In clinical practice, prostatitis is divided into the chronic type and acute type, or the inflammatory one and non-inflammatory one, or the specific one and non-specific one.  

Although the disease name of prostatitis does not exist in traditional Chinese medicine (TCM), it belongs to the categories of suspended yang-carbuncle, white turbidity, white evil, fatigue strangury, grease strangury, seminal turbidity, lumbar pains due to kidney deficient, etc.

Acute Prostatitis

Syndrome Identification and Treatment Determination:

1. Damp and Heat Inrushing Downward

Major symptoms: intermittent fevers and chills when occurring first, rapid progress, frequent micturation, urinary urgency with inhibited voiding, burning sensation and stinging pains in the urethra, or visible bloody urine, falling-like distension or pains of the perineum, dry mouth, a bitter taste in the sticky mouth, constipation, distension and pains in the lower abdomen, red tongue, yellow and slimy tongue coating, soggy and rapid pulse.

Therapeutic principle: clear heat and excrete damp .

Formula and ingredients: Eight Corrections Variant Powder

manshurian aristolochia stem (mu tong), plantago seed (che qian zi), rhubarb (da huang), knotgrass (bian xu), diathus (qu mai), phellodendron bark (huang bai), lonicera flower (jin yin hua), gardenia fruit (shan zhi), fresh rehmannia root (shen di huang), Yedo violet (zi hua di ding), licorice root (gan cao) .

Administration: A dosage per day, decocting with water, taking the decoction twice a day, 200-300ml of pure soup each time.

2.  Intense Heat and Exuberant Toxin

Major symptoms: Sudden onset, persistent high fever, vexation, unrest, thirst, liking drinks, reddening, swelling, heat and pains of the perineum, scanty urine, obstructed urination, or urine with visible pus and blood, burning sensation and pains in the urethra, constipation, red tongue, yellowish tongue coating, rapid and string-like pulse.

Therapeutic principle: discharge heat and resolve toxin .

Formula and ingredients: Gentian Liver-Draining Variant Decoction

gentian root (long dan cao), gardenia fruit (shan zhi), scutellaria root (huang qin), phellodendron bark (huang bai), busy knotweed root (hu zhang), lonicera flower (jin yin hua), fresh rehmannia root (shen di huang), plantago seed (che qian zi), alisma tuber (ze xie), dandelion (pu gong ying), baijiang (bai jiang cao), licorice root (gan cao).

  Chronic Prostatitis

Incomplete treatment of acute prostatitis may result in chronic prostatitis. However, most patients have no obviously acute stage. The etiology is clinically complex. In clinical practice, the following factors may bring on the occurrence of chronic prostatitis, including dysfunction of the immune system, frequent sexual activities, frequent masturbation, indulgence in drinking much wine, influence caused by inflammation of the upper-respiratory tract, urethra, seminal vesicle, rectum, epididymis, perineum, and so forth.

Syndrome Identification and Treatment Determination

1.  Damp and Heat Inrushing Downward

Major symptoms: short disease history, scanty and yellowish urine, frequent micturation, urinary urgency, painful urination, stinging pains or burning sensation in the urethra, distention and pains of the perineum and lower abdomen, intermittent white and profuse excretion from the mouth of the urethra, dry mouth, a bitter taste in the sticky mouth, yellow and slimy tongue coating, stinging and slippery and rapid pulse.

Therapeutic principle: clear heat and excrete damp .

Formula and components: Fish Poison Yam Clear-Turbid Separation Variant Beverage

fish poison yam (bi xie), poria (fu ling), plantago seed (che qian zi), salvia root (dan shen), phellodendron bark (huang bai), acorus root (shi chang pu), lonicera flower (jin yin hua ), alisma tuber (ze xie), magnolia bark (hou po), fangji root (fang ji), licorice root (gan cao).

Administration: A dosage per day, decocting twice a day, taking 200-300ml of pure soup each time.

2.  Qi-Stagnation and Blood Stasis

Major symptoms: relatively long disease history, obvious pains radiating to the lower abdomen, testicle, and waist, white excreting from the urethra at the end of the urinating, strangury when urinating, or visible bloody urine, slight hardening of the prostate checked out by the doctor¡¯s finger insertion from the anus, or palpable nodules and tenderness, darkish tongue body, or stasis macules and speckles on the tongue, uneven pulse.

Therapeutic principle: move the qi, check pains, quicken blood circulation, transform stasis.

Formula and ingredients: Origin-Restoring Blood-Quickening Variant Decoction

tangkuei (dang gui), carthamus flower (hong hua), peach kernel (tao ren), rhubarb (da huang), red peony root (chi shao ), corydalis tuber (xuan hu suo), vaccaria seed (wang bu liu xing), salvia root (dan shen), trichosanthes root (gua lou gen ), pangolin scales (chuan shan jia) .

3.  Deficiency of the Kidney-Yin

Major symptoms: The diseases lasts quite a long term without recovering. The patient is enfeebled due to the chronic course, or he has once indulged in excessive sexual activities or masturbation. White or sticky excretion from the mouth of the urethra usually or at the end of the urination. Post-voiding dribble, aching pains of the loins, soft legs, feverish sensation in the soles and palms in the afternoon, dizziness, tinnitus, insomnia, profuse dreaming, seminal emission, premature ejaculation, hypofunction of the sexual ability, red tongue with few coating, thready and rapid pulse.

Therapeutic principle: tonify kidneys, astringe essence, moisten the yin, and lower fire.

Formula and ingredients: Anemarrhena, Phellodendron, and Rehmannia Variant Decoction

anemarrhena (zhi mu), phellodendron bark (huang bai), fresh rehmannia root (shen di huang), dioscorea root (shan yao), cornus fruit (shan yu you), poria (fu ling), alisma tuber (ze xie), moutan bark (dan pi), plantago seed (che qian zi), vaccaria seed (wang bu liu xing), Cherokee rose fruit (jin ying zi) .  

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