Clinical And Experimental Research Of TNF-α, IL-6, IL-8, IL-10, β-EP Levels Of Chronic Prostatitis Treated By Acupuncture And Medicine In Combination

Object:To observe the influence of acupuncture and Qian-Tong-Ding Decotion on the levels of TNF-α, IL-6, IL-8, IL-10,β-EP in CP rats as well as the clinical effects of combined acupuncture and medicine treatment on CP/CPPS. And to probe into the optimal treatment project for CP/CPPS.Methods:1. Experimental research:40 rats, randomly selected out of 50 Sprague-Dawley male rats, were injected estradiol benzoate subcutaneously after being castrated so as to establish the chronic prostatitis model rats, with the rest as the model group. The CP model rats were divided randomly into four groups:model group, acupuncture group, Qian-Tong-Ding Decoction group and tamsulosin hydrochloride group. The rats were killed and prostate glands removed after intragastric administration respectively, while the acupuncture group treated with electro-acupuncture additionally for 30 days. The weight, volume and index of the prostate were measured. The pathomorphological changes were examined under lightmicroscope. By means of enzyme linked immunosorbent assay (ELISA), the levels of TNF-α, IL-6, IL-8, IL-10, (β-EP in prostate were examined.2. Clinical observation:60 patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were enrolled and divided randomly into combined acupuncture and medicine treatment group and medicine treatment group, with 30 patients for each group.1 tablet of tamsulosin hydrochloride as well as Qian-Tong-Ding Decoction were administrated daily for the medicine group for 30 days, while the combined acupuncture and medicine group were treated with electro-acupuncture additionally. All the patients were evaluated by NIH-CPSI scale and the EPS collected before and after treatment, with the samples stored in low temperature (-70℃). The (β-EP in EPS were tested by means of ELISA after treatment.Results:1. Experimental research:1) pathological findings:the model group shows chronic inflammation of prostate glandular tissue. The glandular organ of prostate gland adheres to the surrounding tissue, kermesinus or yellow, slightly hard in quality, or obviously indurate. Under microscope, infiltration of lymph and mononuclear cells, interstitial edema and fibroplasia, damage, atrophia, or ablate of prostate gland endepidermis, accrementition or damage of prostatic ducts can be seen. According to statistical analysis on classified pathological sections of prostate gland, the difference between model group and normal group has statistical significance. The above results indicate that the model building is successful.2) In the acupuncture group and Qian-Tong-Ding Decoction group, the epithelial tissues recover, the architecture of epithelial tissues are integrated, and the interstitial edemas disappear. In the tamsulosin hydrochloride group, the damage of prostate gland tissues recovers slightly. According to classified statistical analysis, the differences among each group of the acupuncture and the Qian-Tong-Ding Decoction group had statistical significance. The difference between the tamsulosin hydrochloride and normal group had statistical significance, whereas the differences among the other groups had not.3) Compared to the model group, the levels of TNF-α, IL-6, IL-8 of prostate glandular tissues reduced in each group of acupuncture and Qian-Tong-Ding Decoction, whereas IL-10 increased obviously. The difference between the acupuncture group and Qian-Tong-Ding Decoction group had no statistical significance. The level ofβ-EP in the acupuncture group increased obviously compared to the Qian-Tong-Ding Decoction group.2. Clinical observation:The scores of NIH-CPSI of all patients decreased after treatment, while the scores of the combined acupuncture and medicine group decreased obviously compared to the medicine treatment group. The level ofβ-EP increased in both groups after treatment, while the level ofβ-EP increased obviously in the combined acupuncture and medicine treatment group compared to the medicine treatment group.Conclusion:1. The levels of TNF-α, IL-6, IL-8 increase in the CP model rats, while the levels of IL-10,β-EP decrease, which shows that they are concerned with the pathogenesis of chronic prostatitis. It can reduce or eliminate the inflammatory reaction of the prostatic gland so as to relieve pain by adjusting them.2. Both acupuncture and Qian-Tong-Ding Decoction can reduce or eliminate the inflammatory reaction of the prostate glandular tissue, repair the damaged tissue structures so as to exert protective effects on the prostate glandular tissue, which provide experimental basis for clinical research.3. Both acupuncture and Qian-Tong-Ding Decoction can reduce the levels of TNF-α, IL-6, IL-8, and increase the levels of IL-10 andβ-EP, so as to reduce the inflammatory reaction of the prostate glandular tissue.4. Acupuncture and increase theβ-EP in the EPS of CP/CPPS patients, so as to relieve pain and improve the quality of life.5. The symptoms are improved both in the medicine treatment group and combined acupuncture and medicine treatment group after treatment, while they are improved more significantly in the later, which shows that combined acupuncture and medicine treatment exerts better effects for CP/CPPS patients.6. The combination use of western medicine and Chinese drugs as well as acupuncture can relieve the symptoms of CP/CPPS patients, improve the quality of life and improve the clinical effects. It is the optimal treatment project for CP/CPPS and can be popularized in the clinical application.