Golden Needle Practitioner Library

abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On pages 77-78 of issue #8, 2007 of Xin Zhong Yi (New Chinese Medicine), Wang Guang-chao published an article titled “The Treatment of 36 Cases of Prostatic Hypertrophy with Kai Long Qi Bi Tang (Open Dribbling Urinary Block & Initiate Blockage Decoction).” A summary of this article is presented below.

Cohort description:

Altogether, there were 72 cases of confirmed BPH included in this two-wing comparison study. Main symptoms included inhibited urination, lack of force in the expulsion of urine, increased night-time urination, dribbling and dripping of urination, and, if severe, urinary blockage, and lower abdominal distention and fullness but no urinary tract pain. Digital rectal exam (DRE) showed enlarged prostates with disappearance of the central groove and a surface that was slippery and hard. Ultrasonography also confirmed prostatic enlargement. These 72 cases were randomly divided into two groups of 36 cases each, a treatment group and a comparison group. In the treatment group ages ranged from 38-81 years with a disease duration of three months to six years. In the comparison group, ages ranged from 41-83 years, with a disease duration of four months to five years. Therefore, in terms of age and disease duration, these two groups were considered statistically comparable for the purposes of this study.

Treatment method:

All members of the treatment group were orally administered the self-composed formula Kai Long Qi Bi Tang (Open Dribbling Urinary Block & Initiate Blockage Decoction) with additions and subtractions depending on each patient’s presentation. The basic formula consisted of:

Yin Yang Huo (Herba Epimedii), 12g
Jie Geng (Radix Platycodi)
Gui Zhi (Ramulus Cinnamomi), 5g each
Sheng Ma (Rhizoma Cimicifugae)
Wu Yao (Radix Linderae)
Hu Po (Succinum)
Chuan Shan Jia (Squama Mantidis)
Ze Lan (Herba Lycopi), 9g each
Niu Xi (Radix Achyranthis Bidentatae), 15g
Xi Shuai (Gryllodes), 4 pieces

If there was lung heat congestion and exuberance, nine grams of Fu Ping (Herba Lemnae Spirodelae) and 12 grams of Sang Bai Pi (Cortex Mori) were added.

If there was urinary bladder damp heat, 30 grams of Hua Shi (Talcum) and nine grams each of Huang Lian (Rhizoma Coptidis) and Zhi Zi (Fructus Gardeniae) were added.

If there was liver depression qi stagnation, nine grams each of Chai Hu (Radix Bupleuri) and Chuan Lian Zi (Fructus Toosendam) and 15 grams of Yu Jin (Tuber Curcumae) were added.

If there was urinary tract blockage and obstruction, 10 grams of Di Bie Chong (Steleophaga), 12 grams of Tao Ren (Semen Persicae), and nine grams of Da Huang (Radix Et Rhizoma Rhei) were added.

If there was central qi falling downward, nine grams of Chai Hu (Radix Bupleuri) and 30 grams of Huang Qi (Radix Astragali) were added.

If there was kidney qi insufficiency, 15 grams each of Shan Zhu Yu (Fructus Corni) and Shan Yao (Radix Dioscoreae) were added.

If there was kidney yang insufficiency, five grams of Zhi Fu Zi (Radix Lateralis Praeparatus Aconiti) were added.

If there was kidney yin insufficiency, 12 grams of Shu Di Huang (cooked Radix Rehmanniae) were added.

One packet of these medicinals was decocted in water and administered per day.

All members of the comparison group were treated with any combination of several Western drugs. It is assumed that these drugs included Proscar®, Avodart®, Cardura®, Flomax®, and Uroxatral®, all of which are marketed in China.

For both groups, seven days equaled one course of treatment, and two or more were given if and when necessary depending on the therapeutic effects.

