CLINICAL APPLICATIONS

* Benign prostatic hyperplasia (BPH): prostate enlargement with urinary frequency, urgency and nocturia; feeling of incomplete emptying, terminal dribbling, and pain with urination

* Varicocele with enlarged vein, pain within scrotum, and feeling of heaviness in the testicle(s)

* Prostatitis with dysuria and pain or discomfort of the penis or testicle(s)

* Lin zheng (dysuria syndrome) with urinary urgency, painful urination, difficult urination with inflammation

 

WESTERN THERAPEUTIC ACTIONS

* Reduces the size of the prostate gland

* Analgesic and anti-inflammatory effects to relieve pain and reduce inflammation associated with prostatic hyperplasia

* Diuretic effect to promote normal urination

 

CHINESE THERAPEUTIC ACTIONS

* Clears damp-heat

* Promotes normal urination

* Tonifies qi, blood and jing (essence)

 

DOSAGE

Take 3 to 4 capsules three times daily, with warm water, on an empty stomach. Dosage may be increased up to 8 to 10 capsules three times daily in acute conditions until symptoms subside, but for no more than four days. After relief of symptoms, dosage can then be reduced to 3 to 4 capsules daily. For prevention or maintenance, take 2 capsules twice daily.

 

INGREDIENTS

Chi Shao (Radix Paeoniae Rubrae)

Fu Ling (Poria)

Hu Po (Succinum)

Hua Shi (Talcum)

Huang Bo (Cortex Phellodendri Chinensis)

Huang Qi (Radix Astragali)

Mo Yao (Myrrha)

Pu Gong Ying (Herba Taraxaci)

Ru Xiang (Gummi Olibanum)

Tao Ren (Semen Persicae)

Tong Cao (Medulla Tetrapanacis)

Wang Bu Liu Xing (Semen Vaccariae)

Yi Yi Ren (Semen Coicis)

 

BACKGROUND

Benign prostatic hyperplasia is the enlargement of the prostate gland causing varying degrees of bladder outlet obstruction.[1] The exact etiology is unknown, but it is presumed to be linked to hormonal changes associated with aging. Clinically, patients often present with symptoms such as progressive urinary frequency, urgency and nocturia. Furthermore, many will experience a feeling of incomplete emptying, terminal dribbling, and pain with urination. Decreased size and force of the urinary stream is also commonly reported. Therefore, proper therapy requires treatment of both the cause and the symptoms.

 

FORMULA EXPLANATION

In traditional Chinese medicine, benign prostatic hyperplasia in geriatric men is a condition due to both excess and deficiency. Excess refers to the enlargement of the gland leading to stagnation of qi and blood and accumulation of damp-heat. Deficiency refers to the gradual depletion of qi, blood, and Kidney jing (essence) accompanying aging. Therefore, optimal treatment must use herbs that tonify the underlying deficiency, clear damp-heat, and promote normal urination.

        In this formula, many herbs are used to break up and resolve the enlargement and disperse stagnation. Ru Xiang (Gummi Olibanum) and Mo Yao (Myrrha) have excellent functions to activate blood circulation and disperse blood stagnation. This pair is commonly used to disperse masses throughout the entire body ¡V not just the prostate. Chi Shao (Radix Paeoniae Rubrae) and Tao Ren (Semen Persicae) are used to enhance the effect of softening the hardness and promoting normal urination. Hu Po (Succinum) is used to break up blood stagnation and open the orifices. Furthermore, Tong Cao (Medulla Tetrapanacis) and Wang Bu Liu Xing (Semen Vaccariae) are added to disperse and reduce swelling and inflammation. They also have excellent penetrating qualities to help restore healthy, continuous urinary flow. This combination exerts an excellent effect to resolve enlargement and disperse stagnation. In addition, Huang Qi (Radix Astragali) and Fu Ling (Poria) are markedly effective at tonifying qi and regulating water circulation. Fu Ling (Poria), Hua Shi (Talcum), Tong Cao (Medulla Tetrapanacis) and Yi Yi Ren (Semen Coicis) are diuretic herbs used to promote normal urination and relieve various discomforts associated with dampness and swelling. Bitter and cold, Huang Bo (Cortex Phellodendri Chinensis) and Pu Gong Ying (Herba Taraxaci) clear damp-heat and toxic heat from the lower jiao.

