Clinical Study on Treatment of Chronic Prostatitis with Lingze Tablets Combined with TCM Herbal Acupoint Plasters

Objective:To study the therapeutic effect of Lingze tablets combined with traditional Chinese medicine herbal acupoint plasters on chronic prostatitis.Methods:A total of 64 patients with chronic prostatitis who were admitted to the Andrology Clinic of Shuyang County Hospital of Traditional Chinese Medicine from March 2021 to March 2023 were randomly divided into a treatment group and a control group,with 32 cases in each group.The control group took Lingze tablets orally,4 tablets/time,3 times/d;the treatment group took the same medication along with traditional Chinese medicine acupoint herbal plasters.The two groups of patients were treated continuously for 6 weeks,and the differences in the relevant indexes of the curative effect were observed.Results:The NIH-Chronic Prostatitis Symptom Index(NIH-CPSI)scores of the two groups significantly reduced after treatment(P<0.05),and the scores of the patients in the treatment group were lower than those in the control group(P<0.05).The treatment received in the treatment group achieved and efficacy of 96.88%,which was significantly higher than that of the group,which was 81.25%(P<0.05).The maximum flow rate(MFR),average flow rate AFR,and urine output of the patients of both groups improved significantly after treatment(P<0.05).However,the experimental group showed better improvements in these indicators(P<0.05).Conclusion:Lingze tablets combined with traditional Chinese medicine acupoint herbal plasters can significantly improve the symptoms and urodynamic function of patients with chronic prostatitis.

Treatment of chronic prostatitis in Chinese men

The aim of this study is to assess the status of treatment of chronic prostatitis(CP)in Chinese men.A population-based cross-sectional survey was performed,in which 15000 men aged between 15 and 60 years were randomly selected to receive a questionnaire designed to assess National Institutes of Health Chronic Prostatitis Symptoms Index(NIH-CPSI)status,therapeutic efficacy and 28 other items.A total of 12743 men(84.95%)completed the questionnaire,of whom 1071(8.4%)were identified as having prostatitis-like symptoms and 517(4.5%)were diagnosed with CP according to NIH-CPSI criteria and prostatitis-like symptomatology.Of the CP patients,372(65%)underwent long-term routine treatment 12 times per year.Additionally,217(72.8%)patients received antibiotic therapy and 215(79.3%)men showed therapeutic effects.The treatment cost USD 1151(8059 yuan)per person per year on average.Most CP patients received routine treatment,in most cases with antibiotics.Treatment was costly and most CP patients were not satisfied with its effectiveness.Antibacterial treatment might have been effective primarily in patients with bacterial disease.

Boswellia resin extract and propolis derived polyphenols in patients with type III chronic prostatitis/chronic pelvic pain syndrome:An Italian prospective multicenter study

Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome(CP/CPPS).Methods:Patients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive months.Participants were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),the International Prostate Symptom Scores(IPSS),International Index of Erectile Function(IIEF),four-glass test,uroflowmetry,and prostate-specific antigen assessments at baseline and at Week 4,and Week 12.Primary endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total score.Secondary outcomes included improvement of micturition and quality of life(QoL)domains of NIH-CPSI questionnaire.Results:A total of 61 males were enrolled.No adverse events were reported.Significant improvements from baseline to Day 30 were reported for NIH-CPSI total score(mean difference:-9.2;p<0.01),NIH-CPSI pain domain(mean difference:-5.5;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score(mean difference:-5.6;p<0.01).No significant changes from baseline in terms of IIEF score or maximum flow rate were observed.At final follow-up(Day 90),further significant improvements in terms of NIH-CPSI total score(mean difference:-12.2;p<0.01),NIH-CPSI pain domain(mean difference:-6.6;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score were reported.Conclusion:Rectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.

