Wang Shimin National Medical Master (1935.7-)
Wang Shimin, the third national medical master, Professor, chief physician, and doctoral supervisor at Shanxi University of Traditional Chinese Medicine. Wang Shimin has been engaged in clinical and scientific research in traditional Chinese medicine for a long time, especially in the male urinary system. He has made good use of ancient prescriptions without being confined to it. He has unique insights into the diagnosis and treatment of chronic prostatitis and . Now, Professor Wang Shimin's clinical experience in treating chronic prostatitis is introduced as follows to enjoy colleagues.
Chronic prostatitis is a genital and reproductive system disease that is more common in adult male groups. Its incidence is repetitive, refractory, and lingering. It belongs to the type III of the National Institutes of Health prostatitis classification. Its pathogenesis is unknown and its clinical manifestations are diverse. There is no exact and effective treatment plan so far. It has reported that the domestic incidence rate is 6.0%~32.9%, of which 35%~40% are men over 35 years old. Western medicine currently mainly uses non-steroidal anti-inflammatory drugs, alpha-blockers, antibiotics, prostate massage and other means, but it has not achieved satisfactory clinical efficacy, and the adverse reactions and recurrence rates are relatively high. Traditional Chinese medicine syndrome differentiation and treatment of prostatitis has the advantages of few adverse reactions, significantly improving the patient's clinical symptoms, relatively stable efficacy, and safe and difficult to recur. The current treatment methods of traditional Chinese medicine mainly include internal treatment methods and external treatment methods. Internal treatment methods mainly treat this disease through oral Chinese medicine; external treatment methods include acupuncture, microwave treatment, umbilical application, Chinese medicine retention enema, sit-bathing method, etc., and prevent the progress of the disease by regulating inflammatory cytokine , immune response, sex hormone levels and antioxidant effects to achieve the purpose of cure.
Clinical symptoms of chronic prostatitis patients are: frequent urination, burning urethra, incomplete urination, incomplete urination, and abnormal urination; pain and discomfort and swelling in the perineum, penis head, testicles, lower abdomen and other pelvic areas; may be accompanied by mental symptoms such as anxiety, insomnia, forgetfulness, depression, and may have a certain impact on the patient's fertility function. Although the patient's life will not be directly threatened, this disease seriously affects the work, study, physical strength, physical and mental health of male patients. Studies have shown that psychiatric and neurological factors play a crucial role in the occurrence and development of chronic prostatitis, and more than 50% of patients with chronic prostatitis who have not been cured for a long time have obvious mental and psychological problems.
etiology and pathogenesis
Chronic prostatitis can be classified into the categories of traditional Chinese medicine " semen turbidity ", "lumbness", "low back pain", "white lust", "lumbness" and other categories according to its clinical manifestations. "Su Wen·Theory of Impotence" says: "The thoughts are endless, and I can't get what I want, and I'm crazy outside. When I enter the room, my tendons are too much, and my tendons are relaxed and erect, and it is , muscles are impotence , and it is white and lewd." Because this disease has a long course, it is prone to recurrence and long-lasting, which can easily bring various economic and mental pressure to the patient, resulting in poor emotions and discomfort in liver qi, and over time, the liver will be depressed and stagnant. Wang Shimin believes that liver depression and qi stagnation runs through the entire course of chronic prostatitis, and is most closely related to foot Jueyin liver meridian in meridians. "Lingshu·Mingmai" says: "The blood of the liver and foot Jueyin... follows the yin yin, enters the hair, passes through the yin instrument, and reaches the lower abdomen... belongs to the liver and the gallbladder, penetrates the diaphragm, and spreads the ribs." "Lingshu·Mingmai" says: "The muscles of the foot Jueyin... follow the yin thighs, and form on the yin instrument, and connects the tendons... the yin and thighs are painful and turn tendons, and the yin instrument is not used." Patients with chronic prostatitis have high pressure in life and work, and excessive smoking and alcohol, and the liver qi will be dispersed and discharged for a long time; in addition, the patient's diet is not in place, the spleen is ineffective, and the damp heat is internalized, which is accumulated in the essence room. The qi is stagnant and blood stasis over time, leading to the occurrence of this disease. As the "Subject of the Causes of Diseases, Gu Poisons and All Diseases, and All Symptoms of Diseases After Drinking" says: "Wine is toxic, but it is hot again. If you drink too much, the toxic heat penetrates the meridians and overflows the internal organs, causing all diseases."
