Governor vessel moxibustion combined with wenyang yiqi qiwei decoction for erectile dysfunction with spleen-kidney deficiency and its effect on testosterone and vascular endothelial function / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of governor vessel moxibustion combined with wenyang yiqi qiwei decoction on erectile dysfunction (ED) with spleen-kidney deficiency and to explore the possible mechanism.@*METHODS@#A total of 130 ED patients with spleen-kidney deficiency were randomized into an observation group (65 cases, 2 cases dropped off) and a control group (65 cases, 3 cases dropped off). The control group was given wenyang yiqi qiwei decoction orally, one dose daily. On the basis of the treatment in the control group, governor vessel moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) in the observation group, 110 min a time, once a day. The treatment of 4 weeks was required in both groups. Before and after treatment, 5-question international index of erectile function (IIEF-5) score, erection quality scale (EQS) score, erectile hardness assessment (EHS) score, TCM syndrome score, serum testosterone (T) level and vascular endothelial function indexes (prostaglandin I2 [PGI2], endothelin-1 [ET-1] and nitric oxide [NO] levels) were observed respectively, and the clinical efficacy was evaluated in both groups.@*RESULTS@#After treatment, the scores of IIEF-5, EQS, EHS and serum levels of T, PGI2, NO were increased compared before treatment (P<0.01), the TCM syndrome scores and serum ET-1 levels were decreased compared before treatment (P<0.01) in the two groups; the scores of IIEF-5, EQS, EHS and serum levels of T, PGI2, NO in the observation group were higher than those in the control group (P<0.01, P<0.05), the TCM syndrome score and serum ET-1 level were lower than those in the control group (P<0.01, P<0.05). The total effective rate was 88.9% (56/63) in the observation group, which was superior to 74.2% (46/62) in the control group (P<0.05).@*CONCLUSION@#Governor vessel moxibustion combined with wenyang yiqi qiwei decoction can improve the erectile function and increase the erection hardness and quality in ED patients with spleen-kidney deficiency, its mechanism may relate to improving serum T level and vascular endothelial function.

Clinical and mechanism research on functional erectile dysfunction treated with moxibustion and / 中国针灸

OBJECTIVE@#To observe the clinical therapeutic effect on functional erectile dysfunction (FED) of kidney deficiency and liver stagnation treated by @*METHODS@#A total of 120 patients with FED were randomized into an observation group (60 cases, 2 cases dropped off) and a control group (60 cases, 4 cases dropped off). In the control group, the patients were treated with oral @*RESULTS@#After treatment, the scores of IIEF5, EHS and EDITS were all increased as compared with the values before treatment (@*CONCLUSION@#The combined therapy of

Clinical Efficacy on Yishen Tongluofang for Treatment of Male Infertility with Deficiency and Stasis of Kidney / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Yishen Tongluofang in treating oligosperm type male infertility with kidney deficiency and blood stasis syndrome and explore its effect on serum sex hormones and seminal plasma microenviro. Method:One hundred and four patients were randomly divided into observation group and control group with 52 cases each. Patients in control group took compound Xuanju capsules orally， 3 capsules/time， 3 times/day. Patients in observation group took Yishen Tongluofang， 1 dose/day. Treatment courses continued three months and followed up for three months in both groups. The pregnancy situations of spouses within six months were recorded. Examination of semen parameters before and after treatment and score of kidney deficiency and blood stasis syndrome were conducted. The levels of seminal plasma zinc， fructose， elastase， acid phosphatase and <italic>α</italic>-glucosidase， serum follicle stimulating hormone （FSH）， luteinizing hormone （LH）， prolactin （PRT） and testosterone （T） were detected before and after treatment. Result:During the observation period of six months， the pregnancy rate of spouses in the observation group was 22.00%， higher than 10.00% in the control group， but the difference was not statistically significant （<italic>χ</italic>²=2.678，<italic>P</italic>>0.05）. The clinical efficacy in the observation group was better than that of the control group （<italic>Z</italic>=2.326，<italic>P</italic><0.01）. Sperm concentration， sperm motility， sperm motility， normal morphological sperm and linear movement speed of the observation group were all superior to those of the control group<italic> </italic>（<italic>P</italic><0.01）. The levels of zinc and fructose in seminal plasma of the observation group were higher than those of the control group （<italic>P</italic><0.01）， and the score of kidney deficiency and blood stasis syndrome was lower than that of the control group （<italic>P</italic><0.01）. Serum FSH， LH and PRT levels in the observation group were lower than those in the control group （<italic>P</italic><0.01）， and the T level was higher than that in the control group （<italic>P</italic><0.01）. The seminal plasma elastase of the observation group was lower than that of the control group， while the levels of acid phosphatase and <italic>α</italic>-glucosidase were higher than those of the control group （<italic>P</italic><0.01）. Conclusion:Yishen Tongluofang can significantly improve sperm parameters， regulate the level of sex hormones and seminal plasma environment in patients with oligosperm type male infertility， and improve the tendency of spouse pregnancy. Its clinical efficacy is better，so it is worthy of further research and application.

