]]> http://www.goldenneedleonline.com/blog/2009/07/03/low-sperm-count/feed/ 0 http://www.goldenneedleonline.com/blog/2009/05/26/premature-ejaculation-chinese-medicinals-antidepressants/ http://www.goldenneedleonline.com/blog/2009/05/26/premature-ejaculation-chinese-medicinals-antidepressants/#comments Tue, 26 May 2009 20:25:37 +0000 muffy http://www.goldenneedleonline.com/blog/?p=35 Premature Ejaculation, Chinese Medicinals & Antidepressants

abstracted  & translated by

Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On pages 118-120 of issue #2, 2006 of the Zhong Yi Za Zhi (Journal of Chinese Medicine), Yang Xin et al. published an article titled, “Clinical Observations on the Treatment of 50 Cases of Premature Ejaculation with Chinese Medicinals Combined with Antidepressants.” A summary of that article is presented below.

Cohort description:

Altogether, there were 150 out-patients with premature ejaculation (PE) from the Andrology Department of the Zhejiang Hospital of Integrated Chinese-Western Medicine in Hangzhou enrolled in this study. The diagnostic criteria for premature ejaculation were those found in the DSM-IV. Fifty-eight of these patients suffered from primary onset PE and 92 from secondary onset PE. All the men were 23-52 years of age, with an average age of 31. All had a normal penis and testicles. These men had suffered from PE for from three months to eight years, with an average disease duration of 10 months. One hundred sixteen patients were married and 34 were unmarried. However, the unmarried men had all been in sexual relationships for one half year or more. These 150 men were randomly divided into three groups of 50 patients each, and there were no significant statistical differences between these three groups. All these men also met the diagnostic criteria for the Chinese medical pattern of yin vacuity-yang hyperactivity with non-securing of the essence gate or bar. The main signs and symptoms of this pattern included easy sexual arousal, premature ejaculation or seminal emission, low back and knee soreness and limpness, vacuity vexation, insomnia, vexatious heat in the five hearts, a red tongue with scanty fur, and a fine, rapid pulse. Exclusion criteria included abnormal serum parameters of sex hormones, such as testosterone, follicle-stimulating hormone, prolactin, or estradiole (E2). Also excluded were those with prostate, seminal vesicle, urinary tract, and/or psychiatric disorders.

Treatment method:

Group 1 were administered Zhi Bai Gu Jing Tang (Anemarrhena & Phellodendron Secure the Essence Decoction) which consisted of:

Zhi Mu (Rhizoma Anemarrhenae)
Huang Bai (Cortex Phellodendri)
Jin Ying Zi (Fructus Rosae Laevigatae)
Gou Qi Zi (Fructus Lycii)
Wu Wei Zi (Fructus Schisandrae)
Long Gu (Os Draconis)
Mu Li (Concha Ostreae)
Jin Nei Jin (Endothelium Corneum Gigeriae Galli)
Suan Zao Ren (Semen Zizyphi Spinosae)
He Huan Pi (Cortex Albiziae)

Fifty milliliters of the liquid made from these medicinals was administered each time, three times per day.

Group 2 were administered 50 milligrams per day of sertraline (Zoloft®).[1]

Group 3 received both the Zhi Bai Gu Jing Tang and the sertraline.

All three groups were treated for four weeks.

Study outcomes:

Marked effect was defined as the ability to control ejaculation in order for the woman to be sexually satisfied or to control ejaculation for five minutes with both partners satisfied with their sexual activity. Some effect was defined as lack of complete ability to control ejaculation. However, the patient was able to control their ejaculation for more than two minutes and both partners were basically satisfied with their sexual activity. No effect meant that the patient could not control his ejaculation for at least two minutes or that neither partner was satisfied with their sexual activity. Based on these criteria, in group 1, 18 cases got a marked effect, 15 got some effect, and 17 got no effect, for a marked effectiveness rate of 36% and a total effectiveness rate of 66%. In group 2, 20 cases got a marked effect, 15 got some effect, and 15 got no effect, for a marked effectiveness rate of 40% and a total effectiveness rate of 70%. In group 3, 33 cases got a marked effect, 13 got some effect, and four got no effect, for a marked effectiveness rate of 66% and a total effectiveness rate of 92%. Therefore, the combined administration of the Chinese medicinals with sertraline was more effective than either of these two therapies alone.

The following table shows the mean times of ejaculatory latency time expressed in minutes of the members of the three groups before and after treatment.

The next table shows the satisfaction rates before and after treatment.

Discussion:

Life-long PE is a syndrome characterized by a cluster of symptoms. Rapid ejaculations become manifest around the first sexual encounters in puberty or adolescence. Intravaginal ejaculation latency time 1) usually occurs within 30-60 seconds or, maximally, within two minutes after vaginal penetration, 2) is present with nearly every sexual partner, and 3) remains similar throughout life or may become aggravated during aging. In addition, this syndrome may lead to secondary psychological, sexual, and relationship problems. Although, the etiology of this dysfunction is unclear, it probably includes neurobiological and environmental factors. In part, PE is thought to be mediated, in part, by disturbances of serotonergic (5-hydroxytryptamine, 5-HT) neurotransmission and ejaculation-mediating 5-HT receptors in the central nervous system. Sertraline increases the conduction of 5-HT and thus slows ejaculation. However, in some patients, this medicine can cause decreased libido, soft erections, marked gastro-intestinal tract symptoms, and/or dizziness. As this study shows, small dose of sertraline with Chinese medicinals can get a better therapeutic effect with less or no side effects.