Dialectics Ideas
Basic Treatment Methods Because most patients have obvious negative emotions such as anxiety, tension, depression, etc., the patient has a high psychological and mental stress; the clinical symptoms are mainly manifested as lower urinary tract symptoms such as urine waiting for , urine weakness, thinning of urine line, urinary pain, and bifurcation of urine, damp scrotum, pain in the perineum, testicles, lower abdomen on both sides, pubic joint and other parts. Over time, symptoms of sexual dysfunction such as impotence and premature ejaculation may occur.
Wang Shimin National Medical Master (1935.7-)
Wang Shimin, the third national medical master, Professor, chief physician, and doctoral supervisor at Shanxi University of Traditional Chinese Medicine. Wang Shimin has been engaged in clinical and scientific research in traditional Chinese medicine for a long time, especially in the male urinary system. He has made good use of ancient prescriptions without being confined to it. He has unique insights into the diagnosis and treatment of chronic prostatitis and . Now, Professor Wang Shimin's clinical experience in treating chronic prostatitis is introduced as follows to enjoy colleagues.
Chronic prostatitis is a genital and reproductive system disease that is more common in adult male groups. Its incidence is repetitive, refractory, and lingering. It belongs to the type III of the National Institutes of Health prostatitis classification. Its pathogenesis is unknown and its clinical manifestations are diverse. There is no exact and effective treatment plan so far. It has reported that the domestic incidence rate is 6.0%~32.9%, of which 35%~40% are men over 35 years old. Western medicine currently mainly uses non-steroidal anti-inflammatory drugs, alpha-blockers, antibiotics, prostate massage and other means, but it has not achieved satisfactory clinical efficacy, and the adverse reactions and recurrence rates are relatively high. Traditional Chinese medicine syndrome differentiation and treatment of prostatitis has the advantages of few adverse reactions, significantly improving the patient's clinical symptoms, relatively stable efficacy, and safe and difficult to recur. The current treatment methods of traditional Chinese medicine mainly include internal treatment methods and external treatment methods. Internal treatment methods mainly treat this disease through oral Chinese medicine; external treatment methods include acupuncture, microwave treatment, umbilical application, Chinese medicine retention enema, sit-bathing method, etc., and prevent the progress of the disease by regulating inflammatory cytokine , immune response, sex hormone levels and antioxidant effects to achieve the purpose of cure.
Clinical symptoms of chronic prostatitis patients are: frequent urination, burning urethra, incomplete urination, incomplete urination, and abnormal urination; pain and discomfort and swelling in the perineum, penis head, testicles, lower abdomen and other pelvic areas; may be accompanied by mental symptoms such as anxiety, insomnia, forgetfulness, depression, and may have a certain impact on the patient's fertility function. Although the patient's life will not be directly threatened, this disease seriously affects the work, study, physical strength, physical and mental health of male patients. Studies have shown that psychiatric and neurological factors play a crucial role in the occurrence and development of chronic prostatitis, and more than 50% of patients with chronic prostatitis who have not been cured for a long time have obvious mental and psychological problems.
