Acupuncture Beats Drugs For Prostatitis

prostatitis

Acupuncture outperforms drugs for the treatment of chronic prostatitis. Researchers from the First Affiliated Hospital of Chongqing Medical University gathered objective and subjective data in a controlled clinical trial consisting of patients with chronic prostatitis. The acupuncture treatment group achieved a total effective rate of 87.5% and the drug control group achieved a total effective rate of 62.5%.

National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores indicate that acupuncture produces significant improvements in pain or discomfort intensity levels, urinary symptoms, and quality of life scores. Urethral sphincter electromyography uroflow rates show that acupuncture restores urethral sphincter and pelvic floor muscle function. The researchers conclude that acupuncture significantly outperforms drugs for the treatment of chronic prostatitis. [1]

 

Design
Researchers (Zhang et al.) used the following study design. A total of 48 patients were treated and evaluated in this study. All patients were diagnosed with chronic prostatitis. They were randomly divided into an acupuncture treatment group and a drug control group, with 24 patients in each group. Patients from the control group consumed one tablet each of sparfloxacin and Prostat tablets, twice a day, for a total of 4 weeks. Sparfloxacin is a fluoroquinolone antibiotic used for patients with bacterial infections. Prostat contains pollen extract EA-10 and P5 and is used in the treatment of benign prostatic hyperplasia and chronic prostatitis. The treatment group received electroacupuncture monotherapy. The diagnostic criteria included the following:

Symptoms (perineal and lumbosacral pain, abnormal urination) lasting for more than 3 months
Hard, tender, and normal sized/enlarged prostate found by the digital rectal exam
Positive or negative results for urine and prostatic secretion tests
NIH-CPSI scores ≥ 10

 

Acupuncture Points
Patients from the treatment group received acupuncture at the following primary acupoints:

  • CV4 (Guanyuan)
  • 
CV3 (Zhongji)
  • 
BL32 (Ciliao)
  • 
BL35 (Huiyang)

Additional secondary acupoints were added based on differential diagnostic considerations:

  • Qi and blood stagnation: LV3 (Taichong), SP10 (Xuehai), SP6 (Sanyinjiao)
  • Damp-heat pouring downward: LV3 (Taichong), ST40 (Fenglong), SP9 (Yinlingquan)

  • Fire excess due to yin deficiency: KI3 (Taixi), BL23 (Shenshu), SP6 (Sanyinjiao)

  • Kidney yang deficiency: BL23 (Shenshu), CV6 (Qihai), ST36 (Zusanli)

Upon disinfection of the acupoint sites, a 0.30 mm × 50 mm filiform acupuncture needle was inserted into each acupoint to a depth of 25-35 mm. Needles were rotated, lifted, and thrust rapidly after insertion to achieve a deqi sensation. For Guanyuan, Zhongji, Ciliao, and Huiyang, a deqi sensation radiating toward the perineum, penis, and testicles was noted by the researchers as producing better clinical outcomes. It is written in the Ling Shu (The Miraculous Pivot) that “A deqi sensation in the lesion area ensures the effectiveness of acupuncture.”

The acupuncture needles were attached to an electroacupuncture device. A continuous wave (1 Hz) was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. A 30 minute needle retention time was observed, timed from the initiation of electroacupuncture current. Electroacupuncture was applied once per day. Each treatment course consisted of 8 acupuncture treatments followed by a two-day break before the next course began. All patients received a total of 3 treatment courses.

 

Scoring
NIH-CPSI scores, changes in urethral sphincter electromyography determined uroflow rates, and total efficacy rates were measured before and after treatment. NIH-CPSI is a measurement instrument used to assess symptom severity in patients with chronic prostatitis. NIH-CPSI measures three different aspects including pain, urinary symptoms, and quality of life. Higher scores in NIH-CPSI assessment denote a more severe condition.

