Clinical Study On The Effect Of Acupoint Heat-sensitive Moxibustion Combined With Qianliejiedu Decoction On Type ? Prostatitis Based On T Lymphocyte Subset Imbalance

Objective:1.To observe the changes of NIH-CPSI score and TCM syndrome score after the treatment of type ? prostatitis with heat-sensitive moxibustion combined with Qianlie Jiedu Decoction,and evaluate its clinical efficacy and safety.2.From the imbalance of T lymphocyte subsets in peripheral blood,to explore the possible mechanism of acupoint heat-sensitive moxibustion combined with Qianlie Jiedu Decoction in the intervention of type ? prostatitis,and to provide new ideas and directions for clinical treatment of type ? prostatitis.Methods:The study was conducted in a randomized,parallel,controlled,and open trial.100 eligible cases were enrolled from the andrological clinic of Affiliated Hospital of Jiangxi University of TCM.They were divided into a treatment group and a control group,with 50 cases in each group.The treatment group was given acupoint heat-sensitive moxibustion combined with Qianlie Jiedu Decoction,while the control group was given Qianlie Shutong Capsule orally.Both groups were treated for 4 weeks and followed up for 4 weeks after treatment.The NIH-CPSI scores and TCM syndrome scores were collected before treatment,4 weeks after treatment and 4 weeks after drug withdrawal.The levels of CD4⁺,CD8⁺,CD4⁺/CD8⁺in peripheral blood were measured before treatment and 4 weeks after treatment.Adverse reactions during treatment were recorded at any time.Result:1.Comparison of baseline values:There was no significant difference in age and course of disease between the two groups?P>0.05?.There were no significant differences in pain symptom score,urination symptom score,quality of life score,NIH-CPSI total score and TCM syndrome score between the two groups before treatment?P>0.05?.In terms of T lymphocyte subsets,there was no significant difference in CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺levels between the two groups?P>0.05?.All baseline data are comparable.2.Comparison of the cure rate after treatment between the two groups:After 4 weeks of treatment,the cure rate of the treatment group was 68%,and that of the control group was 48%.The curative effect of the treatment group was better?P<0.05?.3.Comparison of NIH-CPSI scores at different time between the two groups:At 4 weeks of treatment,the total score of NIH-CPSI and its three sub-scores in the two groups were significantly improved compared with those before treatment?P<0.001?,and the improvement in the treatment group was more obvious?P<0.05?.Four weeks after withdrawal,the total NIH-CPSI scores and sub-scores of the two groups were still better than those before treatment?P<0.001?,while the difference between the treatment group and the control group was still significant?P<0.05?.4.Comparisons of TCM syndromes scores at different time between the two groups:At 4 weeks of treatment,TCM syndromes scores of both groups decreased compared with those before treatment?P<0.001?,and the degree of decline in the treatment group was more obvious?P<0.05?.Four weeks after withdrawal,the two groups of patients were improved compared with those before treatment?P<0.001?,and the difference between the treatment group and the control group was still statistically significant?P<0.05?.5.Comparison of T lymphocyte subsets in peripheral blood between the two groups after treatment:After 4 weeks of treatment,the levels of CD₄⁺,CD₄⁺/CD₈⁺in peripheral blood of the two groups were significantly higher than those before treatment?P<0.001?,but there was no significant change in CD₈⁺?P>0.05?.In the degree of up-regulation of CD₄⁺,CD₄⁺/CD₈⁺levels,the treatment group was superior to the control group?P<0.01?.6.The safety of treatment in the two groups:2 cases of mild diarrhea occurred in the treatment group,and 3 cases of mild headache in the control group.The symptoms were tolerable.Before and after treatment,the blood routine,urinary routine,stool routine and liver and kidney function of the patients were all within the normal reference value,and no obvious toxic and side effects were found.Therefore,the two groups of treatment methods have good safety.7.Elimination and abscission:The progress of this research is smooth.All the selected cases completed the clinical study.No patients were excluded or shedding,so the data was credible.Conclusion:1.Acupoint heat-sensitive moxibustion combined with Qianlie Jiedu Decoction in the treatment of type ? prostatitis is superior to simple oral Qianlie Shutong Capsule in improving NIH-CPSI score,TCM syndrome score and healing rate,and it has certain safety,low toxicity and side effects.2.Acupoint heat-sensitive moxibustion combined with Qianlie Jiedu Decoction can up-regulate the expression of CD₄⁺,CD₄⁺/CD₈⁺in peripheral blood.Therefore,we speculate that the mechanism of treatment of type ? prostatitis may be through regulation of T lymphocyte disorders.