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Pattern Names

Chronic Prostatitis Stasis of Qi, Blood and Essence in Lower Jiao • •

Classification
Category: Bio Med	Syndrome: Chronic Prostatitis

Symptoms

Tongue: a purple tongue with sticky coating and possible with dark spots

Pulse: String-taut, tense, hesitant

Indications: More severe than damp heat/toxic heat. Sticky tongue coating is common because the damp is still there, just worse. [42] • Pain in the anus, hypogastric pain, pain in the penis, sticky white urethral discharge, dysuria, painful urination, painful sexual intercourse and especially ejaculation, possible spermaturia or hematuria, a hard prostate or possible nodulations on the prostate on rectal examination, possible mental-emotional depression, irritability, insomnia, restlessness [34][47]

BioMed: Chronic Prostatitis/Chronic Pelvic Pain Syndrome: recurrent or chronic genitourinary, prostatic, or pelvic pain without evidence of a urinary tract infection. This is the third most frequent urologic diagnosis in men younger than 50. • Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) presents with symptoms across four key domains: urogenital pain, lower urinary tract symptoms (LUTS), sexual dysfunction, and psychological health. ➞ Pain—typically in the pelvis, perineum, or genital region—is the hallmark symptom, often persistent, relieved by voiding, or triggered by ejaculation. ➞ Common LUTS include hesitancy, weak flow, and frequency. ➞ Sexual dysfunction is prevalent, with ejaculatory pain directly impacting libido and erectile function, while reduced quality of life further contributes to erectile issues. CP/CPPS is also linked to impaired fertility, characterized by abnormal semen parameters such as reduced sperm count, concentration, and motility. ➞ Chronic pain, LUTS, and sexual dysfunction frequently coexist with sleep disturbances and psychological distress, with stress known to exacerbate symptoms.

Etiology: Chronic prostatitis is categorized as “Spermatorrhea” (Bai Yin), “Essence Turbidity” (Jing Zhuo), “ Urinary Syndrome” (Lin and specifically “Sticky Urinary Syndrome” and “Fatigue Urinary Syndrome”) • Urethral discharges of urine are associated with the pathology of Urinary Syndrome (Lin) and thus involve Body Fluids. In contrast, urethral discharges of sperm relate to the pathology of Essence (Jing) and typically result from a weakness of the "Sperm Gate" (Jing Guan). ➞ The "Jing Shi" or “Jing Gong”, the room of essence, includes the testicles, epididymis, seminal vesicles, and prostate gland. It is responsible for the production and storage of sperm and plays a key role in reproduction. • Affected Zang-fu organs: BL, KD, HT, LV • Etiologies: poor genital hygiene, excessive sexual activity or/and masturbation, long prepuce, irregular diet and excessive consumption of greasy and spicy foods • Pathogenic factors: damp-heat, heat toxin, stasis of blood and essence [34]

Treatment Principle

Move Qi, invigorate Blood and Essence, remove obstructions in Lower Jiao

Acupunture

SP4, PC6, Ren6, KI14, SP10, LIV3, Ren1/Ren2/Ren3, BL32/BL33, BL34/BL35, BL54, SP9, SP6, BL22, ST28, LV8 [34][47] • LV8 is a He Sea point and can drain damp heat in the Lower Jiao. In fact all Yin He Sea points can drain damp heat in the Lower Jiao (ie SP9). Start with back shu or ba liao points first because of patient comfort and sensitivity.[42]

Herbs

Huo Xue San Yu Tang (Flaw's formula): Ingredients: Dan Shen, Ze Lan, Chi Shao, Tao Ren, Chuan Xiong, Su Mu, Mu Dan Pi, Bing Lang, Zhi Ke, [47] • Ze Lan is in the Invigorate Blood/ Regulate Menses category. Ze Lan also drain dampness. Su Mu is not used a lot but often found in liniments like Zheng Gu Shui to invigorate Qi and break up blood stasis (good for pain). Bing Lang has a very strong function to breaks down Qi Stagnation[42]. ➞ For lower abdomen, groin or genital distention and pain (Qi stagnation), add 9g of Chai and 9g of Xiang Fu. ➞ For prostate nodules, add 12g each of Gui Zhi, Fu LIng, E Zhu, and 1g of Shui Zhi. Powder and taken with strained decoction[47] Shui Zi is often in powder form and for essence stasis. You can replace Shui Zi with Di Long.

Notes

HT and KD both belong to Shao Yin. Male pathogenic factors include damp heat, heat toxicity when patient has had infections. Stasis of the Essence is very unique because it involves ejaculation problems.