etiology and pathogenesis
Chronic prostatitis can be classified into the categories of traditional Chinese medicine " semen turbidity ", "lumbness", "low back pain", "white lust", "lumbness" and other categories according to its clinical manifestations. "Su Wen·Theory of Impotence" says: "The thoughts are endless, and I can't get what I want, and I'm crazy outside. When I enter the room, my tendons are too much, and my tendons are relaxed and erect, and it is , muscles are impotence , and it is white and lewd." Because this disease has a long course, it is prone to recurrence and long-lasting, which can easily bring various economic and mental pressure to the patient, resulting in poor emotions and discomfort in liver qi, and over time, the liver will be depressed and stagnant. Wang Shimin believes that liver depression and qi stagnation runs through the entire course of chronic prostatitis, and is most closely related to foot Jueyin liver meridian in meridians. "Lingshu·Mingmai" says: "The blood of the liver and foot Jueyin... follows the yin yin, enters the hair, passes through the yin instrument, and reaches the lower abdomen... belongs to the liver and the gallbladder, penetrates the diaphragm, and spreads the ribs." "Lingshu·Mingmai" says: "The muscles of the foot Jueyin... follow the yin thighs, and form on the yin instrument, and connects the tendons... the yin and thighs are painful and turn tendons, and the yin instrument is not used." Patients with chronic prostatitis have high pressure in life and work, and excessive smoking and alcohol, and the liver qi will be dispersed and discharged for a long time; in addition, the patient's diet is not in place, the spleen is ineffective, and the damp heat is internalized, which is accumulated in the essence room. The qi is stagnant and blood stasis over time, leading to the occurrence of this disease. As the "Subject of the Causes of Diseases, Gu Poisons and All Diseases, and All Symptoms of Diseases After Drinking" says: "Wine is toxic, but it is hot again. If you drink too much, the toxic heat penetrates the meridians and overflows the internal organs, causing all diseases."
Dialectics Ideas
Basic Treatment Methods Because most patients have obvious negative emotions such as anxiety, tension, depression, etc., the patient has a high psychological and mental stress; the clinical symptoms are mainly manifested as lower urinary tract symptoms such as urine waiting for , urine weakness, thinning of urine line, urinary pain, and bifurcation of urine, damp scrotum, pain in the perineum, testicles, lower abdomen on both sides, pubic joint and other parts. Over time, symptoms of sexual dysfunction such as impotence and premature ejaculation may occur.Wang Shimin believes that alleviating or eliminating anxiety and depression is a key link in improving the treatment effect of the disease. In terms of treatment, the basic treatment method should be to relieve the liver and regulate the qi and regulate the qi. According to the belonging, physiological functions and characteristics of the liver, Wang Shimin also focuses on removing secondary pathological products such as dampness, heat, and blood stasis. In clinical practice, he often uses to promote blood circulation and remove blood stasis. The self-created Sanhe Decoction treats chronic prostatitis, and emphasizes that the prescription and symptoms are consistent. The medicinal taste is mostly selected based on the "symptom" and the "symptoms" and the , four Qi, five flavors, and the main functions of the drug.
hawthorn core
Sanhe Decoction clinical application basic formula: hawthorn core 20g, orange core 20g, lychee core 20g, litchi core 20g, creek 10g, woody fragrance 10g, ghost arrow feather 20g, yanhusuo 10g, cumin 10g, qian 10g, qian 10g, qian 10g, urichiren 10g, black medicine 3g, snake bed 10g, Bupleurum 10g, licorice 8g. In the prescription, hawthorn core, orange core and lychee core are the main medicines, which can disperse qi and relieve pain; Sichuan melon, Muxiang, Guizhiyu, and Yanhusuo are the main medicines, which regulate qi and promote blood circulation and unblock blood stasis and relieve pain; fennel, Zhiren, and Acorn medicine are warming the kidneys and removing cold, shrinking urine and stopping the hemiplegia. The patient's disease course is long and there are often symptoms such as impotence and premature ejaculation. Therefore, add snake bed to warm the kidney and help yang, and the four medicines are the auxiliary medicines; Bupleurum and licorice are the medicines, Bupleurum leads all medicines into the liver meridian, and licorice is the medicines. All medicines are used together to relieve liver qi, promote blood circulation and remove blood stasis, and warm the kidney and help yang. Sanhe Decoction is mostly warm and bitter medicine, and it mainly belongs to the liver and kidney meridians. Traditional Chinese medicine theory believes that warm medicine can "warm and disperse nodules and inhibit hyperplasia" and "bitter can dry dampness, and bitter can clear away and relieve", which is very consistent with the cause and pathogenesis of patients with chronic prostatitis.
