Clinical Research on Treatment of Benign Prostatic Hyperplasia with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

Benign prostatic hyperplasia （BPH）， a common disease in urology and andrology， is mainly manifested as enlarged prostate glands， bladder outlet obstruction， and lower urinary tract symptoms（LUTS）， which seriously affects the quality of life of middle-aged and elderly men. This disease falls into the categories of "retention of urine" and "prostatic hypertrophy" in traditional Chinese medicine （TCM）. In recent years，many doctors have put forward their understandings of BPH based on academic classics and their clinical experience. Clinical research on the treatment of BPH with TCM has become increasingly abundant. The basic pathogenesis of BPH lies in the disturbance of Qi transformation in the bladder and poor blood circulation due to kidney Qi deficiency in the aged. The disease is located in the kidney and the bladder and is related to the dysfunction of the lung and the kidney. It is basically characterized by deficiency in origin and excess in superficiality. A large number of clinical research reports have proved that TCM is efficient in alleviating the clinical symptoms of BPH patients， improving their quality of life， reducing the volume of the prostate， and decreasing postoperative complications. In addition， the external treatment methods of TCM， such as acupuncture therapy， moxibustion， hot water bathing， acupoint application， anal suppository， and enema therapy， are also widely used in clinical practice， demonstrating the diverse ways of TCM in treating BPH. TCM and western medicine complement each other's advantages in the treatment of BPH， thus enhancing the clinical efficacy and reducing the occurrence of long-term complications. This study reviewed the etiology， pathogenesis， and treatment progress of BPH with TCM in recent years， and summarized the current research status. From three aspects of producing high-quality clinical research， standardizing the clinical diagnosis and treatment of TCM， and combining cutting-edge research to explore the mechanism of TCM， it provided suggestions for clinical research on the treatment of BPH with TCM to promote the development and application of TCM in the treatment of this disease.

Experimental Models of Benign Prostatic Hyperplasia： A Review / 中国实验方剂学杂志

Benign prostatic hyperplasia （BPH） model， as a carrier of BPH， is vital for exploring the pathogenesis of the disease and evaluating the efficacy of corresponding drugs. This paper reviewed the in vivo and in vitro models of BPH， the modeling principles and methods， and evaluation indicators， and analyzed the advantages and disadvantages of different types of models. At present， the BPH model is getting closer to the clinical characteristics of human BPH， providing powerful support for the evaluation of drug efficacy. Furthermore， the model has been developed towards cytology to allow further research on the pathogenesis of BPH. The relevant testing indicators reflect the core pathological changes of BPH from different levels， providing a guarantee for further exploring the pathogenesis of BPH and the development of prevention and control drugs. However， no model can fully simulate the natural development process of human BPH， and each model and evaluation criterion has its unique advantages and limitations. In terms of model evaluation， most BPH models are assessed based on benign prostate enlargement （BPE）， and there is still a lack of reliable models to simulate BPH progression and combine with bladder dysfunction. In terms of indicator evaluation， symptom-reflected behavioral indicators are absent in the replication of BPH models in animals. The study of the BPH model in traditional Chinese medicine （TCM） only focuses on the replication and investigation of the "disease" model， rather than the "syndromes" and "signs"， which cannot simulate the syndrome differentiation and treatment under the guidance of the TCM theory. In view of the above deficiencies， we should further improve the modeling method based on clinical characteristics， explore the multifactor composite models， especially those of disease-syndrome combination suitable for basic research of TCM， replicate the model closing to disease development， and optimize the evaluation indicators， which is of great theoretical and practical significance to develop drugs for effective prevention and control of BPH.