Effect of Modified Shoutaiwan on Recurrent Abortion Due to Prethrombotic Status and Effect on Coagulation Factors / 中国实验方剂学杂志

Objective::To observe the efficacy of modified Shoutaiwan on recurrent abortion due to prethrombotic status with kidney deficiency and blood stasis and investigate its effect on coagulation factors. Method::The 100 cases were randomly divided into control group and observation group, 50 cases in each group. Bushen Yangxue capsule + enoxaparin sodium were given in control group, while modified Shoutaiwan + enoxaparin sodium were given in observation group, with a treatment course of 60 d in both groups. The serum clotting factor activated protein S (PS), activated protein C (PC), platelet aggregation function (PAF), platelet aggregation rate (PagT), antithrombin (AT), lupus anticoagulant material positive positive predictive value (LA), anti cardiolipin antibody positive rate of positive predictive value (ACA), plasminogen activator inhibitor-1(PAI-1), tissue factor (TF), fibrinogen (Fig), fibrinogen (FIB), fibrinogen alpha granule membrane glycoprotein-140 (GMP-140), fibrinogen fragment (F1+ 2), tissue fibrinogen activation factor (t-PA), D-dimer (D-D), activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were observed. Clinical efficacy, pregnancy rate, traditional Chinese medicine(TCM) syndromes and adverse reactions were compared between the two groups. Result::4 cases withdrew from the study. The total effective rate in observation group was 97.9% (48/49), higher than 85.1% (40/47) in control group (χ2=5.713, P<0.05). The pregnancy rate in observation group was 89.8% (44/49), higher than 70.2% (33/47) in control group (χ2=6.351, P<0.05). The score of traditional Chinese medicine syndromes in observation group was lower than that in control group. The indexes of PS, PC, AT, TF, Fig, FPA, APTT and TT in observation group were significantly higher than those in control group (P<0.05), while PAF, PagT, LA, ACA, PAI-1, PAP, TAT, FIB, GMP-140, F1+ 2, t-PA, D-D and PT were lower than those in control group (P<0.05). The incidence of adverse reactions in observation group was 10.2% (5/49), lower than 35.4% (17/48) in control group (P<0.05). Conclusion::Modified Shoutaiwan can effectively improve the clinical symptoms of recurrent abortion due to prethrombotic status and improve the coagulation factors in patients with kidney deficiency and blood stasis.

Effect of Shoutaiwan and Shaoyao Gancao Tang on Recurrent Spontaneous Abortion / 中国实验方剂学杂志

Objective: To observe the effect of Shoutaiwan and Shaoyao Gancao Tang on recurrent spontaneous abortion due to spleen and kidney Qi deficiency. Method: Totally 80 eligible patients were randomly divided into the control group and the treatment group, with 90 cases in each group. The control group was treated with lymphocyte immune; the Shoutaiwan and Shaoyao Gancao Tang combined with lymphocyte immune was applied in the treatment group. Coagulation function[the part plasminogen activator inhibitor-1 (PAI-1), fibrinogen (FIB), type plasminogen activator (t-PA), prothrombin time (PT), D-dimer (D-D) and tissue factor (TF), fibrin peptide A (FPA), fibrinogen (Fig), Plasminase-antifibrinolytic complex (PAP), glycoprotein platelet particle-140 (GMP-140), thrombin-antithrombin complex (TAT)], serum closed antibody (CD3+,CD4+,CD8+,CD4+/CD8+), inflammatory factor interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), interleukin-10 (IL-10)]were scored after the treatment. The rates of birth and adverse reactions in each group were compared. The traditional Chinese medicine(TCM) syndrome differentiation of abortion spleen and kidney Qi deficiency was scored. Result: 5 cases were lost during the study period. The term delivery rate was 92.0%in the treatment group, which was higher than 73.6%in control group (PP+, CD4+, CD4+/CD8+), inflammatory factors (IFN-γ,TNF-α,IL-1β) and TCM syndrome scores were significantly lower in the treatment group than that in control group (P+), inflammatory factors IL-10 were significantly increased compared with the control group (PPConclusion: Shoutaiwan and Shaoyao Gancao Tang have a remarkable effect on recurrent spontaneous abortion case by spleen and kidney Yang deficiency.