plus or subtract as the symptoms: If you see bitter mouth , damp scrotum, yellow and greasy tongue coating, slippery and rapid pulse, Wang Shimin mostly chooses Qinpi 12g on the basis of Sanhe Decoction, salt Huangbai 15g, Achievement 15g, 10g of carbama 10g, Coix seed 4 on the basis of Sanhe Decoction 10g, etc., clear heat and dry dampness, promote diuresis and promote diuresis; if has difficulty urinating , thin urine line and bifurcation, urination and pain in urethra, purple tongue and astringent pulse, etc., Wang Shimin mostly chooses water safflower seed 15g, earthworm 10g, chicken blood vine 15g, chuangshanlong 10g, salvia miltiorrhiza 10g Immediately promote blood circulation, unblock the meridians and relieve pain; patients with erectile dysfunction in the late stage of the disease have erectile dysfunction and kidney yang deficiency and add deer antler glue (melting) 10g, fish bladder glue (melting) 10g, Cistanche 10g, etc.; those with kidney yin deficiency, Ligustrum 15g, Ink-washed lotus 10g, Cuscuta 10g, etc.; those with burning and painful urination should be added to Haijinsha 15g, 南后 10g, talc 12g, raw licorice 10g, etc.; for those with poor sleep, add calcined dragon bone , 15g each of calcined oysters, 15g jujube kernels, etc.; for those with poor spleen and stomach function after taking the bitter cold and clearing medicine, add 10g Codonopsis pilosula, yam 10g, and 10g Atractylodes macrocephala.
Wang Shimin clinically uses Sanhe Decoction as the basic prescription. According to the patient's physical bias, clinical syndrome type and symptoms, the drugs are added and subtracted according to the symptoms, reflecting individualized diagnosis and treatment.
Atractylodes macrocephala
Typical medical case
He, male, 45 years old at the time. First consultation on July 24, 2019. The main complaint was given to " frequent urination and urination urgency, urination for 2 months, and 4 days worsening". I drank too much alcohol during a dinner 4 days ago, and the above symptoms worsened. I said that since March 2019, I have experienced repeated swelling and pain in the pelvic cavity, and felt dull pain, swelling and discomfort in the perineum, lower abdomen and testicles, accompanied by pain after urination, and yellow urine. During the first diagnosis, he urinated frequently and was urged. After seeing the urine, he could not drain all the rest. After urination, he was accompanied by swelling and pain, depression, anxiety and tension, swelling and pain in both sides of the flanks, occasionally white urethra, 5 to 6 times at night, sore waist, sore heels on both feet, pelvic swelling and pain, weakness in the erectile dysfunction, penis pain after sex, damp scrotum, fatigue, cold limbs, loose stools, no fever, good sleep, good stomach, white and greasy tongue coating, stringy and thin pulse. Denied other chronic medical history and denied allergies. B-ultrasound of the scrotum and prostate showed: the volume of the prostate was 4.9cm×4.0cm×3.2cm. Digital rectal examination: enlarged prostate. Prostate fluid examination: leukocytes 28; lecithin bodies (+).
Diagnosis: (qi stagnation and blood stasis type) turbidity of sperm (called chronic prostatitis in Western medicine).
Treatment method: relieves liver and regulates qi, promotes blood circulation and relieves pain.
prescription medicine is added and subtracted by Sanhe Decoction: hawthorn core 20g, orange core 20g, lychee core 20g, 10g of Sichuan melon seeds, 20g of ghost arrow feathers, 10g of Yanhusuo, 10g of cumin, 10g of prickly genus, 3g of black medicine, 10g of wood fragrance, 10g of snake bed, 10g of salted cypress, 10g of Qinpi, 10g of turtle, 10g of turtle, 10g of safflower seeds, 10g of water safflower seeds, 2 centipedes, 12g of talc, 10g of raw licorice. Take 14 doses, 1 dose per day, decocted in water, and take it warm in 2 times. The patient is asked to keep his mood comfortable, avoid smoking and alcohol, reduce sitting for a long time, and actively carry out physical exercises such as Baduan Jin and Tai Chi.
orange kernel
Second visit on August 7: After taking for 14 doses, the patient said that he urinated frequently, and the swelling and pain were slightly relieved after urination. The swelling and pain in the pelvic cavity was relieved compared with the previous one. Symptoms such as swelling and pain in the flanks, fatigue, chills in the limbs, white urethra and damp scrotum disappeared. The number of urination at noon decreased (3 to 4 times/night), weak erection, good sleep, and defecation, and can be admitted. The tongue is red, the coating is thin, white and greasy, and the pulse is stringy. Remove salted cypress, Qinpi and Atractylodesis on the top, add deer antler glue (melted) 10g and Cistanche 10g, and ask the patient to take 14 doses. The same method as before for decoction.