A review of the literature on randomized controlled trials of acupuncture and moxibustion in the treatment of chronic prostatitis/chronic pelvic-pain syndrome within 2016-2021

Chronic prostatitis(CP)/chronic pelvic-pain syndrome(CPPS)is a common urinary-system disease with a high incidence in young and middle-aged men,seriously affecting patients'ability to work and their quality of life(Qo L).Western medicine(WM)has some limitations in treating CP/CPPS.Acupuncture is an ancient Chinese medical method that is commonly used to treat this condition and has a relatively good effect on it.Many randomized controlled trials(RCTs)on this subject have been published.For this study,we searched the China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Periodical(VIP),Wanfang,Sino Med,and Pub Med databases for RCTs on acupuncture treatment of CP/CPPS in the last 5 years(2016/01/01-2021/12/01).In addition,we conducted analysis and research,aiming to summarize acupuncture treatment in CP/CPPS RCTs and the clinical efficacy,with the goal of providing clinical reference.A total of 466 related documents were retrieved in the search,and 62 articles were retained after screening.We obtained RCT information on acupuncture treatment of CP/CPPS.The results showed that several relevant clinical studies have been performed over the last 5 years and that acupuncture and moxibustion have better curative effect on CP/CPPS than WM.Due to the small number of included studies,more experimental evidence is needed to verify the clinical efficacy of acupuncture.

Treatment of Nonspecific Chronic Prostatitis with Qian Lie Xian Yan Suppository in 104 Cases

Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Chinese drug Ye Ju Hua Shuan (野菊花栓Suppository of Flos Chrysanthemi Indici). The results show that chronic prostatitis is markedly improved by using Qian Lie Xian Yan suppository, with a short-term cure rate of 23.1% and a total effective rate of 84.6%, superior to that of the control group. The animal experiment indicates that Qian Lie Xian Yan suppository has better anti-inflammatory and analgesic effects, with an action of promoting blood circulation.

Prediction of the mechanism of prostate prescription Ⅰ in the treatment of chronic prostatitis based on integrative pharmacology of traditional Chinese medicine

Objective:To investigate potential mechanism of Prostate prescriptionⅠin the treatment of chronic prostatitis based on integrated pharmacology.Methods:with the help of TCMIP,the effective compounds of Prostate prescriptionⅠwere screened,and the potential target database of Prostate prescriptionⅠwas established by using the target prediction function of TCMIP.Based on the Human Phenotype Ontology database and protein interaction network(PPI)database,the disease target of CP was identified and the target interaction network was constructed;Through the GO function analysis and KEGG pathway enrichment analysis of the candidate targets,combined with Chinese and foreign literature studies to predict the potential Signaling pathway of Prostate prescriptionⅠin the treatment of CP.Results:79 effective compounds of Prostate prescriptionⅠexerted its effect on 33 targets through 11 pathways.Conclusion:Clinical efficacy of Prostate prescriptionⅠon CP may be reflected in antiinflammation and anti-tumor,cell metabolism,immune regulation,neuroregulation and so on.

Study on the Mechanism of Angelica sinensis-Phellodendri Chinensis Cortex in the Treatment of Chronic Prostatitis Based on Network Pharmacology

[Objectives]To explore the mechanism of Angelica sinensis-Phellodendri Chinensis Cortex in the treatment of chronic prostatitis(CP)based on the method of network pharmacology.[Methods]The active components and action targets of Angelica sinensis-Phellodendri Chinensis Cortex were screened by(TCMSP),a systematic pharmacological analysis platform of traditional Chinese medicine,combined with literature search.The target was corrected by Uniprot database,and the disease CP target was screened by GeneCards and OMIM database.The common targets of drugs and diseases were screened by R language software,and the visual network map of drugs-active components-targets-diseases was constructed by Cytoscape 3.5.1 software.The common target protein-protein interaction(PPI)network was constructed by using STRING platform.The R language software was used to annotate and analyze the gene function and pathway of the core target through geneontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG).[Results]46 active components of Angelica sinensis-Phellodendri Chinensis Cortex were screened,and 212 related targets were predicted,of which 159 were related to disease.These targets were mainly involved in biological processes such as heterologous biological stimulation,oxidation and anti-oxidation,and were mainly concentrated in PI3K-Akt,mitogen-activated protein kinase(MAPK),hypoxia inducible factor-1(HIF-1)and other related signaling pathways.[Conclusions]The multi-component,multi-target and multi-pathway action characteristics of Angelica sinensis-Phellodendri Chinensis Cortex were confirmed by network pharmacology,and the possible mechanism of Angelica sinensis-Phellodendri Chinensis Cortex in the treatment of CP was predicted,which provided a theoretical basis for further experiments to verify its action mechanism.

