Acupuncture Relieves Symptoms Of Chronic Prostatitis/chronic Pelvic Floor Pain Syndrome: A Randomized Controlled Trial

BackgroundChornic prostatitis/chornic pelvic pain syndrome(CP/CPPS)is a common urological disorder,which affects adult men worldwide.It is estimated that CP/CPPS has influenced more than 50%adult men.The National Institute of Health(NIH)has placed CP/CPPS as a chronic disorder that has a malign impact on the quality of life,which is similar to or even worse than that of congestive heart failure and Crohn's disease.The influence of CP/CPPS is noteworthy in terms of symptomatology and cost,common symptoms of CP/CPPS include discomforts in the perineum and suprapubic region,and the lower urinary tract symptoms.Patients with CP/CPPS also experience a wide array of sexual dysfunctions such as erectile dysfunction,which has been reported in several studies.Currently,the cause of CP/CPPS is still unknown and there are no well-conducted epidemiologic studies to support any particular risk factor.Thus,neither single standard diagnostic test nor treatment for CP/CPPS is available.According to previous studies,acupuncture might be effectiveness and safety for relieving the symtpoms of CP/CPPS and improve the quality of life for patients with CP/CPPS.However,owing to the quality of evidence,the level of evidence is relative low.Randomized controlled trials with well designed are needed.ObjectiveBased on the literature review,a treatment protocol of acupuncture for CP/CPPS could be explored.On the other hand,the review of current evidence including randomized controlled trails and systematic reviews could form the base of methodology to conduct a well designed clinical trial.According to the literature review,we performed a randomized controlled trial to assess the effectiveness of acupuncture for CP/CPPS controlled with sham acupuncture.NIH-CPSI(chronic prostatitis symptom index)and IPSS(international prostate symptom score),which were recommended by the international consensus,were evaluated in this trial.Method1.Based on the method of literature review and systematic review,the author searched the electronic database,summarized the acupuncture protocol for CP/CPPS,and assessed the methodology of current systematic reviews of acupuncture for CP/CPPS.2.This study was a randomized,placebo-controlled trial.Sixty-eight patients were allocated randomly to receive acupuncture treatment or placebo needle treatment.Both interventions were performed three times per week for 8 weeks with total 24 sessions.Each session lasted for 30 minutes.The primary outcome is the total score change from baseline in mean weekly National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI)through the 8-week treatment period.Secondary measures include the NIH-CPSI subscales score,International Prostate Symptom Score(IPSS)total score.We also assessed the change from baseline in NIH-CPSI total score at the 20th and 32nd week during the follow-up period.ResultsAcupuncture treatment according to disease differentiation is the most common condition in clinical practice.The formulas of acupuncture treatment are acupoints spreaded in pars sacralis and lower abdomen(e.i.,Zhongliao,Shenshu).In addition,acupoints spreaded in lower extremities should be took into consideration(e.i.,Sanyinjiao).The common frequency is twice daily for one or two month consistently.The results of this review suggest that the use of acupuncture can relieve the symptom of CP/CPPS and acupuncture has a good short-term effect.Moreover,it has a long-term effect as well.Fifty participants were involved in this randomized controlled trial,in which 24 participants were allocated in acupuncture group and 26 were allocated in the sham acupuncture group.No patient dropped off during the whole trial.After 8-week treatment,participants in both two group had a significant improvement compared with the baseline.The decrease of NIH-CPSI total score in acupuncture group was 13.7(95%CI 12.5 to 14.8),and 5.4(95%CI 4.3 to 6.5)in sham acupuncture group,respectively.The difference between two groups was 8.3(95%CI 6.7 to 9.9).The long-term assessment in NIH-CPSI total score at week 20 and week 32 still illustrated a downtrend in acupuncture group;however,a rebound in sham acupuncture group.ConclusionThis subjective provide an acupuncture protocol for treating CP/CPPS and also reviewed previous randomized controlled trials and systematic reviews to assess the methodology.In summary,the methodology of acupuncture for CP/CPPS sysmtematic review is still low which limit the level of evidence.This results of randomized controlled trial provided a reliable evidence and could be referred by large sample randomized controlled trials in the future.