88 Third visit: After taking , the patient complained that he still had weakness in his erectile dysfunction. After sex, the symptoms of penis pain, frequent urination, urgency, inability to urinate, and pain in urine were significantly relieved. There was no discomfort in the perineum and lower abdomen. He urinated 1 to 2 times per night, had a good bowel movement, had a good stomach, had good sleep at night, his tongue was pale red, his tongue was thin white, and his pulse was stringy. The results of the re-examination of prostate fluid microscopy were normal. Remove the saffron seeds, talc and raw licorice in the front, add epimedium 10g, take 14 doses, decoct the same as before.
9-4th diagnosis: patient said that after taking the medicine, his erectile function improved significantly, there was no pain after sexual intercourse, no other special discomfort symptoms, he could absorb, rest assured, and defecate. The tongue is pale red, the coating is thin and white, and the pulse is stringy. Keep the front and 14 doses to consolidate the efficacy.
Note: The patient with came to see the doctor for frequent urination, urgency, pain, and inability to drain after urination. Combined with auxiliary examination, he was diagnosed with chronic prostatitis. The patient is depressed, anxious and nervous, and has a clear cause of aggravation after drinking. Combined with the patient's clinical symptoms and tongue and pulse, it can be diagnosed as qi stagnation and blood stasis, and damp heat and blood stasis. Mental and psychological factors such as nervousness, anxiety, depression, etc. are important factors for the patient's disease, and if it is not correct, it will be painful. Treatment is to regulate qi, promote blood circulation and relieve pain first, and correct the origin and clear the source as supplement. When choosing Sanhe Decoction to treat chronic prostatitis, you should realize that the prostate is used to smooth and clear, and the prescriptions for promoting blood circulation and removing blood stasis, clearing heat and dampness should be carried out throughout the whole process. During the second visit, the patient's scrotum was damp and the patient disappeared. The patient had a body with yin deficiency and was thin, which may damage the yin fluid, so he removed the salted yellow cypress and Qinpi. The patient's symptoms of erectile weakness did not improve significantly, so he added deer antler glue and Cistanche to warm the kidneys and help yang. During the third diagnosis, the patient's various symptoms had improved significantly, but he still had erectile weakness and penis pain after sex. Remove safflower seeds, talc, and raw licorice, and add epimedium to warm the yang and nourish the kidneys to improve erectile dysfunction and pain in sexual intercourse.
solemnly stated:
Due to the different physical constitution and condition of each person, the prescriptions and dosages in this case are only applicable to the patient's condition at that time. The prescriptions and dosages in this case shall not be copied and used without diagnosis and treatment by traditional Chinese medicine. Readers should go to regular hospitals for diagnosis and treatment if necessary to avoid delaying the condition. ■
[Content compiled from: China Chinese Medicine News, fifth edition, October 14, 2022, authors: Zhang Libo, Wang Yao Shanxi University of Traditional Chinese Medicine, Wu Jinhong, Liu Guangzhen Shanxi Institute of Traditional Chinese Medicine]
Treatment method: relieves liver and regulates qi, promotes blood circulation and relieves pain.
prescription medicine is added and subtracted by Sanhe Decoction: hawthorn core 20g, orange core 20g, lychee core 20g, 10g of Sichuan melon seeds, 20g of ghost arrow feathers, 10g of Yanhusuo, 10g of cumin, 10g of prickly genus, 3g of black medicine, 10g of wood fragrance, 10g of snake bed, 10g of salted cypress, 10g of Qinpi, 10g of turtle, 10g of turtle, 10g of safflower seeds, 10g of water safflower seeds, 2 centipedes, 12g of talc, 10g of raw licorice. Take 14 doses, 1 dose per day, decocted in water, and take it warm in 2 times. The patient is asked to keep his mood comfortable, avoid smoking and alcohol, reduce sitting for a long time, and actively carry out physical exercises such as Baduan Jin and Tai Chi.