According to Chinese medical theory, the kidneys store the essence and rule reproduction. If kidney yin is insufficient and vacuity heat harasses internally or ministerial fire tends to become effulgent, this heat may disturb the essence chamber leading to the discharge of the essence qi. Likewise, if kidney qi is vacuous and depleted, the essence gate or bar may be insecure and, therefore, the essence may easily be discharged. However, although the storage and discharge of essence is mainly governed by the kidneys, it is also closely related to the heart and liver. Premature ejaculation is commonly seen with the liver’s loss of control over coursing and discharge, emotional depression, heart vacuity-gallbladder timidity, and lack of tranquility of the heart spirit. Therefore, the authors of this article bleieve that the basic disease mechanisms of PE are heart spirit lack of tranquility and kidney essence insecurity. Hence within the above formula, Zhi Mu and Huang Bai enrich yin and downbear fire. Jin Ying Zi, Gou Qi Zi, and Wu Wei Zi enrich yin and boosts the kidneys. Long Gu, Mu Li, and Ji Nei Jin subdue yang, constrain the essence, and secure discharge. Suan Zao Ren calms the heart and quiets the spirit, while He Huan Pi courses the liver and resolves depression. When all these medicinals are used together, root and tip or branch are treated simultaneously.

Copyright © Blue Poppy Press, 2006. All rights reserved.

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

Keywords: Chinese medicine, Chinese herbal medicine, erectile dysfunction (ED)

On pages 415-416 of issue #7, 2004 of the Shan Dong Zhong Yi Za Zhi (Shandong Journal of Chinese Medicine), Wang Wei-ping published an article titled, “A Clinical Audit of 58 Patients with Erectile Dysfunction Treated with the Methods of Fortifying the Spleen & Supplementing the Kidneys.” A summary of this study is presented below.

Cohort description:

Of the 58 men with erectile dysfunction included in this study, 11 were 20-30 years old, 24 were 31-40, 18 were 41-50, and five were 51 or over. The longest time one of these patients had been married was 35 years and the shortest time was two weeks. In 31 cases, the course of disease had lasted less than one year. In 16 cases, it had lasted 1-3 years; in eight cases, 3-5 years, and in three cases, for more than five years. Thirty-six patients suffered from grade I ED, and 22 from grade II ED. Thirty-four patients had a history of masturbation prior to marriage, 21 had had frequent sex with multiple partners, and 17 cases had accompanying prostatitis. Organic pathology of the reproductive organs had been ruled out.

Treatment method:

The basic formula administered to all patients in this study consisted of:

Dang Shen (Radix Codonopsitis Pilosulae)

Huang Qi (Radix Astragali Membranacei)

Shan Yao (Radix Dioscoreae Oppositae)

Shu Di (cooked Radix Rehmanniae Glutinosae), 15g each

Bai Zhu (Rhizoma Atractylodis Macrocephalae)

Fu Ling (Sclerotium Poriae Cocos)

Shan Zhu Yu (Fructus Corni Officinalis)

Du Zhong (Cortex Eucommiae Ulmoidis)

Ba Ji Tian (Radix Morindae Officinalis)

Yin Yang Huo (Herba Epimedii)

Gou Qi Zi (Fructus Lycii Chinensis)

Chuan Shan Jia (Squama Manitis Pentadactylis)

Rou Cong Rong (Herba Cistanchis Deserticolae), 12g

Xiang Fu (Rhizoma Cyperi Rotundi), 9g

Yang Qi Shi (Actinolitum), 30g

Wu Gong (Scolopendra Subspinipes), 1 strip

One packet of these medicinals was decocted in water and administered per day, with 20 days equaling one course of treatment. If there was accompanying prostatitis, Bi Xie (Rhizoma Dioscoreae Hypoglaucae), Qu Mai (Herba Dianthi), and Bai Jiang Cao (Herba Patriniae Heterophyllae) were added.

Study outcomes:

Cure was defined as the ability to achieve and maintain an erection within one course of treatment with normal resumption of bedroom affairs. Improvement meant that, after one course of treatment, the erection had strength but was still  sometimes better and sometimes not so good. No effect meant that there was no obvious improvement in the patient’s erections. Based on these criteria, 46 out of 58 patients were judged cured, 10 improved, and two got no effect, for a total effectiveness rate of 96.5%.

Discussion:

According to Dr. Wang, ED is mostly due to spleen-kidney vacuity weakness. It is mostly seen in those who engaged in masturbation before marriage or a lot of other sexual activity before marriage. This has damaged the kidney qi and consumed kidney essence. Hence the life-gate fire has declined. If kidney yang is vacuous, it is not able to warm and shine spleen yang. In that case, spleen vacuity may not move. It is also possible for excessive thinking and worry to damage the spleen, thus resulting in qi and blood depletion and vacuity. In that case, latter heaven is not able to fill and nourish the former heaven essence qi. This produces vacuity on top of vacuity. In addition, qi and blood vacuity will not nourish and fill the sinew gathering (i.e., the penis). Therefore, ED results. Based on the foregoing theory, Dr. Wang believes that the former and latter heavens should be supplemented at the same time. Thus, within th above formula, Dang Shen, Huang Qi, Bai Zhu, and Shan Yao fortify the spleen and boost the qi, thereby supplementing the latter heaven. Ba Ji Tian, Yin Yang Huo, Yang Qi Shi, She Chuang Zi (Semen Cnidii Monnieri, sic], Rou Cong Rong, and Du Zhong supplement kidney yang. Shu Di, Shan Zhu Yu, and Gou Qi Zi nourish kidney yin. This use of both yin and yang supplements is based on the interdependence of yin and yang. Xiang Fu, Chuan Shan Jia, and Wu Gong are added to help to spread the qi and blood, insuring that the vessels and network vessels are coursed and smoothly flowing.