The urethral sphincter electromyography determined uroflow rate is a non-invasive test used to assess sphincter and pelvic floor muscle function, including measurements of maximum urine flow rates (Qmax), average urine flow rates (Qave), and TL value. TL value is a derived parameter from urethral sphincter EMG used to measure the degree of detrusor-sphincter synergia. [2] TL quantifies coordination of the detrusor and sphincter; “In normal humans, the bladder is supposed to empty by a synergistic contraction of the detrusor and relaxation of the sphincter during micturition.” [3] If both contract simultaneously, it is termed detrusor-sphincter dyssynergia. After completion of treatment, the efficacy rate for each patient was categorized into 1 of 3 tiers:

  • Recovery: Complete absence of symptoms. NIH-CPSI scoring reduction of at least 2/3.
  • Normal Qmax, Qave, and TL value.
  • 
Effective: Improvement of symptoms. NIH-CPSI scoring reduction of 1/3 to 2/3. Improvement of Qmax, Qave, and TL value.
  • 
Ineffective: No improvement of symptoms. NIH-CPSI scoring reduction of less than 1/3. No improvement of Qmax, Qave, and TL value.

 

Basis
The researchers provided a historical context for the acupuncture point selection administered during the investigation. Guanyuan and Zhongji are located on the Ren meridian. Needling Guanyuan reinforces the kidneys and strengthens yang energy. Guanyuan is indicated for seminal emission, impotence, inhibited urination, frequent urination, lower abdominal pain, and white turbidity of urine. According to the Qian Jin Yao Fang (A Thousand Gold Pieces Formulary), Zhongji is indicated for lower back pain, inhibited urination, impotence, premature ejaculation, and white turbidity of urine. Ciliao and Huiyang are located on the foot Taiyang bladder meridian. Ciliao is indicated for lower back pain, strangury (blockage or irritation of the bladder resulting in pain or urgent urination), and red urine. Needling Huiyang resolves dampness, clears heat, replenishes essence, and benefits the kidneys.

 

Summary
Subjective clinical and objective electromyography data indicate that acupuncture outperforms drugs for the treatment of chronic prostatitis. According to the research, common protocols involve the application of acupoints Guanyuan (CV4), Zhongji (CV3), Ciliao (BL32), and Huiyang (BL35) for this condition. Patients interested in learning more about acupuncture are recommended to contact a local licensed acupuncturist.

 

Prostatis vs. Benign Prostatic Hyperplasia (BPH)
Prostatitis is a term referring to prostate inflammation, usually caused by injury or infection. Bacterial infections in the blood (bacteremia) may cause prostatitis. Inflammation of the epididymis (epididymitis) may also cause prostatitis. The epididymis is a duct posterior to the testis that sperm passes through. Risk factors include catheterization, prostate biopsy, and pelvic trauma. Dysuria (painful or difficult urination), frequent urination, nocturia, urgent urination, hematuria (blood in the urine), painful ejaculation, and pain in the groin, penis, or testicles are all symptoms associated with prostatitis. Benign prostatic hyperplasia (BPH) is a different condition wherein the prostate becomes enlarged. It usually occurs as a result of aging. The aforementioned research applies to prostatitis.

 

References
[1] Zhang J, Liu CD, Ding Y, Tang QB. Clinical Observation on Therapeutic Effect of Electroacupuncture on Chronic Prostatitis and Detection of Urethral Sphincter EMG [J]. Chinese Acupuncture & Moxibustion, 2010,30(1):13-17.
[2] Qu CY, Xu DF, Wang CZ, Chen J, Yin L, Cui XA. Anal Sphincter Electromyogram for Dysfunction of Lower Urinary Tract and Pelvic Floor. 2017.
[3] Chang, Shyang, Shu-Ting Mao, Shih-Jen Hu, Wen-Ching Lin, and Chen-Li Cheng. “Studies of detrusor-sphincter synergia and dyssynergia during micturition in rats via fractional Brownian motion.” IEEE transactions on biomedical engineering 47, no. 8 (2000): 1066-1073.

Source: HealthCMi