Protective effect of Yishen Tongluo Recipe against benzo(a)pyrene-induced sperm DNA methylation changes in male rats / 中华男科学杂志

Objective@#To explore the protective effect of Yishen Tongluo Recipe (YTR) against aberrant sperm DNA methylation in male rats exposed to benzo(a)pyrene (BaP).@*METHODS@#Thirty male SD rats of the SPF grade were randomly divided into three groups of equal number: solvent control, BaP exposure and YTR intervention. The animals of the solvent control group were injected intraperitoneally with 0.5% DMSO while those of the other two groups with BaP at 0.1 mg/kg/d, all for 60 days, and at 31 days of BaP exposure, those of the YTR group were treated intragastrically with YTR for 30 days. Then, the left epididymides were harvested from all the rats and sperm suspensions collected and centrifuged for extraction of sperm DNA. The methylated DNA immunoprecipitation sequencing (MeDIP-seq) technique was used to detect the whole-genome DNA methylation in different groups.@*RESULTS@#Exposure to BaP induced the up-regulation of 828 genes encoding mRNA in the sperm DNA, while YTR intervention produced a significant protective effect on the transforming growth factor β3 (TGF-β3), cystic fibrosis transmembrane conductance regulator (CFTR) and recombination activating gene 1 (RAG1), and down-regulated the expressions of 3 227 genes. BaP exposure also caused the up-regulation of 783 genes encoding lncRNA in the sperm DNA, and YTR treatment exhibited an evident protective effect on 62 of the up-regulated genes, induced the down-regulation of 3 378 genes, and showed a protective effect on 56 of the down-regulated genes.@*CONCLUSIONS@#YTR has a protective effect against aberrant sperm DNA methylation in male rats exposed to BaP, which may be associated with lncRNA.

Characteristics of Chinese Medicine Education Under British Education System in New Zealand / 中国结合医学杂志

With the globalisation of Chinese medicine (CM), the local CM education institutions were established in many other countries outside of China. These CM education institutions have formed a new mode in CM education after integrating with local culture, law and national conditions. This article takes New Zealand CM education institutions as an example to discuss the characteristics of CM education under the British education system, aiming to provide ideas on CM education in China and other countries.

Selection of policy tools for constructing tiered medical care system: A Quantitative analysis based on provincial government policy text / 中国卫生政策研究

Objective:To compare and analyze the choice and application of policy tools in the construction of hierarchical medical system in different provinces of china, and to provide advice for improving the effectiveness of the hierarchical medical policy implementation. Methods:Retrieve the policy documents of provincial governments on hierarchical medical policy through internet search;sort names and categories of policy tools based on the classifica-tion of policy tools by Rothwell&Zegveld after consulting the expert,and analyze the use of policy tools by calculating the frequency of different policy tools. Results:This study has summed up 15 types of policy tools in 3 categories in-cluding demand,supply,and environment of provincial hierarchical medical policy. Supply policy tools accounted for 32.92%,demand policy tools accounted for 20.58%, and environmental policy tools accounted for 46.50%. The most widely used policy tool is the regulatory control, and the least used policy tool is the disease catalog. Conclu-sions:Among the choice of policy tools,the category of environmental policy tools are the most widely used,and de-mand policy tools are applied the least. The use of three types of policy tools in the eastern region are balanced,the demand policy tools in Central China are relatively few, and the environmental policy tools are widely used in the western region,while the demand oriented policy tools are scarce.

Analysis on the hierarchical medical system of regional longitudinal medical consortium based on system dynamics / 中国卫生政策研究

Objective: To analyze the change in community first diagnosis and two-way referral rate under the condition of the regional longitudinal medical consortium implementation in the country at large. According to the simulation results,some suggestions for hierarchical medical system were put forward. Methods : The community first diagnosis and two-way referral rates were determined using the literature meta-analysis, and were simulated under different conditions by means of the system dynamics. Results :The analysis results confirmed that simply increasing the financial subsidies can increase the community first diagnosis rate within a range from 0.08％ to 0. 17％. For in case increases are made by the government in technical financial input to enhance the technical level of the community health service centers and in compensatory financial input to reduce the higher hospitals dependence on the light disease, results showed that the lower conversion rate increased within the range of 0.33％～0.45％ in terms of the two-way referral rating. On the contrary, when technical financial input is increased to improve the technical level of community health service centers, the rate of change was in the range of 7.52％ '- 12.61％ - Conclusions : Firstly, the diversified strategy should be used to promote the achievement of graded diagnosis and treatment. Secondly, the Health Commission plays a key role in the promotion of themedical consortiumconstruction. Thirdly, medical insurance reimbursement differential strategy should be implemented and the supply-side reform should be strengthened. At last,attention should be paid to the rational development of existing referrals, especially the upper and lower ones.