Research progress of miRNA and chronic nonbacterial prostatitis

Chronic nonbacterial prostatitis(CNP),also the typeⅢprostatitis account for more than 90%of all patients with prostatitis.It has a long course of disease,easy to repeat,unknown pathogenesis and poor clinical efficacy.At present,some scholars at home and abroad have found that there is differential expression of microRNA(miRNA)in prostatic fluid of CNP patients or prostate tissue of CNP rat model.Intervention of miRNA expression can alleviate the symptoms and pharmacodynamics of CNP to a certain extent,which opens up a new way and direction for the pathogenesis and diagnosis and treatment of CNP.Therefore,this paper reviews the research progress of miRNA and CNP in recent years.

A comparative study of two methods for establishing a chronic non‑bacterial prostatitis model in rats‑

Objective:To compare the biological characteristics and stability of the chronic non-bacterial prostatitis(CNP)model in rats induced by the depot combined with estrogen induction method and the autoimmune response induction method.Methods:The CNP rat model was prepared using the depot combined with 17β-estradiol induction method in the depot hormone group and three concentrations of prostate protein homogenate at 40 mg/mL,20 mg/mL and 10 mg/mL in the autoimmune group,respectively.The degree of prostate tissue damage was evaluated by pathology(HE staining),and the immunoturbidimetric method was used to evaluate the contents of immunoglobulins IgA,IgM and IgG.ELISA was used to evaluate interleukin-1β(IL-1β),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and high-sensitivity-C-reactive protein(hs-CRP),and electrochemiluminescence was used to evaluate the expression level of testosterone(T),and the two model methods were compared.Results:Compared with the sham-operated group,the body mass of rats in both models was significantly lower in the depot hormone group and autoimmune group before extraction(P<0.01,P<0.01),and histopathology of the prostate in both models showed destruction of glandular structure and a significant increase in inflammatory cells.Compared with the depot hormone group and the autoimmune group,the histopathological changes and inflammatory pathological scores of prostate and the contents of immune indexes IgA,IgM and IgG were significantly different in the depot hormone group(P<0.05,P<0.05,P<0.05),and the levels of IL-1β,IL-10,TNF-α,hs-CRP and T were significantly changed in the autoimmune group(P<0.01).The comparison between the high,medium and low dose groups of the autoimmune group,in which the pathological changes in the medium dose of the autoimmune group were slightly better than the other two groups between the groups,but the changes in IL-1β,IL-10,TNF-α,hs-CRP,and T in the low dose of the autoimmune group were the most significant(P<0.05).Conclusion:The pathological tissues of the chronic non-bacterial prostatitis model established by the depot combined with estrogen induction method and the autoimmune response induction method both showed significant changes,and the comprehensive indexes indicated that the depot combined with estrogen induction method was a more appropriate modeling choice.

Is mild erectile dysfunction associated with severe psychological symptoms in Chinese patients with moderate-to-severe chronic prostatitis/chronic pelvic pain syndrome?

This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients.Patients were interviewed using the Structured Interview on Erectile Dysfunction(SIEDY)for pathogenic quantification.The National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI)and the International Index of Erectile Function-5(IIEF-5)were used for the evaluation of CP/CPPS and ED.The Generalized Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to assess anxiety symptoms and depressive symptoms.The number of patients with mild CP/CPPS and mild ED,mild CP/CPPS and moderate-to-severe ED,moderate-to-severe CP/CPPS and mild ED,and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69(37.9%),36(19.8%),35(19.2%),and 42(23.1%),respectively.The corresponding PHQ-9 scores of the four groups were 6.22,7.19,10.69,and 7.71,respectively.The corresponding GAD-7 scores of the four groups were 5.26,6.31,8.77,and 6.36,respectively.Among patients with moderate-to-severe CP/CPPS,the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group(P=0.007 and P=0.010,respectively).The prevalence of ED and premature ejaculation(PE)in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS(P=0.001 and P=0.024,respectively).Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.

