by  Cheng Yuting 

(In-patient Dept. of Shaoxing Road, Tianhe Hospital, Tianjin 300204, China) 
 

Abstract  In the present series of observations, 360 cases of prostatitis were treated with acupuncture of Sishenchong (EX-HN 1), etc. and self-drafted prescription I, II and III. After 4 courses (28 sessions) of treatment, 321 cases (89.17%) we re cured, 35 cases (9.72%) had improvement and 4 cases (1.11%) failed. The total effective rate was 98.89%. 

KEY WORDS Prostatitis Sishenchong Combined treatment with acupuncture and medicinal herbs 

Prostatitis is a common disease of male adults. Statistical data shows that its morbidity presents an increasing tendency nowadays. It can result in prostatic hyperplasia, male infertility, sexual disorder, adenocarcinoma of prostate, etc.. We adopted acupuncture therapy combined with self-drafted prescription I, II and III to treat it and achieved satisfactory results. 

Clinical Data
This series of treatment was made up of 360 cases of prostatitis patients age d from 19 to 30 years in 124 cases, from 30 to 50 years in 138 cases and from 50 to 80 years in 98 cases. All of them had a concomitant sexual disorder at different degrees, including 3 cases of impotence, 27 cases of prostatic hyperplasia, 13 cases of neurosism and 1 case of prostate adenocarcinoma. The longest duration of disease was 30 years and the shortest one week. 

Acupoints and Medicinal Herbs
1. Acupoints
Sishenchong (EX-HN 1), Zhongji (CV 3), Guanyuan (CV 4), Qugu (CV 2), Yanglingquan (GB 34), Zusanli (ST 36), Sanyinjiao (SP 6), Shenshu (BL 23), Pangguangshu (BL 28), Pishu (BL 20) and Guanyuanshu (BL 26). 

2. Medicinal Herbs
Recipe I: Ramulus Taxilli(Jisheng) 30g, Cortex Eucommiae(Duzhong) 10g, Squama Manitis(Chuanshanjia) 10g, Sargassum(Haizao) 20g, Rhizoma Chuanxiong(Chuan xiong) 10 g, Rhizoma Zedoariae(Ezhu) 10g, Cortex Moutan Radicis(Danpi) 10g, Radix Paeoniae Rubra(Chishao) 10g, Herba Patriniae(Baijiangcao) 20g, and Flos Chrysanthemi Indici(Yejuhua) 20g. 

Recipe II: Ramulus Taxilli(Jisheng) 30g, Cortex Eucommiae(Duzhong) 10g, Semen Plantaginis(Cheqianzi) 10g (wrapped in a cloth bag), Fructus Alpiniae Oxyphy llae(Yizhiren) 10g, Ootheca Mantidis(Sangpiaoxiao) 10g, Talcum(Huashi) 10g, Caulis Clematidis Armandii(Mutong) 10g，Fructus Gardeniae(Shanzhi) 10g, Radix et Rhizoma Rhei(Dahuang) 6g (decocted later), Poria(Fuling)10g, Rhizoma Alismatis(Zexie) 10g, Medulla Junci(Dengxincao) 3g and Radix Glycyrrhizae(Gancao) 10g 

Recipe III: Ramulus Loranthi(Jisheng) 30g, Cortex Eucommiae(Duzhong) 10g, Radix Dipsaci(Chuanduan) 10g, Actinolitum(Yangqishi) 10g, Herba Epimedii(Yinya nhuo) 10g, Radix Morindae Officinalis(Bajitian) 10g, Radix Rehmanniae Praeparata(Shu di) 10g, Cortex Phellodendri(Huangbai) 10 g, Fructus Lycii(Gouqi) 10g, Radix Panacis Quinquefolii(Xiyangshen) 10g (decocted first), Poria(Fuling) 10g, Pericarpium Citri Recticulatae(Chenpi) 10g and Radix Glycyrrhizae(Gancao) 10g. 

TREATMENT METHODS
1. Retention-enema of Recipe I. Decoction
The patients were asked to take a knee-chest position. The Recipe I. decoction was taken about 50 ml with a syringe, connected to an anal tube (for single use) and it was inserted into the anus to a depth of about 5-7 cm, then, the decoction was injected into the rectum and sigmoid colon. After that, the patient took supine position for 10 to 20 min. If had no syringe, you could also ask the patient to take the decoction orally. 

2. Acupuncture and Moxibustion
After having a rectum-enema mentioned above, the patient was asked to take supine position continuously. Then, Sishenchong ((EX-HN 1), Zhongji (CV 3), Guanyuan (CV 4), Qugu (CV 2), Yanglingquan (GB 34), Zusanli (ST 36) and Sanyinjiao (SP 6),etc., were needled and stimulated with reinforcing or reducing method or moxibustioned according to the state of disease. When Sishenchong (EX-HN 1) needled, shallow insertion (only to the dermis layer) was advisable and the needle was manipulated for 20 min. 

