Effect Comparison Of Electroacupuncture At Zhongliao(BL33) And Non-acupoint In Improving The Symptoms Of Moderate And Severe Benign Prostatic Hyperplasia

Objectives1. Make clear whether the improvement of benign prostatic hyperplasia related symptoms is better in the group of acupuncture at Zhongliao (BL33) than that at non-acupoint in the same segment.2. Through the setting of the control group, with the exception of other factors, we can make clear that the effect is the relative specificity effect of the acupoint differing from the non-acupoint in the same segment.MethodsA prospective, randomized, double-blind (blind patients, blind evaluators), controlled study design is carried out. Patients with benign prostatic hyperplasia definitely diagnosed by urologists were recruited through posters and newspapers from June1,2010to October30,2011.100patients were randomly divided into two groups,50in treatment group and50in control group.1. Treatment group:Needle at bilateral BL33with a45°angle. A feeling of soreness and distension will be felt when needling into the3rd posterior sacral foramina (S3) and finally with radiation of sensation to the perineum. Needle60-80mm without lifting, thrusting or rotating. Put on the electric stimulator with a disperse-dense wave,20Hz. The current intensity is increased to the patients’ maximum tolerance and then slightly reduced to a bearable level.2. Control groupTake the site4cm lateral BL33as the non-point for the control group. Manipulation methods and electric stimulator parameters are the same with those of the treatment group. The pilot study shows that patients in the control group have the same feeling with those of the treatment group.There are16sessions for all patients (5sessions in the1st and2nd weeks,3sessions in the3rd and4th weeks) and each session last30minutes. Acupuncture for the two groups will be operated by the same acupuncturist with more than ten years of experience. This acupuncturist is blinded to the outcome assessment at baseline, the6th week, the18th week and the32nd week.ResultsA total of192patients were screened, and92cases were excluded, a total of100patients were enrolled in this study.1. Age and course of disease have no effect on the efficacy evaluation of IPSS which is the primary outcome measure.2. In the6th week, electro-acupuncture at BL33and non-acupoint can both improve the international prostate symptom score and the score of quality of life, with a better efficacy in the treatment group.3. In the6th week, electro-acupuncture at BL33and non-acupoint had no clear effect on the maximum flow rate or the bladder residual urine, and the effects on the two acupoints had no statistical difference.4. The evaluation carried out in the18th week found that the electro-acupuncture at BL33and non-acupoint could still improve both the international prostate symptom score and the score of quality of life, with a still better efficacy in the group of BL33.5. The evaluation carried out in the32th week after treatment found that besides the improving effect on IPSS in the treatment group, no therapeutic effects were made on IPSS in the control group or on QOL in both groups. The effects of both acupuncture methods had no significant difference.6. Differences of the IPSS socre and the QOL score at four evaluation time points had statistical significance, which means the IPSS socre and the QOL score significantly changed at every time point and interactive effect exists between the evaluation time point and the group. Therapeutic effect at the4th week after acupuncture in the treatment group was much more obvious than that in the control group. Better effects still existed at the18th week in the treatment group. Comparision of the effects of the two groups had no statistical significance at the32th week.Conclusion1. EA at BL33can effectively improve the symptoms associated with benign prostatic hyperplasia, such as frequent urination, frequent urination at night, urine retention and so on. Compared with the effect of EA at non-acupoint in the same nerve segment, the effect of EA at BL33is a relatively specific therapeutic effect.2. The therapeutic effect of EA at BL33on BPH-related symptoms can be maintained until12weeks after treatment.3. EA at BL33shows a better therapeutic effect on improving the stimulation symptoms of lower urinary route in BPH.4. Further study will be carried out to improve the specificity research of the acupoints in BPH, such as comparative studies of different acu-points in the same meridian, different points in different meridians and different acupuncturing depth at the same point. At the meantime, the course of treatment will be prolonged as much as possible.