Advantages of Chinese Medicine in Treating Dominant Disease： Benign Prostatic Hyperplasia / 中国实验方剂学杂志

China Association of Chinese Medicine organized specialists in andrology of Chinese and western medicine to explore the population and treatment stage of benign prostatic hyperplasia （BPH） with Chinese medicine as the leading therapy. Chinese medicine has great advantages in the treatment of benign prostatic hyperplasia. However， it is necessary to make clear the stage when Chinese medicine or modern medical treatment can be used as the leading therapy， and the conditions under which Chinese and western medicine can be combined to achieve the best treatment efficacy. The specialists agreed Chinese medicine as the leading therapy for the treatment of BPH in the following populations or conditions： the elderly and weak patients with basic diseases， BPH symptoms， and cannot tolerate anesthesia and surgery， the patients with BPH symptoms and cannot tolerate the adverse reactions or the possible adverse reactions of western medicine； the patients with mild ［international prostatic symptom score （IPSS） ≤ 7］ or moderate lower urinary tract symptoms （IPSS ≥ 8） and the quality of life not significantly affected， the patients with bladder detrusor hypofunction， bladder dysfunction and cannot be treated surgically， or with incomplete bladder emptying after surgical treatment； the BPH patients with prostatitis as the main clinical manifestation， the patients with non-acute complications after operation. BPH is one of the dominant diseases in urology and andrology of Chinese medicine， and the symptoms， complications， and prognosis of BPH patients need to be fully considered during the clinical treatment. When Chinese medicine is taken as the leading therapy， it is essential to regularly review the serum level of prostate-specific antigen to exclude the possibility of prostate cancer， and apply Chinese medicine for full treatment course and cycle. At the same time， Chinese and western medicine can be combined to achieve the most effective， convenient， economical， and satisfactory treatment， which can carry forward the advantages of Chinese medicine in treating this disease.

Mechanism of Huoxue Tongluo Decoction in treatment of erectile dysfunction caused by ischemic stroke based on network pharmacology / 中草药·英文版

Objective: To study the therapeutic effect of Huoxue Tongluo Decoction (HXTLD) on erectile dysfunction caused by ischemic stroke and identify the mechanisms involved. Methods: Network pharmacology was used to predict the key active ingredients and targets of HXTLD. Surgical methods were used to create a rat model of ischemic stroke. The rats were then given a suspension of HXTLD by ig administration. Erectile function was evaluated by Apomorphine (APO) induction. Real-time fluorescence quantitative reverse transcription-polymerase chain reaction (Real-time PCR) and Western blotting were used to detect the expression of related mRNAs and proteins in rat penile corpus cavernous tissue and brain tissue. Hematoxylin & Eosin (HE) staining was used to investigate structural changes in the penile cavernous tissue. Results: Network pharmacology showed that tumor necrosis factor (TNF), nitric oxide synthase 3 (eNOS), and vascular endothelial growth factor (VEGF) were the key targets of HXTLD in the treatment of erectile dysfunction caused by ischemic stroke. Experimental studies showed that HXTLD improved erectile dysfunction caused by ischemic stroke. HE results showed that HXTLD improved the structure of the corpus cavernosa. HXTLD also inhibited the expression of TNF and VEGF proteins in penile tissue (P < 0.05) and enhanced the expression of eNOS protein in penile tissue (P < 0.05). Conclusion: HXTLD improved the erectile function of rats with erectile dysfunction caused by ischemic stroke by regulating the mRNA and protein levels of TNF, eNOS and VEGF.

Chinese Expert's Perspectives on Andrological Diseases Responding Specifically to Traditional Chinese Medicine / 中国实验方剂学杂志

In recent years， the incidence rate of andrological diseases has shown a significant growth trend. Considering the unavailability of a perfect theoretical system for andrology in traditional Chinese medicine （TCM） and the complex pathogenesis despite of the limited types of andrological diseases， it is necessary to improve the clinical efficacy of andrological diseases so as to satisfy the needs of patients. Therefore， the China Association of Chinese Medicine （CACM） organized the andrologists of TCM and western medicine and the outstanding young clinicians to discuss the andrological diseases responding specifically to TCM or integrated TCM and western medicine， such as chronic prostatitis， male infertility， benign prostatic hyperplasia， erectile dysfunction， and premature ejaculation， determine their diagnostic criteria in western medicine， and standardize the specifications for TCM diagnosis and treatment based on syndrome differentiation， thus formulating recognized and integrated diagnosis and treatment protocols. Apart from proposing suggestions on the treatment of such andrological diseases with TCM and western medicine， the experts have also figured out the andrological diseases responding specifically to TCM， the optimal intervention time of TCM and western medicine， and the suitable measures including surgery. The resulting consensus helps to better guide the formulation of accurate， personalized， and optimized treatment plans in clinical practice and improve the diagnosis and treatment effects of andrological diseases by giving full play to the advantages of TCM， which will in turn contribute to further innovation and development of TCM.

