Analysis of Acupuncture As An External Therapy in Treating Chronic Prostatitis in Traditional Chinese Medicine

Chronic prostatitis, as a common disease in the male urinary and reproductive system, mainly presents with pelvic region pain and abnormal urination. Traditional drug treatment is prone to recurrence. The traditional Chinese medicine external treatment method, with its unique advantage of "treating the disease externally while treating the internal condition", shows great potential in the treatment of chronic prostatitis. 

Among them, acupuncture therapy achieves "treating the internal condition from the outside" through meridian regulation. It not only avoids gastrointestinal irritation but also compensates for the limitations of single drug treatment through multi-target regulation mechanisms.

I. The Significance of Traditional Chinese Acupuncture in The Treatment of Chronic Prostatitis

Traditional Chinese acupuncture is based on the theory of meridians, emphasizing the regulation of internal organ functions through surface stimulation. For chronic prostatitis localized in the deep pelvic region related to the prostate and seminal vesicle areas, external treatment methods can bypass the gastrointestinal barrier and directly reach the affected area through transdermal absorption or acupoint stimulation. Compared to oral medication, external treatment methods have the advantages of high safety and fewer side effects, and are particularly suitable for patients who need to take medication for a long time.

According to 440 randomized controlled trials, acupuncture treatment has a remarkable effect on patients with moderate to severe chronic prostatitis, and the therapeutic effect can last for more than half a year, fully demonstrating the long-lasting regulatory advantages of traditional Chinese medicine's external treatment methods.

II. Theoretical Basis of Traditional Chinese Medicine Acupuncture in Treating Chronic Prostatitis

According to the theory of meridians in traditional Chinese medicine, the occurrence of chronic prostatitis is closely related to the imbalance of qi and blood in the meridians. The prostate is located in the lower abdomen below the navel and is closely related to the meridians such as the foot's Shaoyin kidney meridian, foot's Taiyin spleen meridian, and foot's Jueyin liver meridian. Factors such as dampness, heat, stasis, and deficiency of kidney qi can cause poor circulation of qi and blood in the meridians, resulting in stasis blocking the prostate, thereby triggering the symptoms of chronic prostatitis. 

Acupuncture can regulate the qi and blood in the meridians by stimulating relevant acupoints, unblock the stasis, restore the normal function of the meridians, and thus achieve the purpose of treating chronic prostatitis.

III. Clinical Research Progress of Traditional Chinese Medicine Acupuncture in Treating Chronic Prostatitis

i. Acupuncture Therapy: Synergistic Enhancement of Therapeutic Effects Through the Combination of Medication and Acupuncture

Acupuncture is an external treatment method that involves applying hot substances such as mugwort wool or other medications to specific acupoints on the body to stimulate the circulation of qi and achieve therapeutic effects.

By using the method of applying medicinal heat to the umbilicus to treat patients with kidney qi deficiency, the combined effect of medication and heat application is very good.

Applying medicinal ointment (containing ingredients such as fennel seed and camphor) for cupping and purging toxins on areas such as the Liver-2 acupoint, the perineum, and the projection area of the prostate, can significantly improve the levels of inflammatory factors in the prostatic fluid and clinical symptoms of patients with damp-heat stasis syndrome. The therapeutic effect is superior to that of simply taking the Prostate Treatment Capsules orally.

The research data show that after applying the medicinal oil to the acupoints and then performing moxibustion, the total effective rate of the moxibustion group was as high as 90.0%, which was significantly better than that of the simple moxibustion group and the western medicine group. Moreover, it had remarkable advantages in improving symptoms, reducing white blood cells and CRP in prostate fluid, and increasing zinc and lecithin granules.

ii. Acupuncture Therapy: A Treatment Method that Involves Inserting Needles into Specific Acupoints to Regulate The Flow of Qi and Blood, and to Unblock The Meridians

Multiple center studies have confirmed that acupuncture can significantly improve the symptoms of moderate to severe chronic prostatitis/Chronic Pelvic Pain Syndrome.

By using the pressing needles (selecting acupoints such as Zhongwan, Tianshu, Shenshu, and Baoliao, and applying breathing-based reinforcing and reducing techniques), it is superior to taking tamsulosin in relieving pain.

Umbilical needle therapy. Compared to traditional acupuncture, umbilical needles require fewer needles, produce faster results and have more significant therapeutic effects.

Electroacupuncture is more effective than the combination therapy of Western medicine in reducing the elastase of neutrophils in prostate massage fluid.

According to research, acupuncture treatment for chronic prostatitis has a significant effect. The mechanism of action may be through inhibiting the pain transmission pathway of the body and regulating the release of abnormal oxidative stress products, reducing the content of inflammatory cytokines in the prostate tissue, thereby achieving the therapeutic effect. Additionally, it is worth noting that in clinical practice, following the principle of "if the disease persists, keep the needle in for a longer time", the acupuncture time can be appropriately extended according to the condition to enhance the therapeutic effect.

iii. Acupoint Intradermal Thread Insertion Method: An Absorbable Thread Is Implanted into The Muscle Layer of The Acupoint, Providing Long-Lasting and Mild Stimulation

In addition to taking oral medications, acupuncture thread implantation at specific acupoints (such as Zhibian, Guanyuan, Shui Dao, Cixiao, Renyu, etc., with the needle sensation reaching the perineum and behind the penis for implantation) significantly improved the patient's urinary tract symptoms, including the maximum urine flow rate.

Animal experiments have confirmed that simple insertion of sutures at the Renyu and Guanyuan acupoints can improve the pathological state of the prostate in rats. The mechanism may be related to the reduction of IgG in prostate homogenate and the increase of zinc in serum.

iv. Acupuncture Bloodletting and Cupping Therapy

The method of bloodletting through puncture and cupping involves applying puncture to specific acupoints to release blood, thereby allowing the pathogenic factors to be expelled along with the blood. This is a treatment method based on the theory of meridians.

The treatment was carried out using the method of bloodletting through puncture, cupping therapy, and syndrome differentiation. The main acupoints selected were Zhongji, Guanyuan, Zhibian, Taixi, Sanyingjiao, Yanglingquan. For patients with damp-heat syndrome, Waiguan and Hegu were added. For those with blood stasis syndrome, Xuehai and Diyu acupoints were used. 

For patients with spleen-kidney yang deficiency syndrome, Qihai and Zusanli acupoints were added. For patients with kidney deficiency syndrome, Shenshu and Shuidao acupoints were used. Four acupoints were selected each time. Puncture was performed first, followed by cupping therapy. One course of treatment lasted for 15 days.

Firstly, a needle puncture and bloodletting were performed at the Yin acupoint. Then, acupoint puncture with a triangular needle was carried out at the Subiao acupoint, followed by cupping therapy.

Acupuncture, as an important representative of external treatment methods in traditional Chinese medicine, has demonstrated unique values in the treatment of chronic prostatitis, such as multi-target regulation, holistic treatment, and minimal side effects. Whether it is the traditional moxibustion, acupuncture, or innovative methods like medicinal oil moxibustion, acupoint embedding, bleeding and cupping therapy, all have accumulated rich clinical evidence, showing definite effects in alleviating pain, urinary tract symptoms, inflammatory indicators in prostatic fluid, and improving quality of life. 

Moreover, it often outperforms simple drug treatment. Therefore, acupuncture can be combined with the traditional Chinese medicine drug "Diuretic and Anti-inflammatory Pill" for treatment. This drug has the functions of clearing heat and detoxifying, antibacterial and anti-inflammatory, and regulating immunity. When used together, the effect is even better.