of prostate massage fluid,autoimmunity level,and pathological changes of prostate in kidney-yang deficiency type CP patients compared with ordinary acupuncture intervention.It provides research evidence for warm acupuncture treatment of kidney Yang deficiency type CP.MethodsIn this study,a prospective randomized control method was used to conduct a comparative study between the experimental group and the control group.According to the inclusion criteria and exclusion criteria,100 CP patients with kidney Yang deficiency were screened from the male outpatient department of the first affiliated hospital of guangzhou university of traditional Chinese medicine from June 2017 to June 2019.After informed and signed the clinical trial informed consent,the patients were randomly assigned cases by simple randomization and SPSS23.0 statistical analysis software.According to the ratio of 1:1 between the two groups,100 cases of CP patients with kidney-yang deficiency were divided into warm acupuncture group and ordinary acupuncture group,with 50 cases in each group.In the warm acupuncture and moxibustion group,the patients were treated with warm acupuncture and moxibustion,including shenshu(bilateral),qi hai,guan yuan,middle pole,sanyin jiao(bilateral),yinling(bilateral)spring and chichibian.In the warm acupuncture and moxibustion group,the patients were treated with warm acupuncture,including Shenshu(bilateral),Qihai,Guanyuan,Zhongji,Sanyinjiao(bilateral),Yinlingquan(bilateral)and Zhibian(bilateral).Acupoint location refers to "GB/T 12346-2006 Name and Positioning of Acupoints".After acupuncture and de qi,perform the method of flattening and relieving diarrhea,perform needle acupuncture for 3 minutes,put 2cm moxibustion on the acupuncture and ignite,and moxibustion at each point for 2 Zhuang.Once a day,rest for 1 day after 6 consecutive days,2 weeks as a course of treatment,continuous treatment for 2 courses.The acupoints of the ordinary acupuncture group were treated with the same warm acupuncture group.The ordinary acupuncture group only received simple acupuncture treatment.Once a day,rest for 1 day after 6 consecutive days,2 weeks as a course of treatment,continuous treatment for 2 courses.Clinical symptoms of chronic prostatitis were assessed using the the national institutes of health chronic prostates symptom index(NIH-CPSI)and TCM syndrome score scale,and NIH-CPSI score included pain symptoms,urination symptoms,and quality of life.Prostate tissue palpation was evaluated using the glandular texture score and tenderness score around the prostate tissue.Inflammation levels were assessed using white blood cells(WBC)in an expressed prostatitis secretion(EPS).Autoimmune levels were assessed by interleukin-8(IL-8)levels and tumor necrosis factor(TNF-α)levels.The state of anxiety and depression was assessed by self rating Anxiety Scale(SAS)and self rating Depression Scale(SDS).The changes of prostate imaging and pathology were evaluated by the smoothness of prostate surface,the uniformity of internal echo and the size of gland in Bultrasound.A database was established for the assessment results,statistical analysis was performed using SPSS 23.0,the clinical efficacy of the two groups was counted,and various indicators were compared within and between groups.ResultA total of 100 cases were collected in this study,including 50 cases each in the warm acupuncture group and ordinary acupuncture group.During the implementation and observation of this study,9 cases were dropped and removed,91 cases were actually completed,including 46 cases in warm acupuncture group and 45 cases in ordinary acupuncture group1.Baseline comparisonBefore treatment,the age composition,course of disease,TCM syndrome score,NIH-CPSI score,prostate texture score,tenderness score of surrounding prostate tissue,eps-wbc count score,lecithin body score,IL-8 level,TNF-αlevel,SAS score,SDS score and other indicators were compared between the two groups.The differences were not statistically significant(P > 0.05),the baseline was consistent and comparable.2.Comparison of clinical effects(1)Comparison of clinical efficacy of TCMAfter treatment,the two groups of patients were compared in the clinical efficacy of TCM.In the warm acupuncture group,2 cases were cured,24 cases were markedly effective,19 cases were effective,and 1 case was ineffective.The total clinical effective rate was 97.83%.In the general acupuncture group,0 cases were cured,17 cases were markedly effective,and 25 cases were effective.The total clinical effective rates were 93.33%.After statistical test,the difference was statistically significant(P<0.05).It shows that the TCM clinical effect of warm acupuncture group is better than that of ordinary acupuncture group.