Erectile dysfunction and psychological status in infertile males / 中华男科学杂志

Objective@#To investigate the relationship of erectile dysfunction (ED) with psychological factors in male patients with infertility.@*METHODS@#We conducted a questionnaire investigation among 252 male patients with infertility, which involved the general condition, results of semen routine examination, sexual life, and scores in IIEF-5, self-reported 9-item patient health questionnaire (PHQ-9) and 7-item generalized anxiety disorder scale (GAD-7). We analyzed the prevalence of ED, depression, and anxiety and their correlations among the patients in comparison with 100 fertile male controls.@*RESULTS@#In 245 of the infertility patients, the most common symptoms of depression and anxiety were "feeling tired or no vitality" and "easily getting worried or impatient", 20.4% of them with depression disorder and 42.9% with anxiety disorder. The PHQ-9 and GAD-7 scores were significantly higher in the infertile males than in the normal fertile controls (P <0.05), and so was the incidence of ED (28.6% vs 12.4%, P <0.05), while the IIEF-5 scores were markedly lower in the former than in the latter group (P <0.01), and so were sex frequency and sexual satisfaction (P <0.05). The PHQ-9 and GAD-7 scores were remarkably higher in the infertility patients with ED than in those without (P <0.01). Logistic regression analysis showed that the level of libido and results of semen routine examination were the risk factors for depression disorder, while age, education level, disease course and experience of assisted reproduction were those for anxiety disorder.@*CONCLUSIONS@#Male infertility patients have a poorer mental health and a higher incidence of ED than normal fertile men, and there is some interaction between psychological status and ED prevalence.

Qilin Pills for idiopathic oligoasthenospermia: A multi-centered randomized double-blind controlled clinical trial / 中华男科学杂志

Objective@#To evaluate the clinical efficacy and safety of Qilin Pills in the treatment of oligoasthenospermia in infertile men.@*METHODS@#This multi-centered randomized double-blind controlled clinical trial included 216 infertile males with oligoasthenospermia, 108 in the trial group and the other 108 in the control, the former treated with Qilin Pills at the dose of 6 g tid while the latter with Wuziyanzong Pills at 6 g bid, both for 12 weeks. We examined the total sperm count, sperm motility and the count of progressively motile sperm of the patients before and at 4, 8 and 12 weeks after medication and evaluated the safety of the drug based on the adverse events and the laboratory results of blood and urine routine examinations and liver and kidney function tests.@*RESULTS@#Compared with the baseline, the patients in the trial group showed a significant time-dependent improvement after 4, 8 and 12 weeks of medication in sperm motility (21.75% vs 27.54%, 29.04% and 32.95%, P <0.05), total sperm count (156.27 ×106 vs 177.33, 188.18 and 205.44 ×106, P <0.05), and the count of progressively motile sperm (32.08 ×10⁶/ml vs 46.33, 50.98 and 61.10 ×10⁶/ml, P <0.05). The three parameters above were also improved in the controls, but more significantly in the trial group (P <0.05).@*CONCLUSIONS@#Qilin Pills can evidently improve the semen quality of oligoasthenospermia patients with no obvious adverse events.