Mental health of prostatitis patients in China: A statistical analysis of literature / 中华男科学杂志

<p><b>Objective</b>To know the basic status of researches on the mental health of prostatitis patients in China by statistical analysis of the literature published in the past two decades and provide some reference for such studies.</p><p><b>METHODS</b>Using the bibliometrics method, we performed statistical analyses on the publication years, journals, and authors of the articles published in the core journals concerning the mental health of prostatitis patients in China as well as on the topics of the identified studies using their titles, key words and abstracts.</p><p><b>RESULTS</b>Totally, 226 related studies were identified, of which 31 (by 29 authors) were published in the Chinese core journals. As for the topics of the included studies, 102 (45.13%) focused on the role and significance of psychotherapy in the treatment of prostatitis, 52 (23.01%) on the correlation of psychological factors with prostatitis, and 23 (10.18%) on the correlation of psychopathic factors with prostatitis complicated by sexual dysfunction. Most of the articles on the mental health of prostatitis patients were published in National Journal of Andrology.</p><p><b>CONCLUSIONS</b>Studies on the mental health of prostatitis patients in China are carried out in varied institutions and different directions but, however, need to be furthered and deepened. For this condition, a comprehensive therapeutic mode of "prevention-communication-treatment" is coming into being, and the methodology for related researches is gradually turning from linear to stereoscopic.</p>

Traditional Chinese medicine to prevent environmental pollutant-induced epigenetic changes of sperm DNA / 中华男科学杂志

In recent years, the incidences of male infertility and recurrent abortion are increasing. The causes of the conditions are varied and complex, but the affected stability of the genetic material in the sperm is an important etiological factor. Environmental pollutants may invade the body through respiration, diet and other channels, resulting in infertility and abortion or even affecting the reproductive system development of the offspring by changing the epigenetics of sperm DNA. In this paper, we propose the idea of using traditional Chinese medicine to prevent environmental pollutant-induced epigenetic changes of sperm DNA, hoping to provide a new insight into the protection against genetic material damage, male infertility, and recurrent abortion caused by environmental pollutants.

Common TCM syndrome pattern of chronic pelvic pain syndrome relates to plasma substance p and beta endorphin / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the relationship of the common Traditional Chinese Medicine (TCM) syndrome pattern of chronic pelvic pain syndrome (CPPS) with the contents of substance p and beta endorphin in the plasma, and provide reference data for the clinical diagnosis, differentiation and treatment of CPPS by TCM.</p><p><b>METHODS</b>We observed 98 cases of CPPS, which were classified into a lower-part damp-heat invasion group (group A, n = 32), a blood stasis-induced collateral obstruction group (group B, n = 34), and a damp-heat stagnation group (group C, n = 32) according to the TCM syndrome differentiation. Another 35 normal healthy young men were enrolled as controls. We measured the contents of substance p and beta endorphin in the plasma by immunoradiometry and ELISA, and analyzed their relationship with the TCM syndrome pattern.</p><p><b>RESULTS</b>The contents of plasma substance p were significantly higher in groups A ([1135.76 +/- 166.45] pg/ml), B ([1 337.84 +/- 170.81] pg/ml), and C ([1 210.01 +/- 162.27] pg/ml) than in the control ([574.99 +/- 113.09] pg/ml) (all P < 0.01), while the contents of plasma beta endorphin in groups A ([212.70 +/- 29.49] pg/ml), B ([157.99 +/- 24.01] pg/ml), and C ([180.81 +/- 20.20] pg/ml) were remarkably lower than that in the control ([274.73 +/- 27.64] pg/ml) (all P < 0.01).</p><p><b>CONCLUSION</b>In the plasma of CPPS patients, the content of substance p is significantly elevated and that of beta endorphin markedly reduced, which suggests that they may be involved in the inflammatory reaction of CPPS. The levels of plasma substance p and beta endorphin can be used as valuable reference for the TCM classification of chronic prostatitis.</p>