orange kernel
Second visit on August 7: After taking for 14 doses, the patient said that he urinated frequently, and the swelling and pain were slightly relieved after urination. The swelling and pain in the pelvic cavity was relieved compared with the previous one. Symptoms such as swelling and pain in the flanks, fatigue, chills in the limbs, white urethra and damp scrotum disappeared. The number of urination at noon decreased (3 to 4 times/night), weak erection, good sleep, and defecation, and can be admitted. The tongue is red, the coating is thin, white and greasy, and the pulse is stringy. Remove salted cypress, Qinpi and Atractylodesis on the top, add deer antler glue (melted) 10g and Cistanche 10g, and ask the patient to take 14 doses. The same method as before for decoction.
88 Third visit: After taking , the patient complained that he still had weakness in his erectile dysfunction. After sex, the symptoms of penis pain, frequent urination, urgency, inability to urinate, and pain in urine were significantly relieved. There was no discomfort in the perineum and lower abdomen. He urinated 1 to 2 times per night, had a good bowel movement, had a good stomach, had good sleep at night, his tongue was pale red, his tongue was thin white, and his pulse was stringy. The results of the re-examination of prostate fluid microscopy were normal. Remove the saffron seeds, talc and raw licorice in the front, add epimedium 10g, take 14 doses, decoct the same as before.
9-4th diagnosis: patient said that after taking the medicine, his erectile function improved significantly, there was no pain after sexual intercourse, no other special discomfort symptoms, he could absorb, rest assured, and defecate. The tongue is pale red, the coating is thin and white, and the pulse is stringy. Keep the front and 14 doses to consolidate the efficacy.
Note: The patient with came to see the doctor for frequent urination, urgency, pain, and inability to drain after urination. Combined with auxiliary examination, he was diagnosed with chronic prostatitis. The patient is depressed, anxious and nervous, and has a clear cause of aggravation after drinking. Combined with the patient's clinical symptoms and tongue and pulse, it can be diagnosed as qi stagnation and blood stasis, and damp heat and blood stasis. Mental and psychological factors such as nervousness, anxiety, depression, etc. are important factors for the patient's disease, and if it is not correct, it will be painful. Treatment is to regulate qi, promote blood circulation and relieve pain first, and correct the origin and clear the source as supplement. When choosing Sanhe Decoction to treat chronic prostatitis, you should realize that the prostate is used to smooth and clear, and the prescriptions for promoting blood circulation and removing blood stasis, clearing heat and dampness should be carried out throughout the whole process. During the second visit, the patient's scrotum was damp and the patient disappeared. The patient had a body with yin deficiency and was thin, which may damage the yin fluid, so he removed the salted yellow cypress and Qinpi. The patient's symptoms of erectile weakness did not improve significantly, so he added deer antler glue and Cistanche to warm the kidneys and help yang. During the third diagnosis, the patient's various symptoms had improved significantly, but he still had erectile weakness and penis pain after sex. Remove safflower seeds, talc, and raw licorice, and add epimedium to warm the yang and nourish the kidneys to improve erectile dysfunction and pain in sexual intercourse.
solemnly stated:
Due to the different physical constitution and condition of each person, the prescriptions and dosages in this case are only applicable to the patient's condition at that time. The prescriptions and dosages in this case shall not be copied and used without diagnosis and treatment by traditional Chinese medicine. Readers should go to regular hospitals for diagnosis and treatment if necessary to avoid delaying the condition. ■
[Content compiled from: China Chinese Medicine News, fifth edition, October 14, 2022, authors: Zhang Libo, Wang Yao Shanxi University of Traditional Chinese Medicine, Wu Jinhong, Liu Guangzhen Shanxi Institute of Traditional Chinese Medicine]