        In conclusion, P-Support addresses both the cause and the symptoms of benign prostatic hyperplasia. It treats the cause by resolving enlargement of the prostate gland. It treats the symptoms by clearing damp-heat and promoting normal urination, alleviating discomfort and resolving or preventing inflammation. By targeting both the cause and the symptoms simultaneously, it offers both immediate and long-term support for these patients.

 

CAUTIONS & CONTRAINDICATIONS

* P-Support is designed to treat mild to moderate prostate enlargement. While it may help to promote normal urination, it is not suitable for the treatment of prostate cancer. Additional workup is necessary to confirm or rule out the diagnosis of prostate cancer.

* This formula is not designed for long-term use. It should be discontinued when the desired effects are achieved.

* If use of this formula is necessary for extended maintenance, use only a reduced dosage.

 

CLINICAL NOTES

* Benign prostatic hyperplasia is a condition that becomes progressively more common and severe with aging. While the incidence of benign prostatic hyperplasia is 40 to 50% in men aged 51 to 60 years, the incidence is 80% in men older than 80 years of age. Therefore, BPH should be treated as early as possible to prevent the occurrence and deterioration of the condition.

* P-Support is an excellent formula for prevention and/or maintenance, at two capsules twice daily.

* P-Support can be used for geriatric men who are beginning to develop enlarged prostates associated with aging and hormonal changes. P-Support treats BPH by draining damp-heat and tonifying qi and jing (essence).

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Turtle pulse, a convex-shaped pulse, found on both chi positions.

 

SUPPLEMENTARY FORMULAS

* For varicocele, add Resolve (Lower). The dosages of P-Support and Resolve (Lower) should be at a 3:1 ratio, respectively.

* For damp-heat accumulation with turbid, painful urination, use Gentiana Complex.

* For bacterial prostatitis or infection of the urinary tract, use with V-Support or Herbal ABX.

* For kidney stones, add Dissolve (KS).

* For compromised renal functions, add Kidney DTX.

* For Kidney yang deficiency with coldness or impotence, add Kidney Tonic (Yang).

* For Kidney yin deficiency, add Kidney Tonic (Yin).

* For edema and water accumulation, add Herbal DRX.

* For blood stagnation, add Circulation (SJ).

* With severe inflammation, combine with Astringent Complex.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Hegu (LI 4), Sanyinjiao (SP 6), Guanyuan (CV 4), Zhongji (CV 3), Yanglingquan (GB 34), Qugu (CV 2), Huiyin (CV 1)

* Needle Ciliao (BL 32). Apply moxa to Guanyuan (CV 4) and Zusanli (ST 36).

 

Classic Master Tung's Points:

* Benign prostatic hyperplasia (BPH): Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Yizhong (T 77.05), Erzhong (T 77.06), Sanzhong (T 77.07), Shuitong (T 1010.19), Shuijin (T 1010.20). Bleed tender points on the KI area in the back with cupping. Bleed before needling for best result.

* Urinary frequency: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Shuiqu (T 66.09), Huozhu (T 66.04), Makuaishui (T 1010.14), Tongshen (T 88.09), Tongwei (T 88.10)

* Lin zheng (dysuria syndrome): Fenzhishang (T DT.01), Fenzhixia (T DT.02), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tongshen (T 88.09), Tongwei (T 88.10), Tongbei (T 88.11)  

 

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Prostate, urinary disorders: Shuitong (T 1010.19), Shuijin (T 1010.20).

 

Balance Method by Dr. Richard Tan:

* Left side: Dazhong (KI 4), Zhaohai (KI 6), Zhongfeng (LR 4), Yangxi (LI 5), Yangchi (TH 4), Prostate point on the ear

* Right side: Jiexi (ST 41), Shenmai (BL 62), Lieque (LU 7), Daling (PC 7)

* Left and right sides can be alternated from treatment to treatment.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Prostatitis: Prostate, Urethra, Pelvic, Kidney, Lower Jiao, Liver, Spleen, San Jiao, Endocrine. Bleed Ear Apex.