Copyright © Blue Poppy Press, 2005. All rights reserved.

abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK) On page 155 of issue #3, 2007 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Qiu Shun-an et al. published an article titled “The Treatment of 60 Cases of prostatic Hypertrophy by the Methods of Supplementing the Kidneys & Transforming Stasis Plus Acupoint Massage.” A summary of this article is presented below.

Cohort description:

There were a total of 90 participants enrolled in this two-wing comparison study, all of whom met the diagnostic criteria for benign prostatic hypertrophy found in Zhong Yi Bing Zheng Zhen Duan Liao Xiao Biao Zhun (Criteria for Chinese Medicine Disease & Pattern Diagnosis and Treatment Outcomes). The main clinical symptoms of this condition were hesitant expulsion of urine, a fine, thin stream, the expulsion of urine sometimes requiring great expenditure of strength, a feeling of incomplete urination, frequent, numerous nighttime urination, a pale or dark tongue with white fur, and a fine pulse. Digital rectal exam (DRE) showed that both lobes of the prostate gland were enlarged and that the central crease had disappeared. The diagnosis of BPH was confirmed by examination of urine flow rate and ultrasonography. In terms of Chinese medical pattern discrimination, all 90 subjects presented a complex pattern of static blood obstruction and stagnation, central qi falling downward, and kidney yang vacuity decline. These 90 cases were randomly divided into two groups, a so-called treatment group and a comparison group. All members of both groups were 55-75 years of age and had suffered from BPH for from 1-6 years. In the treatment group of 60, the average age was 65 and the average disease duration was 26 months. In the comparison group of 30, the average age was 66 and the average disease duration was 25 months. Therefore, in terms of age and disease duration, there were no significant statistical differences for the purposes of this study.

Treatment method:

All members of the treatment group were administered the following Chinese medicinals:

Huang Qi (Radix Astragali)
Sheng Di (uncooked Radix Rehmanniae)
Bu Gu Zhi (Fructus Psoraleae)
Tu Si Zi (Semen Cuscutae)
E Zhu (Rhizoma Zedoariae)
Fu Ling (Poria)
Chuan Niu Xi (Radix Cyathulae), 12g each
Rou Gui (Cortex Cinnamomi), 6g
Chi Shao (Radix Rubra Paeoniae)
Dang Gui (Radix Angelicae Sinensis)
Hong Hua (Flos Carthami)
Tao Ren (Semen Persicae)
Yi Mu Cao (Herba Leonuri)
Gou Qi Zi (Fructus Lycii), 9g each
Dan Shen (Radix Salviae Miltiiorrhizae), 30g

One packet of these medicinals was decocted in water and administered orally in two divided doses per day, morning and evening, and 30 days of this regime equaled one course of treatment. In addition, during this time, the subjects were instructed to massage the following three points for 1-2 minutes each, one time per day for 30 continuous days:

Zhong Ji (CV 3)
Guan Yuan (CV 4)
Qi Hai (CV 6)

The appropriate hand technique was supposed to be soft and harmonious yet have strength and depth, with movements having a regular rate.

Members of the comparison group were orally administered Long Bi Shu Jiao Nang (Dribbling Urinary Block Soothing Gelatin Capsules), 3 pills each time, two times per day for 30 days. These capsules were made at a pharmaceutical company in Shijiazhuang.

Study outcomes:

Outcomes criteria were based on Zhong Yao Xin Yao Zhi Liao Liang Xing Qian Lei Quan Zeng Sheng Zheng De Lin Chuang Yan Jiu Zhi Dao Yuan Ze (Reference Standards for Clinical Research into Chinese Medicinals & New Medicinals Treatment of Benign Prostatic Hypertrophy). Therefore, marked effect meant that, after treatment, the disease condition had decreased by 70% or more, that the urinary flow rate had increased by more than 30%, and that retained urine had decreased by more than 50%. Some effect meant that, after treatment, the disease condition had decreased by 30% or more, urinary flow rate had increased by more than 10%, and retained urine had decreased more than 20%. No effect meant that these criteria were not met. The following table shows the outcomes of the two groups based on these criteria.

Therefore, there was a significant difference in outcomes between the two groups in terms of total effectiveness (P < 0.05).

The next chart shows the mean urinary flow rates of the two groups before and after treatment.

Therefore, there was a significant mean increase in urinary flow from before to after treatment in the treatment group (P < 0.05). The final table shows the mean changes in amounts of urine expelled from before to after treatment.

Therefore, there was a significant increase in urinary volume from before to after treatment in the treatment group (P < 0.05).

Discussion:

According to the Chinese authors of the above study, BPH corresponds to the Chinese disease diagnosis of dribbling urinary block. Mostly it is due to bodily weakness in the elderly with damage and detriment of the kidney essence and subsequent loss of strength of the bladder qi transformation. Therefore, turbid yin is not downborne. Based on the saying, in enduring diseases, there must be stasis, phlegm and stasis mutually bind, with accumulation producing lumps and putting pressure on the urinary tract. Hence, this condition is characterized by a root vacuity with branch or tip repletions, and treatment should supplement the kidneys and boost the qi, quicken the blood and transform stasis. Within the above formula, Tu Si Zi boosts the liver and warms the kidneys, while Bu Gu Zhi frees the flow of the lifegate. When these two medicinals are used together, they strengthen the bladder’s qi transformation. Rou Gui warmly supplements kidney yang. Gou Qi Zi supplements kidney yin. Huang Qi supplements the qi, and Fu Ling fortifies the spleen and supplements the center. Tao Hong Si Wu Tang (Perica & Carthamus Four Materials Decoction) minus Chuan Xiong (Rhizoma Chuanxiong) but plus Dan Shen, E Zhu, Yi Mu Cao, and Chuan Niu Xi quickens the blood, transforms stasis, and scatters binding. When all these medicinals are used together, they strike the center of the above disease mechanisms. In addition, the three acupoints used in this protocol are all on the conception vessel. These points regulate and rectify the qi mechanism, supplement the kidneys, and invigorate yang, regulate the three burners, and free the flow of urinary block. When these points are regularly massaged, they can get twice the result with half the effort. During the course of treatment, patients were counseled not to hold their urine, to keep their bowel movements freely and smoothly flowing, to lead a regular daily life, to avoid wind and cold, and not to drink alcohol or eat acrid, peppery, stimulating foods.