(2)Comparison of clinical effects of western medicineAfter treatment,the two groups of patients were compared in the clinical efficacy of western medicine.In the warm acupuncture group,0cases were cured,18 cases were markedly effective,26 cases were effective,and 2 case was ineffective.The total clinical effective rate was 95.65%.In the general acupuncture group,0 cases were cured,9 cases were markedly effective,29 cases were effective,and 7 case was ineffective..The total clinical effective rates were 84.44%.It shows that the western medicine effect of warm acupuncture group is better than that of ordinary acupuncture group.3.Comparison of efficacy indexes(1)Comparison of TCM syndrome score and NIH-CPSI scoreAfter treatment,the TCM syndrome score and NIH-CPSI score of the two groups were significantly lower than before treatment,and the difference was statistically significant(P<0.05).Comparison of changes in TCM syndrome scores and NIH-CPSI scores between groups before and after treatment was statistically significant(P<0.05).The changes of NIH-CPSI scores in pain score,urinary symptoms score and quality of life influence score in the two groups were compared within the group,and all scores were significantly reduced,with statistically significant differences(P<0.05).Comparison between two groups found that the difference in pain symptom score and urination symptom score in the warm acupuncture group was statistically significant(P<0.05).This shows that warm acupuncture is better than the ordinary acupuncture group in improving TCM syndrome scores and NIH-CPSI points,and it has better improvement in pain and urination symptoms than the ordinary acupuncture group.(2)Comparison of SAS and SDS scoresAfter treatment,the SAS and SDS scores of the two groups were significantly lower than before treatment,and the difference was statistically significant(P <0.05).Comparison of changes in SAS and SDS scores before and after treatment between the two groups was not statistically significant(P> 0.05).It indicates that both warm acupuncture and ordinary acupuncture can improve the anxiety and depression of patients.(3)Comparison of prostate texture score and tenderness score of peripheral prostate tissuesAfter treatment,the prostate texture score and the tenderness score of the peripheral prostate tissues in the two groups were significantly lower than before treatment(P<0.05).Changes of prostate texture score and tenderness score of peripheral prostate tissues before and after treatment were compared between the two groups,and the difference was statistically significant(P<0.05).It indicates that warm acupuncture can improve the palpation of prostate and is better than the ordinary acupuncture group.(4)Comparison of EPS-WBC count score,lecithin body score,IL-8 and TNF-αlevelsAfter treatment,EPS-WBC count score,lecithin body score,IL-8 and TNF-α levels in the two groups were significantly lower than before treatment(P<0.05).Changes in EPS-WBC count score,lecithin body score,IL-8 and TNF-αlevels were compared between the two groups before and after treatment,and the difference was statistically significant(P<0.05).This shows that warm acupuncture can improve the inflammation levels of patients such as WBC and lecithin and autoimmune levels such as L-8 and TNF-α,and is better than that of ordinary acupuncture.(5)Comparison of prostate capsule,internal echo and gland size on BultrasoundAfter treatment,the prostate capsule ultrasound,internal echo,and glandular size in both groups of prostate B ultrasound images were significantly improved than before treatment(P <0.05).The changes in glandular capsule,internal echo,and glandular size in B ultrasound images before and after treatment between the two groups were compared between groups,and the differences were statistically significant(P <0.05).It shows that warm acupuncture can improve the pathological changes of prostate sonogram in patients,which is better than that of ordinary acupuncture group.ConclusionThe results of clinical trials show that compared with ordinary acupuncture,warm acupuncture can significantly improve the clinical symptoms of CP of kidney yang deficiency(TCM syndrome score,NIH-CPSI score),prostate palpation,prostate inflammation,and autoimmune And prostate sonogram.Warm acupuncture treatment can improve the pain symptoms and urination symptoms of kidney-yang deficiency CP(pain score,urination symptom score).Moreover,the total effective rate of warm acupuncture in the treatment of CP of kidney yang deficiency is better than that of ordinary acupuncture,and the clinical effect is positive.Combined with the above results,warm acupuncture treatment CP has certain advantages and can be applied in clinical practice. |
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