TCM Research and Men's Health

Traditional Chinese Medicine Research & Reviews

In the past 20 years or so, an increasing amount of medical research into the treatment of men's health and CPPS (chronic pelvic pain syndrome) / chronic non-bacterial prostatitis has been preformed. This research has included treatments using western medicine, chinese medicine and integrated chinese and western medicine.

Traditional Chinese Medicine research for CPPS takes various forms. Some studies are of high quality and use control groups plus large sample sizes. Other traditional chinese medicine research is more along the lines of case studies, highlighting the doctors clinical experience. In our experience, it is usually the later (case studies) that provide us with more credible information in the clinical setting. Doctors (both TCM doctors and western doctors) are more likely to publish case studies on treatments that they have success with and have little agenda to publish otherwise. While on the other hand, research with control groups and large sample sizes with multiple authors are usually under pressure( for financial or other reasons) to report success. (Learn why most published research findings are false).

We take all research results with a grain of salt, no matter where they have been published and by whom. Another more tongue in cheek research article proven effects of parachutes to prevent death from gravitational forces, highlights the short-comings of modern "science" research. However, that being said, research and published case reports can still help refine our technique and point us in the right direction for even further investigation.

Below is a list of some traditional chinese medicine research summaries, conclusions or highlighted section of the research. Click on the research title to view more.
 

CPPS Research / Chronic Non-Bacterial Prostatitis Research:

Source:

Si Chuan Yi An Shi Health Centre Journal

Author:

Liu Chun Ming

Title: Integrative Treatment of 40 Cases of Chronic Prostatitis Discussed

Objective: To investigate chinese herbs, enemas and western medicine combined for the treatment of chronic prostatitis.

Methods: 75 patients were randomly divided into two groups. The treatment group used both chinese and western medicine combined (40 cases), while the treatment group used western medicine alone (35 cases). One course of treatment was 15 days. Each patient received two courses of treatment.

Results: In the treatment group, 16 patients were cured, 20 cases were improved, 4 cases had no effect. The total efficiency rate was 90%. In the control group, 8 patients were cured, 19 cases were improved and 8 cases had no effect. The total efficiency rate was 77.1%. (P <0.05)

Conclusion: The combined chinese and western medicine group had an obvious effect that out preformed the western medicine control group.

Source:

Nanjing Chinese Medicine University Affiliated Hospital Journal, 1996

Author:

Xu Fu Song

Summary: 218 cases of chronic prostatitis were treated using Bao Jing chinese medicine formula. Cases were divided into five categories based on symptoms. The treatment period lasted 2 months.

In 43 cases, symptoms were complete resolved. In 125 cases, symptoms improved significantly. In 31 cases, symptoms only partially resolved and in 19 cases there was no effect.

No patients had a negative reaction to the treatment. Based on these numbers, the total effective rate was 91.28 %.

Source:

Rev Urol. 2008 Summer; 10(3): 192–206.

Author:

J Curtis Nickel, Daniel Shoskes, et al

Abstract

Interesth in and use of complementary and alternative therapies, especially nutraceuticals, is high in prostate disease. These therapies have shown potential in benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer. Some have produced results equal to or better than pharmaceuticals currently prescribed for BPH. In category III prostatitis, some nutraceuticals may offer relief to patients who get little from standard therapy. Because it is becoming apparent that inflammation may play a role in the progression of BPH and development of prostate cancer, nutraceuticals, which commonly have anti-inflammatory properties, may play a role. These therapies have also shown potential in prostate cancer treatment and prevention, especially those that also reduce cardiovascular events or risk. Nevertheless, uses of some nutraceuticals in prostate disease have had less desirable consequences, showing lack of efficacy, adulteration, and/or severe side effects or drug interactions. By ensuring that these therapies undergo careful study for effectiveness, quality, and safety, urologists can look forward to adding them to their evidence-based armamentarium for prostate disease.

Selected Reading

Category III

Phytotherapies have shown the greatest potential in category III prostatitis, termed CP/CPPS, which is the most common of the clinical prostatitis syndromes. The symptoms may be similar to those experienced by patients with chronic bacterial prostatitis (category II) but without infection and probably with more pain and discomfort (certainly with more durable and sustained discomfort). The etiology is unknown, but there are many theories, including persistent, occult prostate infection or inflammation, possibly as a response to infection or a dysregulated immune response or a true autoimmune disease. All the symptoms of CP/CPPS, however, can be caused by pelvic muscle spasm and can be extrinsic to prostate tissue. In some patients who underwent radical prostatectomy for CP/CPPS or prostate cancer, CP/CPPS symptoms did not resolve. In these cases, disease may never have been in the prostate or, because of long-term prostatic inflammation and pain, an autonomous neuromuscular condition developed.