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

abstracted & translated by

Bob Flaws, Dipl. Ac., & C.H., Lic. Ac., FNAAOM, FRCHM

Keywords: Chinese medicine, Chinese herbal medicine, benign prostatic hypertrophy (BPH), treatment based on pattern discrimination

Benign prostatic hypertrophy refers to adenomatous hyperplasia of the periurethral prostate gland which causes varying degrees of bladder outlet obstruction. Benign prostatic hypertrophy is present in 8% of men 31-40 years of age and in 40-50% of men 51-60 years of age. Its incidence increases to more than 80% by 80 years of age. The symptoms of BPH are progressive urinary frequency, urgency, and nocturia due to incomplete emptying and rapid refilling of the bladder. Decreased size and force of the urinary stream produce hesitancy and intermittency. On rectal examination, the prostate is usually enlarged, has a rubbery consistency, and frequently has lost its median furrow. Serum prostate-specific antigen (PSA) is moderately elevated in 30-50% of patients with BPH. Definitive Western medical therapy is surgical, with 5-10% of patients treated surgically having problems with sexual potency and continence afterwards. In issue #2, 2003 of the Yun Nan Zhong Yi Zhong Yao Za Zhi (Yunnan Journal of Chinese Medicine & Chinese Medicinals), Ceng Duan-gang and Duan Deng-zhi published an article titled, “A Study of the Therapeutic Efficacy of Treating 93 Cases of Prostatic Hyperplasia by Pattern Discrimination.” This study appeared on page 21 of that journal and a summary is given below. The assumption of these two authors is that BPH always presents a pattern of blood stasis no matter what other concomitant patterns it presents.

Cohort description:

All 93 men in this study were diagnosed with BPH as out-patients at the authors’ hospital via digital rectal examination and ultrasonography. None of these patients had any acute urinary tract infections or functional disturbances of their hearts, livers, lungs, or kidneys. Clinical symptoms included frequent night-time urination, fine urine stream, terminal dribbling and dripping, frequent urination, urinary urgency, and difficulty expressing urine. Ages of the men were not given.

Treatment method:

1. Yang vacuity & blood stasis

Symptoms: Cold body, chilled limbs, low back and knee soreness and limpness, no force expressing urine, uneasy urination, possible dribbling and dripping and non-free flow, lower abdominal cramping and pain, prostatic enlargement, a relatively hard prostate, a fat, pale or dark, purple tongue, and a deep, fine, moderate (slightly slow) pulse

Treatment methods: Warm yang and quicken the blood

Rx: Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi), 30g, cooked Radix Rehmanniae Glutinosae (Shu Di), 15g, Radix Dioscoreae Oppositae (Shan Yao), 10g, Fructus Corni Officinalis (Shan Zhu Yu), 10g, Radix Achyranthis Bidentatae (Niu Xi), 10g, Sclerotium Poriae Cocos (Fu Ling), 10g, Rhizoma Alismatis (Ze Xie), 10g, Radix Salviae Miltiorrhizae (Dan Shen), 10g, Radix Et Rhizoma Rhei (Da Huang), 10g, blast-fried Squama Manitis Pentadactylis (Chuan Shan Jia), 10g, Hirudo Seu Whitmania (Shui Zhi), 15g

2. Qi vacuity & blood stasis

Symptoms: Forceless urination, terminal dribbling, intermittent flow, scanty qi, disinclination to speak, torpid intake, abdominal distention, loose stools, prostatic enlargement with medium consistency, a pale tongue with white fur, and a moderate (slightly slow), forceless pulse

Treatment methods: Boost the qi and quicken the blood

Rx: Radix Astragali Membranacei (Huang Qi), 60g, Radix Codonopsitis Pilosulae (Dang Shen), 10g, Rhizoma Atractylodis Macrocephalae (Bai Zhu), 10g, Rhizoma Cimicifugae (Sheng Ma), 10g, Radix Bupleuri (Chai Hu), 10g, Radix Glycyrrhizae Uralensis (Gan Cao), 5g, blast-fried Squama Manitis Pentadactylis (Chuan Shan Jia), 10g, Radix Angelicae Sinensis (Dang Gui), 15g, Hirudo Seu Whitmania (Shui Zhi), 10g

3. Mutual binding of phlegm & stasis

Symptoms: Urinary dribbling and dripping or fine stream, lower abdominal cramping, distention, fullness, aching, and pain, prostatic enlargement which is not hard when pressed but may have nodular lumps, glossy, white tongue fur with a dark, purple tongue body, and a bowstring, slippery pulse

Treatment methods: Transform phlegm and quicken the blood

Rx: Feces Trogopterori Seu Pteromi (Wu Ling Zhi), 15g, Radix Angelicae Sinensis (Dang Gui), 10g, Radix Ligustici Wallichii (Chuan Xiong), 15g, Semen Pruni Persicae (Tao Ren), 10g, Flos Carthami Tinctorii (Hong Hua), 10g, Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 15g, Cortex Radicis Moutan (Dan Pi), 10g, Rhizoma Corydalis Yanhusuo (Yan Hu Suo), 15g, Radix Linderae Strychnifoliae (Wu Yao), 15g, Rhizoma Cyperi Rotundi (Xiang Fu), 10g, Fructus Citri Aurantii (Zhi Ke), 10g, Radix Scrophulariae Ningpoensis (Xuan Shen), 15g, Bulbus Fritillariae Thunbergii (Zhe Bei Mu), 15g, uncooked Concha Ostreae (Mu Li), 15g