* Hyperplasia of prostate: Prostate, Urethra, Pelvic, Kidney, Liver, Lower Jiao, Pituitary, Endocrine, San Jiao, Gonadotropin.

* Orchitis and epididymitis: Testis, Endocrine, Adrenal Gland, Kidney, Liver, Prostate, Pelvic, Internal Genital, External Genital.

* Urosis: Urethra, M. Prostate, F. Internal Urethra, Liver, Adrenal Gland, Lower Jiao, Endocrine. Bleed Ear Apex.

 

NUTRITION

* Encourage the patient to eat foods rich in zinc, such as raw pumpkin seeds or pumpkin seed oil, and sunflower seeds. Studies have shown zinc deficiency to be linked to prostate disorders.

* Foods with phytoestrogens, such as soy and yams, have a beneficial effect for prostate health.

* Increase the consumption of the following foods beneficial for general prostate health: organic, fresh, leafy vegetables, whole grains and raw wheat germ, carrots, citrus fruits, tomatoes, and natural enzymes. It is also recommended to eat cooked vegetables instead of raw ones.

* Avoid fruits such as watermelon and citrus that are cold or sour in nature.

* Avoid tobacco smoking, alcoholic beverages, junk food, and spicy food. Reduce salt intake.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Recommendations: pumpkin seeds, anise, tangerines, cherries, figs, litchis, sunflower seeds, mangos, and seaweeds.

* Roast pumpkin seeds or boil into tea and incorporate into the diet, one large handful twice daily.

* Make tea from rhubarb root, peach kernels, winter melon seeds, pearl barley, azuki beans, and corn silk; drink three times daily.

* Boil fig tea.

* Avoid dairy products, rich foods, fatty foods; all stimulants such as alcohol, caffeine, and smoking; stress, tension, sex, and eating meat late in the day.

 

LIFESTYLE INSTRUCTIONS

* Take steps to reduce blood cholesterol levels if necessary. Studies have shown high cholesterol to be linked to prostate disorders.[2]

* Relaxation exercises help to relieve tension and facilitate bladder emptying.

* Abstain from sexual intercourse as much as possible until the condition is resolved, and then observe moderation in sexual activity.

 

CASE STUDIES

* A 61-year-old male patient complained of frequent urination, with incomplete sensation afterwards. He described it as he did not feel like he was completely empty. No lab reports were present, but he was diagnosed with an enlarged prostate. This condition was given a TCM diagnosis of Kidney yin deficiency and damp-heat. The patient was treated with P-Support at four capsules three times a day. The symptoms improved and the patient had reported that the formula does the job for him; urination is a lot easier for him and he feels more complete after. Submitted by A.I., Hilo, Hawaii.

* R.A., 78-year-old male, presented with frequent urination up to three to four times each night with urgency and difficulty in flow at times. The Western diagnosis was BPH; the TCM diagnosis was Kidney yin deficiency and qi stagnation in the Bladder. This condition was treated with P-Support at 12 capsules a day. After taking the herbs, the patient only needed to get up once each night. The dosage was lowered to 9 pills a day to maintain the results. Since then, there had only been a few times where the patient needed to increase the dosage for a short time. The patient continued to keep them on hand. Submitted by L.M., Portland, Oregon.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

P-Support is formulated to treat prostate enlargement and prostatitis with symptoms such as urinary frequency, urgency, nocturia, feeling of incomplete emptying, terminal dribbling, and pain with urination. P-Support contains herbs that effectively reduce the size of the prostate, promote normal urination, relieve pain, and reduce inflammation.