Even though the term prostatitis is often applied to category III, there is often no evidence of inflammation. Only about 50% of symptomatic patients have leukocytes in expressed prostatic secretions (EPS),55,56 and only about 33% have any apparent inflammation in biopsy specimens, with only 5% having moderate to severe inflammation.57 Leukocytes, however, are not the only indicators of inflammation in EPS and seminal fluid. Various investigators have found evidence of elevated oxidative stress58,59 and elevated levels of certain cytokines and chemokines that are inflammatory mediators in EPS and semen of men with category III prostatitis.60

Interestingly, some of these cytokines are blocked directly by quinolone and macrolide antibiotics, which may account for the reduction in symptoms with antibiotics even when patients have no proven infection. Typically, symptoms return within a day or 2 of stopping the antibiotics, which is not characteristic of infection because bacteria remain suppressed for weeks after antibiotic therapy is stopped.

Many phytotherapies have antioxidant and anti-inflammatory characteristics, and it might be by these mechanisms that these compounds produce their clinically beneficial effects. The best-studied phytotherapies in this category are quercetin, rye and other pollen preparations, and saw palmetto.

Source:

Evid Based Complement Alternat Med. 2005 December; 2(4): 495–501.

Author:

Jillian L. Capodice, Debra L. Bemis, et al

Selected Passage

"Other Herbal Agents for Prostatitis

Finally, a wide variety of herbal compounds not previously discussed were found during this review, many of which are commonly used in the TCM herbal material medica. Some of the compounds are Nan mi qing capsules containing Rheum palmatum and Rx. astragalus memberanaceus, Ye Ju Hua Shuan, an herbal suppository of Flos Chrysanthemi Indici and a variety of other formulae or capsules of which the ingredients were not listed (5862).

Initial in vitro studies examining some of the herbal compounds effects on markers of inflammation such as thromboxanes (TBX2) and 6-keto-PGF1-α are promising as the link between chronic inflammation in CP/CPPS is still under investigation (58). While the preliminary reports of additional herbal compounds are encouraging, a number of difficulties exist in the extraction of this data. Namely, the articles are in the Chinese or other language and data including the ingredients, constituents and other practices including good manufacturing are unable to be assessed. While this conundrum exists for many herbal agents despite their historical use in a variety of traditional herbal medicine systems, testing of safety and utility are still necessary. However, the variety of herbal agents available offers a large source to draw from and the possibility that other herbal products might be beneficial in the treatment of CP/CPPS."

 

 

Low Testosterone:

Source: Life Sci. 2001 Oct 19;69(22):2593-602.

Author: Huang BM, Hsu CC, Tsai SJ, Sheu CC, Leu SF

The stimulatory effect of Cordyceps sinensis (CS) on MA-10 mouse Leydig tumor cell steroidogenesis was previously demonstrated in our laboratory. In the present studies, we further determined the effect of CS on steroidogenesis in purified normal mouse Leydig cells. Different concentrations of CS (0.1-10 mg/ml) were added to Leydig cells without or with human chorionic gonadotropin (hCG) (50 ng/ml), and the steroid production was determined by radioimmunoassay (RIA). The results illustrated that CS stimulated normal mouse Leydig cell steroidogenesis in a dose-dependent relationship. CS at 3 mg/ml significantly stimulated testosterone production (p<0.05). Concerning the temporal relationship, CS at 3 mg/ml stimulated maximal testosterone production between 2 to 3 hr. Interestingly, hCG-stimulated testosterone productions were suppressed by CS in a dose-dependent relationship. CS also reduced dbcAMP-stimulated testosterone productions, which indicated that CS affected signal transduction pathway of steroidogenesis after the formation of cyclic AMP. Moreover, cycloheximide inhibited CS-treated mouse Leydig cell testosterone production, suggesting that new protein synthesis was required for CS-stimulated steroidogenesis.

Source: J Ethnopharmacol. 2008 Sep 2;119(1):166-71. Epub 2008 Jul 1.

Author: Yang J, Wang Y, Bao Y, Guo J.

OBJECTIVE:
To discover the effect of the total flavones from Semen cuscutae (TFSC) on the kidney-yang deficiency male mouse, especially on hormone levels and the androgen receptor (AR) mRNA and protein level in the kidney and testicle.