4. Damp heat stasis obstruction

Symptoms: Urinary frequency and urgency, burning, painful urination, possible thin stream, dribbling and dripping, lower abdominal distention and pain, constipation, prostatic enlargement which is relatively hard and/or is accompanied by pressure pain, slimy, yellow tongue fur with a dark, purple tongue, and a bowstring, rapid pulse

Treatment methods: Clear heat and quicken the blood

Rx: Herba Dianthi (Qu Mai), 10g, Semen Plantaginis (Che Qian Zi), 15g, Talcum (Hua Shi), 3g, Cortex Phellodendri (Huang Bai), 15g, Radix Et Rhizoma Rhei (Da Huang), 10g, Rhizoma Smilacis Glabrae (Tu Fu Ling), 20g, Fructus Gardeniae Jasminoidis (Zhi Zi), 15g, Radix Glycyrrhizae Uralensis (Gan Cao), 5g, Semen Pruni Persicae (Tao Ren), 15g, blast-fried Squama Manitis Pentadactylis (Chuan Shan Jia), 10g, Hirudo Seu Whitmania (Shui Zi), 15g

Treatment outcomes:

Three months of treatment equaled one course. Marked effect was defined as improvement in three or more of the six clinical symptoms mentioned above, shrinkage of the prostatic as evidenced by ultrasound, and less than 30ml of residual urine in the bladder as also evidenced by ultrasound. Some effect was defined as improvement in at least two of the six clinical symptoms, while no effect meant that there was no improvement in at least two of the symptoms. Based on these criteria, 25 out of 93 patients were judged to have gotten a marked effect, 47 got some effect, and 21 got no effect. Therefore, the total effectiveness rate was given as 76.67%.

Discussion:

According to the Chinese authors, BPH is a commonly seen male disease with various causative factors and which is relatively difficult to pattern discriminate. Therefore, treatment of this condition also tends to be difficult. Based on their clinical experience, the authors divided their 93 patients into four patterns, all of which included an element of blood stasis. They believe that the existence of blood stasis is evidenced by the prostatic enlargement which is fixed in location and not movable. They equate this type of enlargement which the Chinese medical concept of concretions and accumulations. They also say that this is a disease associated with aging, and that most elderly exhibit more or less signs of blood stasis. Therefore, on top of whatever other treatment methods are necessary, one should use relatively strong blood-quickening medicinals, such as Shui Zhi, Chuan Shan Jia, and Da Huang. However, because the bodies of the elderly are weak and their righteous qi is insufficient, one must be careful when using blood-breaking medicinals so as not to damage the righteous qi. Given these provisos, it is possible to get relatively good treatment effects in this condition.

Copyright © Blue Poppy Press, 2003. All rights reserved.

For more information on the Chinese medical treatment of benign prostatic hypertrophy, see Bob Flaws & Philippe Sionneaus’s The Treatment of Modern Western Medical Diseases with Chinese Medicine available from Blue Poppy Press.

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

On pages 36-37 of issue #3, 2007 of Hei Long Jiang Zhong Yi Yao (Heilongjiang Chinese Medicine & Pharmacology), Shao Chang-jie published an article titled “An Integrated Chinese-Western Medical Treatment of 100 Cases of Male Oligospermia Sterility.” A summary of this article is presented below

Cohort description:

All 100 cases enrolled in this cohort study were seen as outpatients. Their ages ranged from 26-40 years, with an average age of 30.8 years. Duration of conceptionless marriage had lasted from 2-12 years, with an average duration of 3.7 years. Ninety-seven of these 100 men were diagnosed with primary-onset sterility and three cases were diagnosed with secondary-onset sterility. In all these cases, sperm motility was decreased up to 60% and sperm count was less than 0.6 million per milliliter. In fact, six cases had zero sperm, 11 cases had extremely few sperm of only 1-3 sperm, 19 cases had counts of 0.05-0.1 million/ml, 18 cases had 0.15-0.2 million/ml, 34 cases had 0.25-0.3 million/ml, and 12 cases had 0.4-0.5 million/ml. In 46 cases, motility was decreased by 10%; in 28 cases, it was decreased 11-30 %; in 24 cases, it was decreased 31-55%; and in two cases, it was normal. Seminal fluid contained red blood cells (RBCs) in five cases and white blood cells (WBCs) in eight cases.

Treatment method:

Chinese medical treatment consisted of a self-composed formula to course the liver and increase progeny consisting of:

Chai Hu (Radix Bupleuri)
Fu Ling (Poria)
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Yin Yang Huo (Herba Epimedii), 12g each
Dang Gui (Radix Angelicae Sinensis)
Bai Shao (Radix Alba Paeoniae)
Fu Pen Zi (Fructus Rubii)
Shu Di (cooked Radix Rehmanniae)
stir-fried Shan Yao (Radix Dioscoreae), 15g each
Gou Qi Zi (Fructus Lycii)
Tu Si Zi (Semen Cuscutae), 30g each
Shan Zhu Yu (Fructus Corni), 10g
Gan Cao (Radix Glycyrrhizae), 6g

If there was a tendency to kidney essence insufficiency, Rou Cong Rong (Herba Cistanchis), processed He Shou Wu (Radix Polygoni Multiflori), and Zi He Che (Placenta Hominis) were added.