Effect of thermophilic bacterium HB27 manganese superoxide dismutase in a rat model of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)

We investigated the therapeutic effects of superoxide dismutase(SOD)from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)and its underlying mechanisms.A Sprague–Dawley rat model of CP/CPPS was prepared and then administered saline or Thermus thermophilic(Tt)-SOD intragastrically for 4 weeks.Prostate inflammation and fibrosis were analyzed by hematoxylin and eosin staining,and Masson staining.Alanine transaminase(ALT),aspartate transaminase(AST),serum creatinine(CR),and blood urea nitrogen(BUN)levels were assayed for all animals.Enzyme-linked immunosorbent assays(ELISA)were performed to analyze serum cytokine concentrations and tissue levels of malondialdehyde,nitric oxide,SOD,catalase,and glutathione peroxidase.Reactive oxygen species levels were detected using dichlorofluorescein diacetate.The messenger ribonucleic acid(mRNA)expression of tissue cytokines was analyzed by reverse transcription polymerase chain reaction(RT-PCR),and infiltrating inflammatory cells were examined using immunohistochemistry.Nuclear factor-κB(NF-κB)P65,P38,and inhibitor of nuclear factor-κBα(I-κBα)protein levels were determined using western blot.Tt-SOD significantly improved histopathological changes in CP/CPPS,reduced inflammatory cell infiltration and fibrosis,increased pain threshold,and reduced the prostate index.Tt-SOD treatment showed no significant effect on ALT,AST,CR,or BUN levels.Furthermore,Tt-SOD reduced inflammatory cytokine expression in prostate tissue and increased antioxidant capacity.This anti-inflammatory activity correlated with decreases in the abundance of cluster of differentiation 3(CD3),cluster of differentiation 45(CD45),and macrophage inflammatory protein 1α(MIP1α)cells.Tt-SOD alleviated inflammation and oxidative stress by reducing NF-κB P65 and P38 protein levels and increasing I-κBαprotein levels.These findings support Tt-SOD as a potential drug for CP/CPPS.

Effect of Essential Oil on Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Pilot Randomized Controlled Trial

Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type Ⅲ CP/CPPS patients were assigned to the essential oil group(35 cases) or almond placebo oil control group(35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index(NIH-CPSI) and expressed prostatic secretions(EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. Results: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations(P>0.05). In the essential oil group, pain between rectum and testicles(perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group(P<0.01). No serious adverse events occurred. Conclusion: The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS.

Molecular mechanism and promising treatments of chronic prostatitis/chronic pelvic pain syndrome:An exploratory bibliometric analysis and literature review of preclinical studies

Background:As one of the most common diseases in urology,a large number of preclinical studies have been accumulated to explore the etiological mechanism and potential intervention of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).Methods:In this study,we systematically evaluated the current status of preclinical research on CP/CPPS through bibliometrics analysis using VOSviewer and Citespace.Characteristics of publication such as year,country/region,institution,author,journal,citation,and keywords were analyzed.Based on the bibliometrics analysis results of keywords,we summarized the possible mechanisms and promising treatments for CP/CPPS narratively.Results:According to the results of this study,the most common mechanisms involved in CP/CPPS were as follows:Disturbed immune and inflammation mediators,immune cell dysfunction,oxidative stress,dysregulated signaling pathways,apoptosis,gut microbiota,and testosterone metabolism.Traditional Chinese Medicine and extracorporeal shock wave therapy have important potential in the treatment of CP/CPPS.Conclusion:Further translational studies targeting the above mechanisms and validating the objective efficacy of potential treatments indicated by preclinical studies in clinical patients are needed in the future.