METHODS:
ICR male mouse were separated into six groups, and, except for the normal group, hydrocortisone was injected intraperitoneally to make the kidney-yang deficiency. The groups were then treated with TFSC, methyltestosterone and Jinkui Shenqi Wan, except for the normal group and control group. 14 days after administering, testosterone levels in the total serum were analysed by radioimmunoassay, AR mRNA levels measured by real time RT-PCR and protein levels by immunohistochemistry.

RESULTS:
The control group had the lowest testosterone level, AR mRNA level and protein level, and the TFSC can reverse the reduction of testosterone level, AR mRNA level and protein level induced by the hydrocortisone.

CONCLUSIONS:
This is the first study to demonstrate that TFSC treatment may reverse kidney-yang deficiency symptoms by restoring the levels of testosterone and AR mRNA and protein expression in the kidney and testicle.

Source: J Sex Med. 2010 Apr;7(4 Pt 1):1518-28. Epub 2010 Feb 5.

Author: Shindel AW, Xin ZC, Lin G, Fandel TM, Huang YC, Banie L, Breyer BN, Garcia MM, Lin CS, Lue TF.

Epimedium species (aka horny goat weed) have been utilized for the treatment of erectile dysfunction in Traditional Chinese Medicine for many years. Icariin (ICA) is the active moiety of Epimedium species.

AIM:
To evaluate the penile hemodynamic and tissue effects of ICA in cavernous nerve injured rats. We also studied the in vitro effects of ICA on cultured pelvic ganglia.

METHODS:
Rats were subjected to cavernous nerve injury and subsequently treated for 4 weeks with daily gavage feedings of a placebo solution of normal saline and Dimethyl sulfoxide (DMSO) vs. ICA dissolved in DMSO at doses of 1, 5, and 10 mg/kg. A separate group underwent a single dose of ICA 10 mg/kg 2 hours prior to functional testing. Functional testing with cavernous nerve stimulation and real-time assessment of intracavernous pressure (ICP) was performed at 4 weeks. After functional testing, penile tissue was procured for immunohistochemistry and molecular studies. In separate experiments, pelvic ganglia were excised from healthy rats and cultured in the presence of ICA, sildenafil, or placebo culture media.

MAIN OUTCOME MEASURE:
Ratio of ICP and area under the curve (AUC) to mean arterial pressure (MAP) during cavernous nerve stimulation of subject rodents. We also assayed tissue expression of neuronal nitric oxide synthase (nNOS), eNOS: endothelial nitric oxide synthase (eNOS), calponin, and apoptosis via immunohistochemistry and Western blot. Serum testosterone and luteinizing hormone (LH) were assayed using enzyme-linked immunosorbant assay (ELISA). Differential length of neurite outgrowth was assessed in cultured pelvic ganglia.

RESULTS:
Rats treated with low-dose ICA demonstrated significantly higher ICP/MAP and AUC/MAP ratios compared with control and single-dose ICA animals. Immunohistochemistry and Western blot were revealing of significantly greater positivity for nNOS and calponin in penile tissues of all rats treated with ICA. ICA led to significantly greater neurite length in cultured specimens of pelvic ganglia.

CONCLUSION:
ICA may have neurotrophic effects in addition to known phosphodiesterase type 5 inhibiting effects.

Source: Zhonghua Nan Ke Xue. 2011 Aug;17(8):758-62.

Author: Jin HQ, Jiang F, Deng DM, Chen WX, Yang GZ, Zhuang TQ.

OBJECTIVE:
To study the regulatory effect of Bushenfang on the serum testosterone (T) level of naturally aging rats and its mechanism, in order to provide a theoretical and experimental basis for the clinical treatment of late onset hypogonadism (LOH) in males.

METHODS:
Thirty-two 18-month-old male SD rats were randomly divided into four groups of equal number, naturally aging model and low-, medium- and high-dose Bushenfang groups, and another eight 4-month-old rats were taken as normal controls. The rats of the aging model and normal control groups were treated with normal saline, while those of the low-, medium- and high-dose Bushenfang groups received intragastrically Bushenfang at 3.25, 7.50 and 15.00 g/kg, respectively, all for 3 weeks. Then the rats were sacrificed, the histomorphologic changes of the testis observed by HE staining, the serum T level measured by radioimmunoassay, and the expressions of the StAR protein, P450scc and 3beta-HSD I determined by RT-PCR.