If there was a tendency to kidney qi insufficiency, Dang Shen (Radix Codonopsis), Huang Qi (Radix Astragali), Lu Jiao Shuang (Cornu Degelatinum Cervi), and She Chuang Zi (Semen Cnidii) were added.

If sperm motility was decreased due to yang insufficiency and decline of life-gate fire, Zhi Fu Zi (Radix Lateralis Praeparatus Aconiti) and Ba Ji Tain (Radix Morindae Officinalis) were added.

If the rate of abnormal sperm morphology was high due to yin vacuity and fire effulgence, Huang Bai (Cortex Phellodendri), Zhi Mu (Rhizoma Anemarrhenae), Rou Cong Rong (Herba Cistanchis), and He Shou Wu (Radix Polygoni Multiflori) were added.

If the seminal fluid contained lots of RBCs and WBCs due to yin vacuity and fire effulgence accompanied by damp heat pouring downward, Huang Bai (Cortex Phellodendri), Zhi Mu (Rhizoma Anemarrhenae), Mu Tong (Caulis Akebiae), and Jin Yin Hua (Flos Lonicerae) were added.

If there was dizziness, tinnitus, low back soreness, and slippery essence, Jin Ying Zi (Fructus Rosae Laevigatae) and Qian Shi (Semen Euryalis) were added.

If the condition was accompanied by fear of cold, chilled extremities, low back soreness, and yang wilting due to kidney yang insufficiency and decline of life-gate fire, Rou Gui (Cortex Cinnamomi),

Zhi Fu Zi (Radix Lateralis Praeparatus Aconiti), and Yang Qi Shi (Actinolium) were added.

If there was accompanying lesser abdominal chilly pain and scrotal distention and pain due to cold congealing in the liver vessel, Wu Zhu Yu (Fructus Evodiae), Xiao Hui Xiang (Fructus Foeniculi), Li He Zhi (Semen Litchi), and Ju He (Semen Citri Reticulatae) were added.

One packet of these medicinals was decocted in water and administered per day, with 15 days equalling one course of treatment.

Western medical treatment consisted of 50 milligrams of clomiphene orally administered one time per day along with 100 milligrams of vitamin E three times per day. If there were RBCs and WBCs in the seminal fluid, patients were also treated with anti-flammatories. Fifteen days also equaled one course of treatment with these Western drugs.

Study outcomes:

Cure was defined as disappearance of all clinical signs and symptoms with a return to normal of sperm counts and seminal fluid or the wife getting pregnant during treatment. Marked effect meant that the clinical symptoms disappeared and the sperm counts and seminal fluids were almost normal. Some effect meant that the clinical symptoms decreased and that the sperm counts were higher than originally. No effect meant that, after two months of treatment, there was no marked improvement in sperm counts and seminal fluid. Based on these criteria, 82 cases were cured,14 cases got a marked effect, three cases got some effect, and one case got no effect. The shortest course of treatment was 15 days and the longest was 60 days, with an average duration of treatment of 37.3 days.

Discussion:

Dr. Shao begins his discussion with a typical recounting of Chinese medical theory in terms of reproductive function. The kidneys store the essence and govern reproduction. Therefore sterility is mostly treated via the kidneys. However, if one attempts to treat male sterility simply by supplementing the kidneys and fortifying the spleen, the results are not good. This is because, in the young and strong, the kidney qi is naturally effulgent and exuberant and kidney vacuity signs and symptoms are not very obvious. On the other hand, the liver stores the blood and governs coursing and discharge. Further, the liver and kidneys together mutually transform the blood and essence. If the liver stores the blood correctly and courses and discharges normally, then the qi blood penetrate, thrust, or course harmoniously and this then leads to the ability to reproduce. Therefore, reproduction is closely associated with both the viscera of the liver and the kidneys. In fact, according to Dr. Shao’s experience, oligospermia or low sperm counts are mostly due to a combination of liver depression and kidney vacuity. Hence, within the above formula, Chai Hu, Dang Gui, Bai Shao, Fu Ling, and Shan Yao course the liver and fortify the spleen, nourish and harmonize the blood. Yin Yang Huo, Fu Pen Zi, Shu Di, Gou Qi Zi, and Shan Zhu Yu supplement the kidneys and foster the essence. When all these medicinals are used together, they treat both the root and the tip or branch at the same time. According to Dr. Shao, decreased sperm count is mostly due to kidney essence insufficiency, decreased sperm motility is due to kidney yang insufficiency, and poor morphology as well as RBCs and WBCs in the seminal fluid are due to yin vacuity with fire effulgence with or without damp heat pouring downward. The combination of the above Chinese medicinals with clomiphene and vitamin E strengthens the production and development of the sperm. Thus, when these Chinese medicinals are integrated with these Western drugs, the therapeutic effects obtained are fully satisfactory.

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

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

On pages 39-40 of issue #7, 2007 of Xin Zhong Yi (New Chinese Medicine), Cheng Ke-jia et al. published an article titled “Observations on the Therapeutic Effects of Treating 132 Cases of Male Immune Infertility with Ju He Wan (Citrus Seed Pills). A summary of this article is presented below.