3. Administration of Recipe II
About 200 ml of Recipe II. decoction was taken orally respectively in the morning and the evening, 100 ml every time, one dose daily. For patients with digestive diseases, this decoction could be taken after meal or taken in a small amount and separately for several times. Generally, after continuously taking Recipe II. decoction for 3-4 weeks and disappearance of prostatitis, Recipe III. was administrated for 1-2 weeks with the methods same to Recipe II. The aforementioned three methods are termed as “three methods for treatment of prostatitis�? which were given once daily, with 7 days being a therapeutic course. The interval between two courses was one day. After 4 courses of treatment, the therapeutic effect was analyzed.
 

4. Modified Drugs Based on Symptoms and Differentiation of Syndromes
Common symptoms of prostatitis were generally treated with Recipe I and II. When Recipe II was used for treatment of special symptoms, more medicinal herbs were added, for example, for hematuria and concomitant pain, Herbal Cephalanoploris(Xiaoji), Cacumen Biotae(Cebaitan) and Rhizoma Imperatae(Baimaogen) were used in combination; for lithangiuria with pain, Herba ysimachiae(Jinqiancao) and Spora Lygodii(Haijinsha) used together; and for turbid urine or gonorrhea, Rhizoma Acori Graminei(Changpu) and Rhizoma Dioscoreae Septemlobae(Bixie) supplemented; and for dark urine, yellow greasy tongue coating and severe damp-heat, Rhizoma Atractylodis(Cangzhu) and Cortex Phellodendri(Huangbai) used in combination. 

The Criterion for Evaluating the Therapeutic Effect and Treatment Results
1. Standards for evaluating the therapeutic effect; Cured: After treatment, clinical symptoms and signs disappeared; Effective: Symptoms and signs lessened; Ineffective: After treatment, symptoms and signs had not any improvement. 

2. Results
After 4 courses of treatment, of the 360 cases, 321 (89.17%) were cured, 35 ( 9.72%) had improvement and 4 (1.11%) had not any effect, with the total effective rate being 98.89%.   

A TYPICAL CASE 

Mr Lin, aged 70 years, a retired worker, visited our department on June 2, 1997 and complained of having got prostatitis for one month. He had received treatment with oral administration of antibiotics and parenteral fluid therapy in several hospitals but had not any significant improvement. Current symptoms at that time were frequent urination (6-8 times during night), urodynia, turbid urine, dribbling urination, occasional uroschesis and low fever (37oC). He once suffered from hypertention and coronary heart disease. Routine uronoscopy showed WBC 4-6/HP, RBC 6-8/HP. Digital examination indicated the prostate being rough at the surface, hard in texture, with a size of 5.7×6.1 cm. Ultrasonic examination suggested prostatitis, prostatic hyperplasia (5.6×6.2×5.3 cm). It was diagnosed as 1). prostatitis; and 2). prostatic hyperplasia. He was treated once with the aforementioned “three methods". On the following day, this patient told us that his symptoms abated obviously, he had only 3 times' urination during the night. His temperature was normal. His symptoms had a striking improvement after two courses of treatment and disappeared after 4 courses of treatment. He had urination once during night and could have a good sleep. Routine uronoscopy examination (-); ultrasonic examination suggesting disappearance of prostatitis; the prostate being 4.6×4.3×5.0 cm in size. He was cured and the follow-up showed no relapse up to now. 

COMMENTS
In this paper, the aforementioned approach of acupuncture of points Sishenchong (EX-HN 1) etc. combined with self-drawn up Recipe I., II. and III. is a comprehensive therapy established through my long-term medical practice and uninterrupted summing-up and exploration on treatment of prostatitis, in view of the current state of frequently encountered drug tolerance of antibiotics and the physiological and pathological characters of prostatitis. Sishenchong point can function in improving microcirculation and raising immunocompetence of the body. When used in combination with Guanyuan (CV 4), Sanyinjiao (ST 6), Pishu (BL 20), Shenshu (BL 23), Guanyuanshu (BL 26), Zhongji (CV 3), Qugu (CV 2), Yanglingquan (GB 34) and Zusanli (ST 36), it is capable of dredging meridians, modulating kidney-qi and raising the therapeutic effect of medicinal herbs. The above mentioned Recipe I. (retention-enema) is used to tonify the liver and kidney, soften and remove the hard masses, promote blood circulation and eliminate blood stasis. Recipe II. (oral administration) is used to eliminate heat and dampness and remove toxic materials, reinforce qi and induce diuresis. Recipe III. (oral administration ) is employed to replenish essence and qi, strengthen the spleen, tonify the kidney and enhance body's resistance. Combined administration of acupuncture and medicinal herbs can help each other in accelerating blood circulation and qi flow, normalizing functions of meridians and Zang-Fu organs, removing pathological factors and arousing the intrinsic ability of the body resisting diseases. Besides, we use this comprehensive therapy to treat diseases of the urogenital system including acute and chronic pyelonephritis, ureteritis, cystitis, etc. and have achieved a better therapeutic effect.