Transperineal ultrasonic therapy for chronic prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of transperineal ultrasonic therapy for chronic prostatitis (CP) by analyzing the scores of NIH-CPSI and the results of prostate fluid routine examination.</p><p><b>METHODS</b>We conducted a randomized, double-blind, multi-centered trial on 96 CP patients that met the inclusion criteria. We divided the patients into groups A (trial) and B (control) of equal number, the former treated by transperineal ultrasound, while the latter with the same machine but no ultrasound waves, 10 min a time qd alt for 2 weeks. Then we evaluated the therapeutic effect and safety by comparing the scores of NIH-CP-SI and counts of white blood cells (WBC) and lecithin corpuscles (LC) in the prostate fluid between the two groups before and after treatment.</p><p><b>RESULTS</b>The total effectiveness rate was 70.83% in group A and 25% in group B (P < 0.01). The scores on prostate pain, urinary symptoms and quality of life as well as the total NIH-CPSI score were significantly improved in group A as compared with pretreatment (P < 0.05), and so were the prostate pain score and total NIH-CPSI score in group B (P < 0.05). Statistically significant differences were observed between the two groups in the scores on prostate pain and urinary symptoms and total NIH-CPSI score after treatment (P < 0.05), but not in any of the NIH-CPSI scores before treatment (P > 0.05), nor were there any significant differences in the counts of WBCs and LC either between the two groups or within each group before and after treatment (P > 0.05). Two patients experienced adverse events in group A, and 1 in group B (P > 0.05).</p><p><b>CONCLUSION</b>Transperineal ultrasonic therapy is highly effective for CP, especially in relieving prostate pain. With its advantages of safety, easy operation and high acceptability, it deserves a wider clinical application.</p>

Multiple factors logistic regression analysis on the basic syndromes related factors in patients with chronic prostatitis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the basic syndrome related factors in patients with chronic prostatitis (CP).</p><p><b>METHODS</b>Using questionnaire to collect data of CP patients from three hospitals in Beijing, Epidata 3.02 to establish database, the uni-variate and multiple Logistic regression analysis was performed with SPSS 17.0 software to determine the basic syndrome related factors.</p><p><b>RESULTS</b>Engagement in brainwork was the main risk factor for suffering from dampness-heat downward-flow syndrome; CP of type IIIA (classified by Western medicine), employed on brainwork or physical work, and working time < or =8 h were risk factors for suffering from qi-stagnancy and blood-stasis syndrome; illness duration >12 months, uncomfortable habitat, dislike for irritative beverages and poor digestive function were risk factors for Gan-qi stagnation syndrome; and aging, decreased burden from work, winter onset of the illness were those for Shen-yang deficiency syndrome.</p><p><b>CONCLUSIONS</b>The basic syndrome related factors in patients with CP are age of patient, duration and type of illness, occupational type, daily working time, burden from work, onset season of illness, living amenity, state of digestion, and relish for irritative beverage.</p>

Affection of Bushen Shengjing pill on NO and NOS in testicle and ante-oxidization of rat with spermatogenic cell injury / 中国中药杂志

<p><b>OBJECTIVE</b>Discuss the functional mechanism of treating male infertility with Bushen Shengjing pill (BS).</p><p><b>METHOD</b>Fill the SD rat with adenine so as to injure the germ cell which will produce the model rat with kidney yang deficiency. Measure the activity of SOD and NOS, the amount of NO and MDA in the testicle.</p><p><b>RESULT</b>BS can promote the activity of SOD, reduce the activity of NOS and the amount of NO and MDA.</p><p><b>CONCLUSION</b>BS has the function of protecting the germ cell which is closely related to the function that the pill can promote the activity of SOD, reduce the activity of NOS and the amount of NO and MDA.</p>

Clinical analysis of yuziwan in the treatment of 30 sterile men with abnormal protamine / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the clinical application and effects of Yuziwan in the treatment of male sterility patient with abnormal protamine.</p><p><b>METHODS</b>The changes of protamine, semen and sex hormones of 30 male sterility patients treated by Yuziwan were observed before and after the treatment.</p><p><b>RESULTS</b>After a 3-month course of treatment, 9 cases were cured, 15 obviously improved and 6 failed to respond. The ratio of histone to protamine was decreased from (1.34 +/- 0.52) before the treatment to (0.72 +/- 0.32) after it, with significant difference (P < 0.01), the semen quality obviously improved (P < 0.05), and the LH and T levels markedly raised (P < 0.01). Yuziwan evidently improved the abnormal protamine, sperm quality and endocrine function of the sterility patients.</p><p><b>CONCLUSION</b>Yuziwan has good curative effect on male sterility.</p>