        Many herbs in P-Support have been used with marked success to treat benign prostatic hyperplasia and prostatitis, along with their associated symptoms. Pharmacologically, Huang Bo (Cortex Phellodendri Chinensis) is one of the most effective herbs to treat benign prostatic hyperplasia. It has been used successfully to treat prostatic urethral obstruction by promoting the relaxation and inhibiting the contraction of smooth muscle in the prostate.[3] Clinically, one study reported a 90% rate of effectiveness for treatment of chronic prostatitis among 108 patients. The herbal formula was given in decoction, and contained many herbs, such as Huang Bo (Cortex Phellodendri Chinensis), Wang Bu Liu Xing (Semen Vaccariae), Chi Shao (Radix Paeoniae Rubra), Pu Gong Ying (Herba Taraxaci), and others.[4] According to another study on chronic prostatitis, use of herbs was associated with a 93.7% rate of effectiveness among 32 patients (13 with recovery, 10 with significant improvement, 7 with moderate improvement, and 2 had no effect). Lastly, according to a study on prostatic hyperplasia, 52 patients were treated with very positive results using a decoction made from Huang Qi (Radix Astragali), Hua Shi (Talcum) and Hu Po (Succinum). That study reported that 38 of 52 patients reported complete remission of symptoms, 13 reported improvement in flow rate and reduction in prostate size, and 1 reported no improvement.[5]

        Since benign prostatic hyperplasia is often accompanied by inflammation of the prostate gland and painful urination, herbs are added to alleviate these conditions. Ru Xiang (Gummi Olibanum) and Mo Yao (Myrrha) have excellent analgesic effects, and are commonly used to treat various types of pain.[6]^,[7],[8] Tao Ren (Semen Persicae), Tong Cao (Medulla Tetrapanacis) and Hu Po (Succinum) show marked anti-inflammatory properties, and are used to reduce swelling and enlargement of the prostate gland.[9]^,[10]^,[11]

        Altered patterns and distinct characteristics of urination are some of the most common symptoms of benign prostatic hyperplasia that must be addressed. Herbs with diuretic effect are often quite successful in reducing frequency and urgency of urination, improving the force of the urinary stream, and relieving dribbling and incontinence. Herbs with diuretic action that promote normal urination and increase urinary output include Fu Ling (Poria), Tong Cao (Medulla Tetrapanacis), and Pu Gong Ying (Herba Taraxaci).[12]^,[13]^,[14]

        In summary, P-Support is carefully crafted to address both the cause and the symptoms of benign prostatic hyperplasia and prostatitis. P-Support contains herbs that treat the cause by reducing the size of the prostate gland, and herbs that treat the symptoms by promoting normal urination, relieving pain, and reducing inflammation.

 

COMPARATIVE ANALYSIS

Benign prostate hyperplasia (BPH) is a disorder that affects most men as they age. In Western medicine, BPH may be treated with drugs that relax the bladder muscle to improve urination [such as Minipress (prazosin)], or drugs that shrink the prostate [such as Proscar (finasteride)]. However, Minipress (prazosin) is an £\-adrenergic drug originally used to treat hypertension, and may cause side effects such as hypotension, dizziness, lightheadedness, orthostatism, syncope, and if/when the drug is discontinued, rebound hypertension. Proscar (finasteride) is effective, but requires three months or more to take effect, and may cause sexual dysfunction with side effects such as impotence, decreased libido, and decreased volume of ejaculate. In severe cases of prostate hyperplasia, a catheter is inserted through the penis into the bladder to drain urine. Finally, Western medicine considers surgical removal of the prostate to be the best option.

        Many herbs can be used to effectively treat BPH. The main therapeutic benefits of this formula include an analgesic effect to relieve pain, an anti-inflammatory effect to reduce swelling and inflammation, and a diuretic effect to promote normal urination. Though this formula does not cure BPH, it is quite effective to reduce the size of the prostate gland and relieve the symptoms.

        Both Western and traditional Chinese medicines are effective to treat BPH. Drug therapy is usually unsatisfactory, as its effectiveness is limited, and is associated with significant side effects. Herbal therapy, on the other hand, is both safe and effective, and has short- and long-term benefits. However, in serious cases of prostate cancer, patients should be referred to Western medicine, as use of herbs as a sole treatment modality is not recommended.