Electroacupuncture for moderate and severe benign prostatic hyperplasia: a randomized controlled trial

Yang Wang, Baoyan Liu, Jinna Yu, Jiani Wu, Jing Wang, Zhishun Liu, Yang Wang, Baoyan Liu, Jinna Yu, Jiani Wu, Jing Wang, Zhishun Liu

Abstract

Purpose: To evaluate the effects of electroacupuncture (EA) on the International Prostate Symptom Score (IPSS), postvoid residual urine (PVR), and maximum urinary flow rate (Qmax), and explore the difference between EA at acupoints and non-acupoints in patients with moderate to severe benign prostate hyperplasia (BPH).

Subjects and methods: Men with BPH and IPSS ≥8 were enrolled. Participants were randomly allocated to receive EA at acupoint (treatment group, n = 50) and EA at non-acupoint (control group, n = 50). The primary outcome measure includes the change of IPSS at the 6th week and the secondary outcome measures include changes of PVR and Qmax at the 6th week and change of IPSS at the 18th week.

Results: 100/192 patients were included. At the 6th week, treatment group patients had a 4.51 (p<0.001) and 4.12 (p<0.001) points greater decline in IPSS than the control group in the intention to treat (ITT) and per-protocol (PP) populations. At the 18th week, a 3.2 points (p = 0.001) greater decline was found in IPSS for the treatment. No significant differences were found between the two groups in Qmax at the 6th week (p = 0.819). No significant difference was observed in PVR (P = 0.35).

Conclusion: Acupoint EA at BL 33 had better effects on IPSS, but no difference on PVR and Qmax as compared with non-acupoint EA. The results indicate that EA is effective in improving patient's quality of life and acupoint may have better therapeutic effects than non-acupoints in acupuncture treatments of BPH.

Trial registration: ClinicalTrials.gov NCT01218243.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. The flowchart of study participation.
Figure 1. The flowchart of study participation.
Figure 2. Time frame of each period.
Figure 2. Time frame of each period.
Figure 2 shows the time frame of baseline period, treatment period and follow-up period.

