The Relationship Between TCM Syndrome Types Of BPH And IPSS,Pathological Types

ObjectiveIt is widely accepted that International Prostate Symptom Score(IPSS) is the best method to detect the severity of clinical symptoms of benign prostatic hyperplasia(BPH).Furthermore,there were positive correlation between subjective symptoms and TCM Syndrome Type.BPH is a progressive disease,some patients demand Surgical Treatment,in order to lower urinary tract symptoms (LUTS),which cause complication and influence the quality of life.To guarantee the surgical operation effect and to improve the quality of postoperative life,we have to give the proper peri-operative management round the surgical operation period.TCM has the special advantage in peri-operative management,it can relieve LUTS of BPH patients,and prenvent the postoperative complications,also keep the quality of life after operation. In this research,in order to explore the relationship between TCM Syndrome Type(including kidney qi deficiency,blood stasis in low energize,bladder Damp-heat Pattern) and therapeutic efficacy objective index for Maximum flow rate (Qmax),pathological types(Proliferation is mainly occurred in interstitial tissue,or glandular organ,inflammatory exudation).It has been proved that BPH had different significance when it occurred in interstitial substance or glandular organ,it may be have different significance TCM Syndrome Type.This research may be helpful to explore the objective indexes of Chinese Medical Syndrome Differentiation of BPH and instruct clinical medication.MethodⅠ:Literature Review and the clinical data of BPH patients,cases of The First Affiliated Hospital of Guangzhou TCM University and The First Affiliated Hospital of Guangxi TCM College from 2005 to 2006 were analyzed retrospectively. The target establishment of this investigation is to find out TCM Syndrome Type of BPH on Peri-operative.Using the methods of literature data,BPH patients aged 50-85 years, diagnosis criteria of BPH was according to《Clinical Practice Guidelines for patients with urologic diseases》(Na Yan Quan as the Chief Compiler). The diagnostic criteria referred to the classification and diagnostic standard of《Guiding Principles for Clinical Study of New Chinese Medicines》(Chinese Ministry of Health,1997 Edition3),TCM Syndrome Type including Lung-heat syndrome,syndrome of downward flow of damp-heat,Kidney-Yang Deficiency, kidney-yin deficiency,Qi stagnation and blood stasis syndrome,Zhong Qi deficiencyⅡProspective Study of BPH patients preoperative investigative according to TCM Syndrome Type of on Peri-operative.Using the methods of prospective survey.BPH patients aged 50-85 years,diagnosis criteria of BPH was according to Clinical Practice Guidelines for patients with urologic diseases(Na Yan Quan as the Chief Compiler).The diagnostic criteria referred to the classification and diagnostic standard of《Guiding Principles for Clinical Study of New Chinese Medicines》(Chinese Ministry of Health,1997 Edition3),TCM Syndrome Type including kidney qi deficiency syndrome,blood stasis in low energize,bladder Damp-heat Pattern.BPH was definitely diagnosed by postoperative pathological examination in all of patients under went TURP or prostatectomy in The First Affiliated Hospital of Guangzhou TCM University.Investigation content including IPSS,TCM Syndrome Type,Qmax,PSA,the prostatevolume measured and residual urine by transrectal ultrasound.ⅢProspective Study of BPH patients post-operative investigative according to TCM Syndrome Type of on one week after operation.Investigation content including IPSS,TCM Syndrome Type,Qmax,pathological types.ResultLiterature Review and the clinical data of BPH patients,324 cases of The First Affiliated Hospital of Guangzhou TCM University and The First Affiliated Hospital of Guangxi TCM College from 2005 to 2006 were analyzed retrospectively.Among them,60 cases of kidney-yin deficiency,36 cases of Kidney-Yang Deficiency,40 cases of Zhong Qi deficiency,and these 3 kinds of TCM Syndrome Type can be concluded kidney-qi deficiency,and then total 136 cases account for 42%.76 cases of Qi stagnation and blood stasis syndrome account for 23.5%,96 cases of syndrome of downward flow of damp-heat account for 29.6%.The numerical results show that kidney-qi deficiency,Qi stagnation and blood stasis syndrome,syndrome of downward flow of damp-heat were the most common type.The investigation result showed that,TCM Syndrome Type of BPH on Peri-operative is closely related to IPSS,Qmax,PSA,the prostatevolume measured and residual urine by transrectal ultrasound,pathological types.ConclusionBy discussing the etiology,pathogenesis,syndrome differentiation according to TCM Syndrome Type of BPH on Peri-operative,the article puts forward that kidney-qi deficiency,Qi stagnation and blood stasis syndrome,syndrome of downward flow of damp-heat were the most common type,which means BPH outpatients turn into inpatients and receiving operation.To guarantee the surgical operation result and to improve the postoperative life quality, we have to give the proper peri-operative management round the surgical operation period processing.The closely relation between TCM Syndrome Type of BPH on Peri-operative and several clinical factors(IPSS,Qmax,PSA, the prostatevolume measured and residual urine by transrectal ultrasound, pathological types),it may be helpful to explore the objective indexes of Chinese Medical Syndrome Differentiation of BPH.Exert the Advantages of TCM to management in peri-operative and to prevent postoperative complications, and guarantee the quality of life after operation.In the future, multi-center,large sampled and prospective random comparison therapeutic study based on evaluative criteria constituted by Traditional Chinese Medicine-Western Medicine Integrating Institute provide basic information and evidences.