Qinghua decoction(清化饮)improves chronic nonbacterial prostatitis possibly via regulating the chromogranin A/nerve growth factor/tyrosine kinase A signaling pathway mediated by inflammatory factors

OBJECTIVE:To explore the mechanism by which Qinghua decoction(清化饮)regulates neuroendocrine inflammation in chronic nonbacterial prostatitis(CNP)model rats and provide an experimental basis for clinical treatment.METHODS:The rats were randomly divided into six groups:normal control,model,Qianlie Tongyu capsule,low-dose Qinghua decoction,medium-dose Qinghua decoction,and high-dose Qinghua decoction group with six rats in each group.Rats in each group were sacrificed on the 29th day of treatment,and blood and prostate tissues were collected.Serum levels of tumor necrosis factor-alpha and interleukins 1-beta,6,8,and 10(TNF-αand IL-1β,-6,-8,and-10,respectively)were measured using enzyme-linked immunosorbent assay.The pathological changes in the rat prostate tissue in each group were observed under a light microscope.The expression levels of chromogranin A(CgA),nerve growth factor(NGF),and tyrosine kinase A(TrkA)were detected using reverse transcription quantitative polymerase chain reaction.Western blotting was used to detect protein expression of CgA,NGF,and TrkA.RESULTS:In the model group,the prostate capsule membrane and stroma were significantly dilated with more inflammatory cells infiltrating the stroma and perivessels.TNF-α,IL-1β,-6,and-8,CgA,NGF,and TrkA levels increased,whereas the content of IL-10 decreased,which was statistically significant compared to that in the normal control group(P<0.05).Prostate tissue cells in the high-dose group were neatly arranged with no obvious inflammatory cell infiltration.When compared with the model group,the high-dose Qinghua decoction group showed a significant improvement in these indices(P<0.05).CONCLUSION:Qinghua decoction led to inhibition of pathological changes in the prostate tissue of rats with CNP,regulation of inflammatory cytokine expression,and inhibition in the expression of CgA,NGF,and TrkA.This mechanism may be primarily related to regulation of the CgA/NGF/TrkA signaling pathway mediated by various inflammatory factors.

Electroacupuncture stimulating Zhongji(CV3),Guanyuan(CV4),and bilateral Dahe(KI12)attenuates inflammation in rats with chronic nonbacterial prostatitis induced by estradiol through inhibiting toll-like receptor 4 pathway

OBJECTIVE:To investigate the anti-inflammatory effect of electroacupuncture(EA)on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS),also known as chronic nonbacterial prostatitis(CNP),and explore its underlying mechanism.METHODS:A CNP rat was established by surgical castration combined with 17-βestradiol injection in male Sprague-Dawley rats for thirty consecutive days.The CNP rats received EA treatment once a day for eight days.Chronic pelvic pain was evaluated by mechanical withdrawal threshold measurement.The histological change was assessed by hematoxylin-eosin staining.The inflammatory cytokines in prostates were determined by enzyme-linked immunosorbent assays.The expressions of toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),inhibitors of kappa-B alpha(IκBα),and nuclear factor-kappa B(NF-κB)were detected by Western blotting.The nuclear translocation of NF-κB and the location of TLR4 were observed with immunofluorescence staining.RESULTS:The results showed that EA decreased the prostate index,upregulated the mechanical withdrawal threshold,restored the histomorphology of the prostate,reduced the inflammatory factor levels,inhibited NF-κB p65 nuclear translocation,and downregulated the expression levels of critical proteins involved in the TLR4/NF-κB signaling pathway in prostates.CONCLUSIONS:Our findings suggested that EA could relieve pelvic pain and attenuate prostatic inflammation in estradiol-induced CNP rats.The underlying mechanism may be related to the inhibition of the TLR4/NF-κB signaling pathway.