Study outcomes:

Cure was defined as smooth and easy urination and disappearance of any other disease-specific or generalized signs and symptoms. Improvement was defined as improvement in disease-specific and generalized signs and symptoms, and no effect meant that there was no improvement in either of these. The following table shows the outcomes of both groups based on these criteria.

Thus this shows that the Chinese herbal regimen was marked more effect than the Western drug therapy. In the treatment group, the longest course of treatment was 26 days, the shortest was four days, and the average was nine days. In the comparison group, the longest course of treatment was 48 days, the shortest was eight days, and the average was 17 days.

Discussion:

According to Wang, BPH corresponds to the traditional Chinese medical disease category of dribbling urinary block. In modern Western medicine, this condition is treated medically with testosterone, alpha-adrenergic inhibitors, and 5-alpha-reductase inhibitors. However, these drugs tend to have many side effects. This condition is also treated surgically. However, the “knife damage” is large, the procedure is relatively painful, and a large number of patients with this condition are elderly and are too weak for surgery. In terms of Chinese medicine, this disease is located in the bladder but is closely related to the liver, spleen, kidneys, and three burners. Due to overeating acrid, peppery foods, thick-flavored foods, or drinking alcohol, damp heat brews and binds. It is also possible for food taxation to attack and damage the spleen. In addition, in the elderly, their bodies are weak and there is kidney qi insufficiency. It is also possible for detriment and damage by the seven affects to cause liver qi depression and binding, Further, static blood may obstruct essence giving rise to urinary tract blockage and obstruction. Any of these may also cause of loss of lung diffusion, effusion, and depurative downbearing. Hence the lungs are not able to free the flow and regulate the water passageways and, therefore, descend and transport fluids to the bladder. If the spleen loses its movement and transformation, then it is not able to upbear the clear and downbear the turbid. If the kidneys lose their qi transformation, they are no able to open and unit or close. If the liver loses its coursing and discharge, then it is not able to free the flow and disinhibit the qi mechanism. If the triple burner qi transformation is inhibited, then this results in dribbling urinary block. To make matters worse, since BPH normally occurs in the elderly, there is also phlegm and stasis mutually obstructing in many cases.

Therefore, treatment should supplement the kidneys and invigorate yang, quicken the blood and transform stasis, soften the hard and scatter binding or nodulation, open above in order to free the flow below, rectify the qi in order to disinhibit its mechanism, upbear clear yang, and downbear turbid qi. Within the above formula, Yin Yang Huo warms the kidneys and invigorates yang. Thus it treats the root of kidney vacuity. Jie Geng opens and lifts up the lung qi, opening above in order to free the flow below. Wu Yao is acrid, scattering, warming, and flow-freeing. It courses and disinhibits the triple burner qi mechanism. Gui Zhi warms yang in order to invigorate qi transformation. Hu Po and Ze Lan quicken the blood, transform stasis, and disinhibit water. Chuan Shan Jia quickens the blood and frees the flow of the network vessels, softens the hard and scatters binding. Xi Shuai (cricket) has a predilection for arising and descending and is used in order to disinhibit the lower orifices, disinhibit urination and break the blood. Sheng Ma upbears and lifts the clear yang qi. Niu Xi supplements the liver and kidneys and guides the other medicinals to move downward. When Sheng Ma and Niu Xi are used together, one upbears the clear and lifts the fallen while the other guides the other medicinals to move downward. One upbears and one downbears. Thus they mutually assist and work together well. When all these medicinals are used together, the supplement the spleen and kidneys, invigorate the qi transformation, qi transformation obtains movement, and the flow of urination is automatically freed. In addition, there is the transformation of static blood, the scattering of stasis and binding, the disinhibition of the qi mechanism, and the free flow of the water passageways. Clear yang is upborne, turbid yin is downborne, the upper orifices are opened, and this leads to the flow of the lower orifices being freed. When this basic formula is modified based on pattern discrimination, it can treat every type of BPH.

Copyright © Blue Poppy Press, 2007. All rights reserved.