RESULTS:
The number of Leydig cells was obviously increased after Bushenfang treatment. The levels of serum T were significantly higher in the low-, medium- and high-dose Bushenfang groups ([6.74 +/- 1.56] nmol/L, [8.50 +/- 1.99] nmol/L and [12.41 +/- 2.91] nmol/L) than in the model group ([3.48 +/- 0.75] nmol/L) (P < 0.05). The three Bushenfang groups also showed a remarkable elevation in the mRNA expressions of StAR (0.74 +/- 0.29, 0.83 +/- 0.32 and 1.35 +/- 0.50), P450scc (0.72 +/- 0.36, 1.023 +/- 0.30 and 1.41 +/- 0.37) and 3beta-HSD I (0.58 +/- 0.14, 0.72 +/- 0.07 and 0.85 +/- 0.18), as compared with the models (StAR: 0.44 +/- 0.09; P450scc: 0.33 +/- 0.05; 3beta-HSD I: 0.34 +/- 0.02), with significant differences in the StAR expression between the high-dose Bushenfang and the model groups, as well as in P450scc and 3beta-HSD I expressions between the medium- and high-dose Bushenfang and the model groups (P < 0.05).

CONCLUSION:
Bushenfang could improve the pathological status of testicular injury and increase the expression of testosterone synthetase, which might be the mechanism behind its regulatory effect on the serum T level of aging rats.

Source: Zhonghua Nan Ke Xue. 2011 Oct;17(10):953-6.

Author: Zhou SH, Weng ZW, Chen YQ, Li L, Fang YQ

OBJECTIVE:
To investigate the effects of Compound Xuanju Capsule on the levels of sex hormones and the weight of sexual organs in castrated male rats.

METHODS:
A randomized model control trail was performed in 60 young male SD rats of SPF grade, of which 12 were included in the normal control group, and the others were castrated and randomly divided into a model control group and a high-dose, a median-dose and a low-dose Xuanju group. The control groups received intragastric administration of normal saline, and the model groups solution of Compound Xuanju Capsule, all for 20 days. Then we determined by radioimmunoassay the levels of testosterone (T), luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the peripheral blood of the rats, and measured the weights of the epididymis, preputial gland, seminal vesicle, prostate and levator ani muscle.

RESULTS:
The T levels were remarkably lower in the castrated groups than in the normal controls, and significantly higher in the three Xuanju groups than in the model controls (P < 0.01). Both LH and FSH levels were increased in the model control and Xuanju groups as compared with the normal control group, the former with statistically significant difference (P < 0.05) and the latter without. In comparison with the normal controls, the model control rats showed a marked reduction in the indexes of the preputial gland, seminal vesicle, prostate and levator ani muscle, and the high-dose Xuanju group exhibited a significant increase in the seminal vesicle index as compared with the model controls (P < 0.05). There were no statistically significant differences in the indexes of preputial gland, prostate and levator ani muscle among different dose groups (P > 0.05).

CONCLUSION:
Compound Xuanju Capsule can elevate T and LH levels in the peripheral blood of male SD rats and improve the indexes of their sex organs, which may be an important mechanism behind its effect on ED.

Source: Zhong Xi Yi Jie He Za Zhi. 1989 Dec;9(12):737-8, 710.

Author: Kuang AK, Chen JL, Chen MD.

It had been found that Yang-restoring herb medicines Radix Aconiti Praeparata (AP), Cortex Cinamomi(CC), Herba Cistanchis(HC) and Epimedium brevicorum (EB) reduced the cold-resistant potential of normal mice and disturbed the balance of thyroid hormones in normal rats. The aim of this study was to further investigate the effects of these four herb medicines on the levels of plasma corticosterone (B), testosterone (T) and triiodothyronine (T3) in rats by administering herbs together (mixed group) or individually. It was shown that all four Yang-restoring herbs tended to raise plasma B level and it was significant in HC, EB and mixed groups, especially in HC administered rats (P less than 0.001). Rise of plasma T level was seen in CC and mixed groups. All four herbs could decrease plasma T3 level and it was significant in AP, CC and mixed groups, particularly evident in AP administered rats (P less than 0.001). This may be one of the adaptating-protecting mechanisms of normal organism against the toxicity of AP. Combination of the four herb medicines did not result in the cumulation of effects of the given medicines, however, this did reflect the average effect of these four herbs, which showed a restraining and harmonious relationship in a Chinese medical prescription.

 

*Some of the above text is copyright protected. Many of these summaries and conclusions have been translated from the chinese source material. (While the chinese source material is free for copying), our translation of such material is subject to copyright laws. Do not copy the information from this page without prior approval. Thank you.