Cohort description:

Altogether, there were 264 men enrolled in this two-wing comparison study. These 264 subjects were randomly divided into two groups of 132 patients each – a treatment group and a comparison group. All 264 men were AsAb blood serum and/or seminal fluid positive sufferers of immune infertility. The age in the treatment group ranged from 24-52 years, with an average age of 28.9 years. These patients had been married without conception for1-9 years, with an average duration of marriage of 2.15 years. Forty-two cases were AsAb serum positive, 34 cases were AsAb seminal fluid positive, and 56 cases were positive in both. There were 82 men who presented a Chinese medical pattern of liver depression and blood stasis in the treatment group and 50 men who presented a pattern of liver depression, blood stasis, and damp heat pouring downward. In the comparison group, the men’s ages ranged from 25-51 years, with an average age of 33.7 years. These men had been married with conception for 2-11 years, with an average duration of marriage of 2.52 years. Forty-five of these cases were serum AsAb positive, 36 were seminal fluid AsAb positive, and 51 cases were positive in both. Eight-four men in this group presented a liver depression and blood stasis pattern, and 42 presented a liver depression, blood stasis, and damp heat pouring downward pattern. Therefore, in terms of age, length of being married, AsAb, and Chinese pattern discrimination, these two group were considered statistically comparable.

As for the criteria of liver depression and blood stasis,, there were three main criteria: 1) chest oppression and discomfort with a tendency to great sighing, 2) chest and rib-side distention and pain, and 3) testicular hardness, distention, and pain. There were also seven secondary criteria: 1) vexation, agitation, and easy anger, 2) seminal vesicle varicosity, 3) testicular or testicular adnexal nodulations, 4) yang wilting, i.e., impotence, or nonejaculation, 5) an excessively high dead sperm count, 6) a dark tongue substance, and 7) a deep, bowstring, possibly choppy pulse. Patients had to have all three of the main symptoms or one at least one of the main symptoms and at least two of the secondary symptoms to qualify for this pattern.

Treatment method:

All members of the treatment group were administered Ju He Wan with added flavors:

stir-fried Ju He (Semen Citri Reticulatae)
stir-fried Hai Zao (Sargassum)
stir-fried Kun Bu (Thallus Algae)
stir-fried Hai Dai (Thallus Eckloniae)
stir-fired Chuan Lian Zi (Fructus Toosendan)
stir-fried Tao Ren (Semen Persicae), 30g each
ginger juice stir-fried Hou Po (Cortex Magnoliae)
stir-fried Mu Tong (Caulis Akebiae)
stir-fried Zhi Shi (Fructus Immaturus Aurantii)
stir-fried Yan Hu Suo (Rhizoma Corydalis)
stir-fried Rou Gui (Cortex Cinnamomi)
stir-fried Mu Xiang (Radix Auklandiae), 15g each

One packet of these medicinals was decocted in water and administered per day in two divided doses, morning and evening. One and a half months equalled one course of treatment. If, after one course of treatment, AsAb was still positive, another course of treatment was given up to a total of three courses.

All members of the comparison group were orally administered 15 milligram of prednisone one time per day in the morning. The course of treatment was the same for the treatment group above. If there was a reproductive tract infection, antibiotics were also administered.

Study outcomes:

Cure was defined as the patient’s wife conceiving after1-2 courses of treatment. Marked effect meant that, although the wife had not yet conceived after 1-2 courses of treatment, eight criteria of the seminal fluid and sperm returned to normal. These included pH, liquefaction time, sperm motility, morphology, and mortality, white blood cells counts, etc. Some effect meant that the sperm function was not yet normal but the seminal fluid had improved. No effect meant that, after 1-2 courses of treatment, there was no change from before to after treatment. Based on these criteria, the following table shows the outcomes in the two groups.

Thus there was a very marked difference in the total effectiveness rates between these two groups. Further, AsAb turned negative in 120 patients (90.91%) in the treatment group compared to only 59 patients (44.70%) in the comparison group. Note that these percentages were the same as the total effectiveness rates. Six months after treatment, 74 families (56.06%) had given birth (with two pairs of twins) as compared to only 26 cases (19.70%) in the comparison group. In addition, there were no adverse reactions reported in the treatment group. However, in the comparison group, 107 cases reported such side effects as acne, hirsutism, insomnia, upper abdominal discomfort, and decreased libido.

Discussion:

According to the Chinese authors, the basic disease mechanisms of male immune infertility are damp heat, stasis, and stagnation, yin vacuity with fire effulgence, and a mixture of vacuity and repletion. Mostly they see this condition in men with prostatitis, epididymitis, orchitis, varicocele, nongonorrheal urinary tract inflammation, etc. or those who have a history of surgical damage to their reproductive organs. These conditions result in liver qi depression and binding, inhibition of the movement of essence, and essence stasis leading to essence pathway blockage and obstruction. Or they may lead to liver-kidney yin debility, yin vacuity and fire effulgence, or damp heat pouring downward, internally harassing the essence chamber. Further, these condition may also result in spleen-kidney yang vacuity with essence cold leading to congelation and stagnation and stasis obstruction of the essence pathway. In all these cases, either vacuity of the righteous is unable to overcome evils or there is recurrent contraction of damp heat.

Within Ju He Wan, Ju He moves the qi and treats child welling abscesses. These latter are probably welling abscesses on the genitalia. It is the sovereign ingredient in this formula. Mu Xiang and Chuan Lian Zi move the qi and stop pain. Tao Ren and Yan Hu Suo quicken the blood and scatter binding. Together, these are the ministerial medicinals. Rou Gui warms the liver and kidneys in order to scatter cold evils. Zhi Shi and Hou Po break the qi and divide accumulation and stagnation. Hai Zao, Kun Bu, and Hai Dai saltily soften the hard and scatter binding. Mu Tong frees the flow and disinhibits lower burner damp evils. Together, these are the adjuvant medicinals. When used together, these medicinals can straighten and spread the jue yin liver channel, clear and dry dampness, soften the hard and scatter binding, move the qi and transform stasis. Thus they treat the root and tips or branches of this condition simultaneously.

