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Prostatitis is a commonly encountered disease of uri-nary system in men. It is either acute or chronic. Acute prostatitis is marked by stimulating symptoms of the uri-nary tract, bloody urine in the end of urination and peri-neum pain. Chronic prostatitis is marked by delayed urina-tion, dripping after urination, or discharge of whitish tur-bid prostate fluid, or seminal emission, premature ejacu-lation and impotence. It is similar to stranguria, sperma-torrhea, gonorrhea and semen in urine in TCM. Prostati-tis is usually caused by exogenous damp-toxin, excessive drinking of alcohol, partiality to pungent and greasy foods, or excessive sexual life and endogenous asthenia-heat that lead to accumulation of damp-heat in the lower energizer. The major manifestation is sthenia in branch. Prolonged duration leads to asthenia of liver and kidney yin and asthenia of spleen and kidney yang, further resul-ting in qi stagnation and blood stasis marked by asthenia of the root or mixture of asthenia and sthenia.

[Syndrome differentiation]

1. Downward migration of damp-heat

Burning sensation in the urinary tract, yellow and scanty urine, profuse whitish secreta from the external orifice of urethra, bitter taste and dryness of mouth, thirst and desire to drink water, retention of dry feces, red tongue, yellow and greasy tongue fur, slippery and Taichong (LR 3) are added; for asthenia of liver and kid-ney yin, Guanyuan (CV 4), Fuliu (KI 7), Taixi (KI 3), Shenshu (BL 23) and Ganshu (BL 18) are added; for as-thenia of spleen and kidney yang, Mingmen (GV 4 ), Pishu (BL 20), Shenshu (BL 23) and Zusanli (ST 36) are added; for qi stagnation and blood stasis, Taichong (LR 3) and Geshu (BL 17) are added; for hematuria, Xuehai (SP 10), Geshu (BL 17) and Zhibian (BL 54) are added; for seminal emission and spermatorrhea, Jinggong (Ext.), Guanyuan (CV 4) and Dahe (KI 12) are added.

Performance: Urine is discharged completely, then Zhongji (CV 3), Guanyuan (CV 4) and Qugu (CV 2) are needled vertically for 1.5 - 2 cun to direct the needling sensation to the perineum; Ciliao (BL 32) and Zhibian (BL 54) are needled 1.5 - 3 cun toward the bladder to di-rect the needling sensation to the lower abdomen and peri-neum; the other acupoints are needled with routine proce-dure. The needling technique used is mainly for reducing purpose. For the treatment of asthenia of the spleen and kidney yang, reinforcing needling technique is used to-gether with moxibustion. For the treatment of asthenia of liver and kidney yin, mild reinforcing and reducing nee-dling technique is used.

2. Ear acupuncture

Prescription: Angle of Cymba Concha (C08), Kidney (C010), Bladder (C09), Liver (C012), Triple Energizer (C017), Ear Shenmen ( TF4 ), Pelvic Cavity ( TF5 ), Sympathetic Nerve (AH6a), Endocrine (CO18) and Adre-nal Gland (TG2p).

Performance: Each time 3 - 5 acupoints are selected with normal procedure. For the treatment of acute prosta-tiffs, strong stimulation (with bloodletting from the tip of ear) is used. The needles are retained for a longer (45 60 minutes) time and manipulated at intervals. For the treatment of chronic prostatitis, moderate stimulation is used. The needles are retained for 20 minutes and the needling is done once a day.

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