Effects of Additional Glycine in Outpatients Being Treated for Urine Storage Disorders

Objectives: This study aimed to determine whether additional glycine can improve urine storage symptoms in outpatients. Methods: We recruited 50 outpatients (15 females, 35 males) with an Overactive Bladder Symptom Score (OABSS) of 3 or more. Participants being treated for urine storage disorders took additional glycine for 8 weeks at a dose of 3 g twice a day. Outcome measures included blood pressure, the International Prostate Symptom Score (IPSS), OABSS, Nocturia Quality of Life (N-QOL) score, urination frequency, sleep latency, time until the first void at night, bladder pain, improvement in urinary symptoms assessed with the Global Self-Assessment (GSA), and adverse events. Results: In the OABSS, the number of nighttime voids, urgency to urinate, urgent incontinence, and total score were improved. Improvements were also found in the IPSS total score for urine storage items, blood pressure, IPSS-QOL, time to first void, bladder pain, and GSA score, but no changes were seen in the frequency of urination at night, sleep latency or N-QOL score. No adverse events were recorded. Conclusion: Oral glycine improves objective and self-assessed urine storage symptoms, blood pressure, and bladder pain.

Effectiveness and Safety of Umbilicus Treatment with Modified Dinggui Powder(加味丁桂散)in Patients with Chronic Nonbacterial Prostatitis:A Randomized,Double-Blind,Placebo-Controlled Clinical Trial

Objective:To evaluate the effectiveness and safety of Chinese herbal external umbilicus treatment with Modified Dinggui Powder(加味丁桂散,MDGP)in patients with chronic nonbacterial prostatitis(CNP).Methods:A randomized,double-blind,placebo-controlled clinical trial was conducted among 72 patients with CNP.Participants were randomly allocated to a treatment group and a placebo group using computer software in a 1:1 ratio,and received either MDGP external umbilicus treatment(MDGP group,36 cases)or placebo(control group,36 cases)at acupoints Shenque(CV 8),twice a week for 4 weeks.In addtion,patients all received herbal medicine treatment twice a day for 4 weeks.The primary outcome was the US National Institutes of Health Chronic Prostatitis Symptom Scores Index(NIH-CPSI)with a questionnaire at weeks 2 and 4.The secondary outcomes including prostatic fluid examination(white blood cells and lecithin bodies),the clinical efficacy evaluation,and the adverse events were also assessed during the entire trial.Results:The NIH-CPSI scores regarding pain or discomfort scores showed greater improvement in the MDGP group than placebo control group at weeks 2(P=0.001)and week 4(P=0.004),respectively.NIH-CPSI scores of symptom severity,total scores and leukocytes number in the prostatic fluid in the MDGP group were significantly improved(P<0.05).There was no statistical difference in the urinary symptoms,quality of life,lecithin and other scores between two groups(P>0.05).The clinical effective rate was 73.53%(25/34)in the MDGP group,which was significally higher than the placebo control group with 48.39%(25/31,P<0.05).Patients were blinded successfully,and no serious adverse effects were found during the trial.Conclusion:A 4-week course of umbilicus treatment with modified Dinggui Powder seems to relieve pain and symptom severity effectively and increase the amount of leukocytes number in patients with CNP(Trial registration No.ChiCTRI 800014687).

Prostate-derived IL-1βupregulates expression of NMDA receptor in the paraventricular nucleus and shortens ejaculation latency in rats with experimental autoimmune prostatitis

Experimental autoimmune prostatitis(EAP)-induced persistent inflammatory immune response can significantly upregulate the expression of N-methyl-D-aspartic acid(NMDA)receptors in the paraventricular nucleus(PVN).However,the mechanism has not yet been elucidated.Herein,we screened out the target prostate-derived inflammation cytokines(PDICs)by comparing the inflammatory cytokine levels in peripheral blood and cerebrospinal fluid(CSF)between EAP rats and their controls.After identifying the target PDIC,qualified males in initial copulatory behavior testing(CBT)were subjected to implanting tubes onto bilateral PVN.Next,they were randomly divided into four subgroups(EAP-1,EAP-2,Control-1,and Control-2).After 1-week recovery,EAP-1 rats were microinjected with the target PDIC inhibitor,Control-1 rats were microinjected with the target PDIC,while the EAP-2 and Control-2 subgroups were only treated with the same amount of artificial CSF(aCSF).Results showed that only interleukin-1β(IL-1β)had significantly increased mRNA-expression in the prostate of EAP rats compared to the controls(P<0.001)and significantly higher protein concentrations in both the serum(P=0.001)and CSF(P<0.001)of the EAP groups compared to the Control groups.Therefore,IL-1βwas identified as the target PDIC which crosses the blood-brain barrier,thereby influencing the central nervous system.Moreover,the EAP-1 subgroup displayed a gradually prolonged ejaculation latency(EL)in the last three CBTs(all P<0.01)and a significantly lower expression of NMDA NR1 subunit in the PVN(P=0.043)compared to the respective control groups after a 10-day central administration of IL-1βinhibitors.However,the Control-1 subgroup showed a gradually shortened EL(P<0.01)and a significantly higher NR1 expression(P=0.004)after homochronous IL-1βadministration.Therefore,we identified IL-1βas the primary PDIC which shortens EL in EAP rats.However,further studies should be conducted to elucidate the specific molecular mechanisms through which IL-1βupregulates NMDA expression.