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

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

Premature ejaculation (PE) is the persistent or recurrent experience of ejaculation with minimal sexual stimulation before or shortly after penetration. Therefore, ejaculation occurs before the man wants it to occur. Normally, men ejaculate approximately 2-3 minutes after vaginal penetration. In PE, ejaculation occurs in less than two minutes and may cause marked personal distress or interpersonal problems. Premature ejaculation may be lifelong, occurring throughout the patient’s active sexual life, or it may be acquired, meaning that there was a time when the patient did not have this sexual dysfunction. Further, PE may be generalized or situational. It is generalized if the disorder occurs with all partners and in all situations; it is situational if it occurs only with certain partners or in certain situations. Premature ejaculation is most common in younger, inexperienced males and tends to decline with age. Although there are physical causes which should be considered, the vast majority of cases of PE are due to psychological factors, such as guilt, fear, and performance anxiety, and PE is especially common when having sex with a new partner. If a single instance of PE becomes associated with fear that it will happen again, this may create a self-reinforcing negative feedback loop. The Western medical treatment of PE consists of behavioral therapy utilizing certain sexual techniques, such as the start and stop method and the squeeze method, psychotherapy, and, in certain cases, antidepressants to treat anxiety. On page 514 of issue #9, 2007 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Chen Cheng-de et al. published an article titled “Clinical Observations on the Treatment of “Heart-caused Premature Ejaculation with Xiao Yao Gu Jing Tang (Rambling Secure the Essence Decoction).” A summary of this article is presented below.

Cohort description:

Altogether, there were 125 cases of PE enrolled in this two-wing comparison study. These 125 patients were randomly divided into a treatment group of 68 cases and a comparison group of 57 cases. All cases met the diagnostic criteria for PE based on the Chinese Index of Premature Ejaculation (CIPE). In the treatment group, ages ranged from 21-56 years, with an average age of 34.2 years. The course of disease ranged from six months to eight years, with an average disease duration of 1.5 years. Premature ejaculation was graded as slight in 12 cases, moderate in 32 cases, and severe in 24 cases. In the comparison group, ages ranged from 20-58 years, with an average age of 31.3 years, while disease duration ranged from five months to seven years, with an average duration of 1.1 years. In this group, 15 cases were judged slight, 31 cases were moderate, and 11 cases were severe. Thus, for the purposes of this study, these two cohorts were judged statistically comparable.

Treatment method:

All members of the treatment group were orally administered self-composed Xiao Yao Gu Jing Tang (Rambling Secure the Essence Decoction) which consisted of:

Chai Hu (Radix Bupleuri)
Bai Shao (Radix Alba Paeoniae)
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Sha Yuan Zi (Semen Astragali Complanati)
Yi Zhi Ren (Fructus Alpiniae Oxyphyllae)
Sang Piao Xiao (Ootheca Mantidis), 10g each
Bo He (Herba Menthae Haplocalycis), 6g
Wu Wei Zi (Fructus Schisandrae), 10-15g
Ci Shi (Magnetitum)
Qian Shi (Semen Euryalis), 20-30g each
Lian Zi (Semen Nelumbinis), 10 pieces

If there was heart vexation with a bitter taste in the mouth, six grams of Huang Lian (Rhizoma Coptidis) were added.

If night-time sleep was difficult and restless, 10 grams of Bai He (Bulbus Lilii) and 15 grams of He Huan Pi (Cortex Albiziae) were added.

If low back pain was severe, 10 grams of Du Zhong (Cortex Eucommiae) and 15 grams of Xu Duan (Radix Dipsaci) were added.

If there was qi vacuity, 20 grams each of Huang Qi (Radix Astragali) and Dang Shen (Radix Codonopsis) were added.

If there was kidney yang vacuity, 10 grams each of Xian Ling Pi (Herba Epimedii) and Ba Ji Tian (Radix Morindae Officinalis) were added.

One packet of these medicinals was decocted in water, reduced to 250 milliliters, and administered in two divided doses per day, with four weeks of continuous administration equaling one course of treatment.

All members of the comparison group were orally administered 20 milligrams per day of an unidentifiable Western drug (Sai Le Te), presumably an antidepressant. Fours weeks continuous administration also equaled one course of treatment in this group.

Study outcomes:

An increase of more than 10 points on the CIPE scale was defined as a marked effect. An increase of 5-10 points was defined as some effect, and an increase of less than five points was defined as no effect. The following table shows the outcomes of the two groups based on these criteria.

Therefore, there was a marked statistical difference in therapeutic outcomes between these two groups, with the Chinese herbal therapy being, overall, more clinically effective.

Discussion:

According to the Chinese authors of this study, premature ejaculation in Chinese medicine is closely associated to the loss of regulation of the function of the heart, spleen, liver, and kidney viscera and, in general, is mostly caused by loss of the liver’s control over coursing and discharge, heart-spleen dual vacuity, heart-kidney non-interaction, yin vacuity and fire effulgence, and the kidneys’ loss of sealing and storing, securing and containing. However, in the case of psychologically induced PE, the main cause is tension resulting in liver qi depression and binding with loss of duty over coursing and discharge plus fear and fright causing kidney qi depletion and vacuity which then loses its command over sealing and storing. Therefore, within self-composed Xiao Yao Gu Jing Tang, the ingredients of Xiao Yao San, i.e., Chai Hu, Bai Shao, Bai Zhu, and Bo He, are meant to course the liver and resolve depression. Qian Shi, Sha Yuan Zi, Yi Zhi Ren, and Sang Piao Xiao are then chosen to boost the kidneys and secure the essence, while Wu Wei Zi and Ci Shi are added to quiet the spirit and stabilize the mind. When all these medicinals are combined together, their effect is to course the liver and supplement the kidneys, secure the essence and stop slippage. For best effect, treatment should be combined with relaxation and psychotherapy.

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

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.