References

    1. Nickel JC (2006) The overlapping lower urinary tract symptoms of benign prostatic hyperplasia and prostatitis. CurrOpinUrol 16: 5–10.
    1. Hong SK, Lee ST, Jeong SJ, Byun SS, Hong YK, et al. (2010) Chronic kidney disease among men with lower urinary tract symptoms due to benign prostatic hyperplasia. BJU Int 105(10): 1424–8.
    1. Bruskewitz RC (2003) Quality of Life and Sexual Function in Patients with Benign Prostatic Hyperplasia. Rev Urol 5: 72–80.
    1. Tanguay S, Awde M, Brock G, Casey R, Kozak J, et al. (2009) Diagnosis and management of benign prostatic hyperplasia in primary care. Can UrolAssoc J 3(3 Suppl 2)S92–S100.
    1. American Urology Association (2012) Guideline on the Management of Benign Prostatic Hyperplasia. . pdf (accessed 1/31/2013).
    1. Wang QC (2003) Acupuncture therapeutics. Beijing: China Traditional Chinese Medicine Publishing.
    1. Ricci L, Minardi D, Romoli M, Galosi AB, Muzzonigro G (2004) Acupuncture reflexotherapy in the treatment of sensory urgency that persists after transurethral resection of the prostate: a preliminary report. NeurourolUrodyn 23(1): 58–62.
    1. Kubista E, Altmann P, Kucera H, Rudelstorfer B (1976) Electro-acupuncture's influence on the closure mechanism of the female urethra in incontinence. Am J Chin Med (Gard City N Y) 4(2): 177–81.
    1. Philp T, Shah PJ, Worth PH (1988) Acupuncture in the treatment of bladder instability. Br J Urol 61(6): 490–3.
    1. Aune A, Alraek T, LiHua H, Baerheim A (1998) Acupuncture in the prophylaxis of recurrent lower urinary tract infection in adult women. Scand J Prim Health Care 16(1): 37–9.
    1. Alraek T, Soedal LI, Fagerheim SU, Digranes A, Baerheim A (2002) Acupuncture treatment in the prevention of uncomplicated recurrent lower urinary tract infections in adult women. Am J Public Health 92(10): 1609–11.
    1. Capodice JL, Jin Z, Bemis DL, Samadi D, Stone BA, et al. (2007) A pilot study on acupuncture for lower urinary tract symptoms related to chronic prostatitis/chronic pelvic pain. Chin Med 6 2: 1.
    1. Karaman MI, Koca O, Küçük EV, Öztürk M, Güneş M (2010) Laser acupuncture therapy for primary monosymptomatic nocturnal enuresis. J Urol 185(5): 1852–6.
    1. Yang T, Zhang XQ, Feng YW, Xu HR, Liu ZS, et al. (2008) Efficacy of Electroacupuncture in Treating 93 Patients with Benign Prostatic Hyperplasia. Chinese Journal of Integrated Traditional and Western Medicine 28(11): 998–1000.
    1. Yang T, Liu ZS, Zhang XQ, Feng YW, Xu HR, et al. (2008) Evaluation on therapeutic effects of electroacupuncture for benign prostatic hyperplasia: A prospective randomized controlled study. Chinese Journal of Rehabilitation Medicine 23(11): 1028–1031.
    1. Ding Y, Yu J, Liu Z (2011) A pilot trial of point speciality using electroacupuncture at Zhongliao point for benign prostatic hyperplasia. Journal of Clinical Acupuncture and Moxibustion 27(7): 1–4.
    1. Shuran J, Zhongsuan H (1987) Specific effect of acupuncture at ST36 for visceral pain. Acupuncture Reaearch 1: 73–76.
    1. Cheng K, Han Y (2004) Study on the Specificity of Effects of Acupuncture of Different Acupoints in Reducing Gentamycin Induced Ototoxicity in Guinea-pigs. Acupuncture Reaearch 29(3): 204–208.
    1. Xu B, Yu XC, Chen CY, Wang LL, Liu JL, et al. (2010) Relationship Between Efficacy of Electroacupuncture and Electroacupuncture Stimulation of Different Acupoints and Different Tissue Layers of Acupoint Area in Hypotension plus Bradycardia Rats. Acupuncture Reaearch 35(6): 422–428.
    1. Dıraçoğlu D, Vural M, Karan A, Aksoy C (2012) Effectiveness of dry needling for the treatment of temporomandibularmyofascial pain: a double-blind, randomized, placebo controlled study. J Back MusculoskeletRehabil 25(4): 285–90.
    1. Kalichman L (2010) VulfsonsS (2010) Dry needling in the management of musculoskeletal pain. J Am Board Fam Med 23(5): 640–6.
    1. Wang Y, Liu ZS, Yu JN, Ding TL, Liu X (2011) Efficacy of electroacupuncture at Zhongliao point (BL33) for mild and moderate benign prostatci hyperplasia: study protocol for a randomized controlled trial. Trials 12: 211.
    1. Chapple RC, Montorsi F, Teuvo LJT, Wirth M, Koldewijn E, et al. (2011) Silodosin therapy for lower urinary tract symptoms in men with Suspected Benign Prostatic Hyperplasia: Results of an International, Randomized, Double-Blind, Placebo- and Active-Controlled Clinical Trial Performed in Europe. European Urology 59: 342–352.
    1. Yu HJ, Lin AT, Yang SS, Tsui KH, Wu HC, et al. (2011) Non-inferiority of silodosin to tamsulosin in treating patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). BJU INTERNATIONAL 108(11): 1843–1848.
    1. Wang J (2001) Clinical Epidemiology-design, measurement and evaluation. Shanghai: Shanghai Science and Technology Press: 41–142.
    1. Liu ZS, Zhou KH, Wang Y, Pan YX (2011) Electroacupuncture improves voiding function in patients with neurogenic urinary retention secondary to caudaequina injury: results from a prospective observational study. Acupunct Med 29(3): 188–192.
    1. Yu JS, Shen KH, Chen WC, Her JS, Hsieh CL (2011) Effects of Electroacupuncture on Benign Prostate Hyperplasia Patients with Lower Urinary Tract Symptoms: A Single-Blinded, Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine 20: 303198.
    1. Johnstone PA, Bloom TL, Niemtzow RC, Crain D, Riffenburgh RH, et al. (2003) A prospective, randomized pilot trial of acupuncture of the kidney-bladder distinct meridian for lower urinary tract symptoms. J Urol 169(3): 1037–9.
    1. Wendy WL, Michael BC (2005) How does Nerve Stimulation Neuromodulation Works. UrolClin N Am 32: 11–18.
    1. Vignes JR, De Seze M, Dobremez E (2005) Sacralneuromodulaiton in lower urinary tract dysfunction. Adv Tech Stand Neurosurg 30: 177–224.
    1. Hino K, Honjo H, Nakao M, Kitakoji H (2010) The Effects of Sacral Acupuncture on Acetic Acid-induced Bladder Irritation in Conscious Rats. Urology 75: 730–734.
    1. Fang J, Jin Z, Wang Y, Li K, Kong J, et al. (2009) The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Hum Brain Mapp 30(4): 1196–206.
    1. Fang J, Wang X, Liu H, Wang Y, Zhou K, et al. (2012) The Limbic-Prefrontal Network Modulated by Electroacupuncture at CV4 and CV12. Evid Based Complement Alternat Med 2012: 515893.
    1. Napadow V, Lee J, Kim J, Cina S, Maeda Y, et al. (2012) Brain correlates of phasic autonomic response to acupuncture stimulation: An event-related fMRI study. Hum Brain Mapp 000: 00–00.
    1. Chung IM, Kim YS, Sung YH, Kim SE, Ko IG, et al. (2008) Effects of acupuncture on abdominal leak point pressure and c-Fos expression in the brain of rats with stress urinary incontinence. NeurosciLett 439(1): 18–23.

Source: PubMed

3
订阅