Clinical Analysis of Acupuncture Combined with Acupoint Injection for the Treatment of Chronic Nonbacterial Prostatitis

Objective:To evaluate the therapeutic effect of acupuncture combined with acupoint injection on chronic nonbacterial prostatitis(CNP).Methods:A total of 72 CNP patients admitted between March 2022 and October 2023 were selected.The patients were randomly divided into two groups using a random number table.The combined treatment group(36 cases)received acupuncture combined with acupoint injection therapy,while the control group(36 cases)received conventional Western medicine treatment.The overall efficacy rate,symptom severity,prostatic fluid indicators,incidence of adverse reactions,and recurrence rates were compared.Results:The overall efficacy rate of the combined treatment group was higher than that of the control group(P<0.05).After 10 days of treatment,the symptom severity score of the combined treatment group was higher than that of the control group,and the prostatic fluid indicators were lower than those of the control group(P<0.05).The incidence of adverse reactions in the combined treatment group was lower than in the control group(P<0.05).During the follow-up period of 1-6 months,the recurrence rate in the combined treatment group was lower than that in the control group(P<0.05).Conclusion:Acupuncture combined with acupoint injection can alleviate CNP disease symptoms,improve prostate function,and prevent post-treatment adverse reactions.It also has a lower recurrence risk and demonstrates excellent efficacy.

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.

MicroRNA expression profile in chronic nonbacterial prostatitis revealed by next-generation small RNA sequencing

MicroRNAs (miRNAs) are con sidered to be involved in the pathogenic in itiatio n and progress! on of chronic non bacterial prostatitis (CNP);however, the comprehensive expression profile of dysregulated miRNAs, relevant signaling pathways, and core machineries in CNP have not been fully elucidated. In the current research, CNP rat models were established through the intraprostatic injection of carrageenan into the prostate. Then, next?generation sequencing was performed to explore the miRNA expression profile in CNP. Gene Ontology (GO) and Kyoto En cyclopedia of Genes and Geno mes (KEGG) bioinformatical an a lyses were conducted to reveal the enriched biological processes, molecular functions, and cellular components and signaling pathways. As a result, 1224, 1039, and 1029 known miRNAs were annotated in prostate tissues from the blank control (BC), normal saline injection (NS), and carrageenan injection (CAR) groups (n = 3 for each group), respectively. Among them, 84 miRNAs (CAR vs BC) and 70 miRNAs (CAR vs NS) with significantly different expression levels were identified. Compared with previously reported miRNAs with altered expression in various inflammatory diseases, the majority of deregulated miRNAs in CNP, such as miR-146b-5p, miR?155-5p, miR-150-5p, and miR-139-5p, showed similar expression patter ns. Moreover, bioinformatics analyses have en riched mitoge reactivated protei n kinase (MAPK), cyclic adenosine monophosphate (cAMP), endocytosis, mammalian target of rapamycin (mTOR), and forkhead box 0 (FoxO) signaling pathways. These pathways were all invoIved in immune response, which indicates the critical regulatory role of the immune system in CNP initiati on and progression. Our inv estigatio n has presented a global view of the d iff ere ntially expressed miRNAs and potential regulatory networks containing their target genes, which may be helpful for identifying the novel mechanisms of miRNAs in immune regulation and effective target-specific theragnosis for CNP.

The effect of sensation of transmission along meridian acupuncture for chronic nonbacterial prostatitis

Objective:To investigate the short-term efficacy difference between sensation of transmission along meridian acupuncture and non-sensation of transmission along meridian acupuncture in the treatment of chronic nonbacterial prostatitis.Methods:A randomized,controlled,and single-blind clinical study was performed to collect 63 patients with chronic nonbacterial prostatitis who met the inclusion criteria and were randomly assigned to a transmission sensation group(31 patients)and a non-transmission sensation group(32 patients).The two groups of patients took the same acupuncture points.When they were lying down on their backs,Guānyuán(关元 CV4),Zhōngjí(中极 CV3)and Dàhè(大赫 K112)were taken.When they were lying down on their stomachs,Shènshū(肾俞 BL 23),Cìliáo(次髎 BL32)and Huìyáng(会阳 BL35)were taken.Among them,the transmission sensation group was treated with transmission sensation along meridian to apply deep needling to the lower abdomen and lumbosacral acupuncture points with lifting,thrusting,and twirling method,so that the needling sensation was transmitted to the bladder,perineum and urethra.The non-transmission sensation group was treated with non-transmission sensation along meridian,and the acupuncture points were treated with conventional acupuncture until the patient felt soreness and distending etc.and the arrival of qi.Both groups of patients were treated with electro-acupuncture during acupuncture,and the sparse-dense wave(sparse wave 4 Hz,dense wave 20 Hz),and the needle retention continued for 20 min.All patients were treated for 3 times with once every other day,and the treatment lasted for one week.The CV4,CV3 and KI12 were used in the first and third treatments,and the BL23,BL32 and BL35 were used in the second treatment.The National Institute of Health chronic prostatitis syndrome index(NIH-CPSI)and Hamilton Anxiety Rating Scale(HAMA)were observed,and the clinical efficacies of the patient were observed.Results:After treatment,the NIH-CPSI scores(18.29±1.25,21.56±1.28)and HAMA scores(10.29±1.16,11.25±1.14)in the transmission sensation group and non-transmission sensation group were all lower than the pre-treatment NIH-CPSI score(24.90±1.45,24.94±1.25)and HAMA(14.10±1.53,14.47±1.22)in the transmission sensation group and non-transmission sensation group,the differences were statistically significant(all P<0.05).The difference value between the pre-treatment and post-treatment NIH-CPSI scores of the transmission sensation group(6.61±0.97)was higher than that of the nontransmission sensation group(3.48±0.59),and the difference was statistically significant(P<0.05).The difference value between the pre-treatment and post-treatment HAMA scores of the transmission sensation group(3.81±0.81)was higher than that of the non-transmission sensation group(2.77±0.54).The total effective rate of the transmission sensation group(35.48%)was higher than that of the nontransmission sensation group(12.50%),and the difference was statistically significant(P<0.05).Conclusions:Both the method of transmission sensation along meridian and the method of nontransmission sensation along meridian can effectively relieve the clinical symptoms and anxiety symptoms of patients with chronic nonbacterial prostatitis,improve the quality of life,and the method of transmission sensation along meridian had a more advantageous effect.

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).

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.