Efficacy observation on chronic pelvic pain syndrome of damp-heat stagnation pattern treated with acupoint catgut embedding therapy / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy difference in the treatment of chronic pelvic pain syndrome of Sev-damp-heat stagnation pattern between acupoint catgut embedding therapy and western medication.</p><p><b>METHODS</b>enty cases were randomized into a catgut embedding group (40 cases) and a western medication group (30 cases) at the ratio of 4 : 3. In the catgut embedding group, the catgut embedding therapy was applied to Sanyinjiao (SP 6), Quchi (LI 11), Huiyin (CV 1), Zusanli (ST 36), Zhongji (CV 3), Shenshu (BL 23), etc. The treatment was given once every two weeks, the treatment for 4 weeks was as one session and totally 2 sessions were required. In the western medication group, tamsulosin hydrochloride capsules 0. 2 mg, oral administration, once a day, and Indometacin sustained release tablets, 75 mg, once a day, 3 tablets each time were prescribed. The symptom score of TCM, score of NIH Chronic Prostatitis Symptom Index (NIH-CPSI), lecithin body number in prostatic fluid, (SAS) score of Self-Rating Anxiety Scale and score of Self-Rating Depression Scale (SDS) were compared before and after treatment in the patients of the two groups. The efficacy was evaluated in the two groups.</p><p><b>RESULTS</b>(1)The total effective rate was 91. 9% (34/37) in the catgutembedding group and was 86. 2% (25/29) in the western medication group. The efficacy in the catgutembedding group was better than that in the western medication group (P<0. 05). (2) The symptom score of TCM was all reduced significantly after treatment in the two groups (both P<0.01), and the result in the catgut embedding group was superior to the western medication group (6.42 +/-2. 81 vs 10. 99+/-3. 11 ,P<0. 01). (3) Lecithin body number was increased apparently in the two groups after treatment (both P<0.01), and the result in the catgut-embedding group was superior to the western medicine group (33.56+/-5.88 vs 29. 78+/-7. 06,P<0. 05). (4) Total score of NIH-CPSI, score of pain, score of SAS and score of SDS were all improved apparently after treatment in the two groups (all P<0. 01), and the results in the catgut embedding group were superior to the western medication group (P<0. 01, P<0. 05).</p><p><b>CONCLUSION</b>The acupoint catgut embedding therapy achieves the superior efficacy on chronic pelvic pain syndrome of damp-heat stagnation pattern as compared with conventional western medicine. This therapy relieves clinical symptoms, improves the states of anxiety and depression and increases lecithin body number obviously.</p>

Treating oligospermia patients of Shen-essence deficiency syndrome by 3 different treatment programs: a clinical observation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy of 3 different treatment programs for oligospermia patients of Shen-essence deficiency syndrome (SEDS).</p><p><b>METHODS</b>Totally 450 male patients were randomly assigned to 3 groups, i.e., the treatment group, the control group 1, and the control group 2, 150 in each group. Patients in the treatment group were treated by Bushen Yijing Decoction (BYD), tamoxifen tablet (TT), Licorzine Capsule (LC), and Vitamin E Soft Capsule (VESC). Those in the control group 1 were treated by BYD, LC, and VESC. Those in the control group 2 were treated by TT, LC, and VESC. All patients were treated for 3 months. Their pregnant rates were compared. Clinical efficacies of each Chinese medical symptom and sperm parameters [sperm density, grade a sperm motility rate, grade (a + b) sperm motility rate, grade (a + b + c) sperm motility rate, and normal sperm morphology rate] were compared before and after treatment.</p><p><b>RESULTS</b>At 3 months after treatment 61 patients were pregnant in the treatment group, 36 patients were pregnant in the control group 1, and 30 patients were pregnant in the control group 2. The differences in the sperm density, grade a sperm motility rate, and grade (a + b) sperm motility rate, and grade (a + b + c) sperm motility rate between before and after treatment were significantly higher in the treatment group than in the control group 1 and the control group 2 (P < 0.01). The difference in the normal sperm morphology rate between before and after treatment was obviously higher in the treatment group and the control group 1 than in the control group 2 (P < 0.01). Better results were obtained in the treatment group and the control group 1 in improving the sexual apathy, soreness and weakness of waist and knees, impotence, premature ejaculation, seminal emission, dizziness, tinnitus, forgetfulness, alopecia, when compared with the control group 2 (P < 0.01, P < 0.05). There was no statistical difference in the total effective rate of improving Chinese medical symptoms between the treatment group and the control group 1 (P > 0.05).</p><p><b>CONCLUSION</b>BYD combined with TT, LC, and VESC could significantly improve sperm qualities and clinical Chinese medical symptoms of oligospermia patients of SEDS.</p>