针刺配合腰骶刺络放血治疗慢性前列腺炎

Objective:To observe the effect of acupuncture and bloodletting therapy at the lumbosacral region for chronic prostatitis.Methods:A total of 36 patients with chronic prostatitis were collected,and treated in the Department of Acupuncture and Moxibustion and the External Treatment Center of Chinese Medicine,Affiliated Hospital of Shandong University of Traditional Chinese medicine.The patients were treated with acupuncture,combined with bloodletting therapy at the lumbosacral region.The treatment for 4 weeks was as one course and 2 consecutive courses of treatment were required.The therapeutic effect,including the score of the National Institute of Health-Chronic prostatitis symptom index(NIH-CPSI),was assessed.Results:After 1 and 2 courses of treatment,the symptom scores and NIH-CPSI total score were all reduced as compared with that before treatment,respectively(all P<0.01).After 2 courses of treatment,the score of each symptom and NIH-CPSI total score were reduced as compared with that after 1 course of treatment,respectively(all P<0.01).Regrading the 3 syndromes/patterns of chronic prostatitis in the patients,i.e.downward invasion of damp heat,qi and blood stagnation and liver qi stagnation,after 1 and 2 courses of treatment,NIH-CPSI total scores were all reduced as compared with that before treatment(all P<0.01).Additionally,after 2 courses of treatment,NIH-CPSI total score of each syndrome/pattern was reduced as compared with that after 1 course of treatment(all P<0.01).For kidney yin deficiency,after 2 courses of treatment,NIH-CPSI total score was reduced as compared with that either before treatment or after 1 course of treatment(both P<0.01).The total effective rate was 91.67%after 1 course of treatment and 97.22%after 2 courses of treatment.No obvious adverse events occurred during the treatment.Conclusion:The combined treatment with acupuncture and bloodletting therapy at the lumbosacral region effectively relieves the symptoms of chronic prostatitis and improves the quality of life in the patients.

The impact of the COVID-19 pandemic on erectile function in Chinese CP/CPPS patients

This study aimed to investigate the impact of the coronavirus disease 2019(COVID-19)pandemic on erectile function in Chinese patients with chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).A retrospective study was conducted on 657 CP/CPPS patients who visited The Third Xiangya Hospital of Central South University(Changsha,China)from November 2018 to November 2022.Patients were divided into two groups based on the timeline before and after the COVID-19 outbreak in China.The severity of CP/CPPS,penile erection status,anxiety,and depression was evaluated using the National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),International Index of Erectile Function-5(IIEF-5),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)scales,respectively.Compared with patients before the COVID-19 outbreak,more CP/CPPS patients developed severe erectile dysfunction(ED)due to depression and anxiety caused by the pandemic.After developing moderateto-severe ED,mild and moderate-to-severe CP/CPPS patients exhibited more apparent symptoms of anxiety and depression(P<0.001 and P=0.001,respectively),forming a vicious cycle.The COVID-19 pandemic has adversely affected the psychological status of CP/CPPS patients,exacerbating their clinical symptoms and complicating ED.The exacerbation of clinical symptoms further worsens the anxiety and depression status of patients,forming a vicious cycle.During the COVID-19 pandemic,paying more attention to the mental health of CP/CPPS patients,strengthening psychological interventions,and achieving better treatment outcomes are necessary.