2022 International Journal of Urology

Chinese herbal medicine can significantly reduce the risks of complications and need for surgery associated with benign prostatic hyperplasia.

The methodology of the retrospective cohort study involved analyzing data from Taiwan's National Health Insurance Research Database, covering the period between 2001 to 2013. 4142 patients newly diagnosed as having benign prostatic hyperplasia were divided into Chinese herbal medicine users and non-users. To compare these groups, they employed 1:1 propensity score matching, and the risk of complications related to benign prostatic hyperplasia was evaluated using the Cox proportional hazard model.

The results showed that during the study period, the risk of complications related to benign prostatic hyperplasia was considerably lower in the Chinese herbal medicine group compared to the non-Chinese herbal medicine group, even when other variables were controlled for. The Chinese herbal medicine users had a significantly lower risk of urinary tract infection and urine retention. Plus, the Chinese herbal medicine users experienced a lower incidence rate of surgery related to benign prostatic hyperplasia and enjoyed a longer surgery-free interval than non-Chinese herbal medicine users. Among the Chinese herbal medicine, Salviae miltiorrhizae and Ji-Sheng-Shen-Qi-Wan were prescribed the most by traditional Chinese medicine practitioners.

Effects of Chinese herbal medicine in patients with benign prostatic hyperplasia: A nationwide cohort study in Taiwan Ou SC, Huang ST, Lin MC, Chen WC, Huang CP, Lin HJ

2022 Frontiers in Pharmacology

Various traditional Chinese medicine treatment strategies could potentially provide an effective alternative in slowing the progression of Chronic Kidney Disease.

The study explores the use of Traditional Chinese Medicine (TCM) and various Chinese materia medica (CMM) to manage Chronic Kidney Disease (CKD). The review delves deeper into the principles and treatment approaches of TCM in battling CKD, dictating that the disease's nature is deficient in the root and excessive in the branches, where deficiency and excess persist simultaneously throughout the condition. The main strategies employed by TCM in the treatment of CKD include invigorating Qi, tonifying kidneys, promoting blood circulation, removing stasis, eliminating heat and dampness, reducing turbidity, and controlling edema.

The discussion highlights the effectiveness of several CMMs in treating CKD, which are undergirded by clinical evidence or experimental studies. Notably, it points out a correlation between the macroscopic view of TCM and the microscopic view of modern medicine. These TCM and CMM strategies are hailed for their multi-targeted and multi-functional characteristics, potentially providing an effective alternative treatment approach for CKD.

Traditional Chinese Medicine in the Treatment of Chronic Kidney Diseases: Theories, Applications, and Mechanisms Yunlai Wang, Ye Feng, Manman Li, Mo Yang, Gaoxiang Shi, Zihua Xuan, Dengke Yin, Fan Xu

2022 Frontiers in Pharmacology

The Jian Pi Yi Shen formula in traditional Chinese medicine demonstrates a protective effect on kidneys by modulating tryptophan metabolism and Aryl hydrocarbon receptor activation.

A chronic kidney disease (CKD) rat model was induced by feeding a diet containing 0.75% adenine over a four-week period. Concurrently, the Jian-Pi-Yi-Shen formula was administered every day starting from the third week and continued for four additional weeks. Multiple factors were evaluated including renal injury, fibrotic markers expression, and serum creatinine and blood urea nitrogen levels. The levels of 10 tryptophan metabolites in the rat serum and Aryl hydrocarbon receptor signaling were detected and analyzed using ultra-high performance liquid chromatography-tandem mass spectrometry and Western blot analysis, respectively.

The Jian-Pi-Yi-Shen formula demonstrated significant effects of reducing both serum creatinine and blood urea nitrogen levels and improving renal pathological injuries in the CKD rat model. It was found that the formula also regulated tryptophan metabolism and decreased the levels of tryptophan metabolites in the serum. Furthermore, the formula suppressed the overactivated Aryl hydrocarbon receptor signaling in the kidney. These observations imply that the actions of the Jian-Pi-Yi-Shen formula could effectively protect against CKD.

Jian-Pi-Yi-Shen Formula Improves Adenine-Induced Chronic Kidney Disease via Regulating Tryptophan Metabolism and Aryl Hydrocarbon Receptor Signaling Liu X, Deng R, Chen Y, Huang S, Lu J, Zheng L, Xiong G, Li S

2021 Medicine

Acupuncture can effectively improve the post voided residual urine, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy.

There is insufficient evidence that acupuncture can increase the patient's MFR, BR, and UIR. However, acupuncture can effectively improve the PVR, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy. Although limited due to the quality and methodological limitations of the included studies, acupuncture can still be used as an effective and safe treatment for women with urinary retention after hysterectomy.

Efficacy and safety of acupuncture for urinary retention after hysterectomy Zhao Q, Yan C, Dan M, Jia H

2021 Medicine

Acupuncture can effectively improve the post voided residual urine, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy.

There is insufficient evidence that acupuncture can increase the patient's MFR, BR, and UIR. However, acupuncture can effectively improve the PVR, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy. Although limited due to the quality and methodological limitations of the included studies, acupuncture can still be used as an effective and safe treatment for women with urinary retention after hysterectomy.

Efficacy and safety of acupuncture for urinary retention after hysterectomy Zhao Q, Yan C, Dan M, Jia H

2021 The Brazilian Journal of Nursing

Acupuncture has a positive effect in improving quality of life, fatigue and sleep in patients with chronic kidney disease.

Nine studies were selected; the acupuncture techniques used were auriculotherapy, electroacupuncture and acupressure aimed at improving quality of life, fatigue, sleep and clinical variables of the disease. The studies that assessed quality of life, sleep and fatigue presented significant benefits. Studies that assessed quality of life, sleep and fatigue presented significant benefits. There was no statistical significance in the improvement of serum creatinine levels and glomerular filtration rate. Methodological and assessment tools’ divergence made impossible meta-analysis.

Effects of acupuncture in patients with chronic kidney disease: a systematic review Melo GAA, Aguiar LL, Silva RA, Pereira FGF, Silva FLBD, Caetano JÁ.

2021 Frontiers in Pharmacology

Luteolin, a component of traditional Chinese medicine herb Zi Su Ye, has been found to alleviate kidney disease stage 3-5 by reducing renal tubular epithelial cell apoptosis.

By using network pharmacology, the research identified the active components of a traditional Chinese medicine herb used for treating chronic kidney disease stages 3-5. Active components were analyzed using high performance liquid chromatography and enriched for substantial analysis. Thereafter, critical components were verified using molecular docking and experimentations. The key therapeutic targets were observed from a constructed PPI network, and further focused on five core nodes: AKT1, TP53, IL6, TNF, and MAPK1.

In discussing the results, it was revealed that 19 active components were recognized, interlinking with 108 targets of chronic kidney disease stages 3-5. The potential regulation of various biological functions by these targets was suggested. Specifically, apoptosis, T cell receptor, and PI3K-AKT signaling pathways would be modulated. Molecular docking supported the premise that active components dock successfully with corresponding targets. Luteolin emerged as the most effective component in managing adriamycin-induced renal tubular apoptosis by affecting oxidative stress and downgrading the MAPK and p53 pathways.

Exploring the Critical Components and Therapeutic Mechanisms of Perilla frutescens L. in the Treatment of Chronic Kidney Disease via Network Pharmacology Yong C, Zhang Z, Huang G, Yang Y, Zhu Y, Qian L, Tian F, Liu L, Wu Q, Xu Z, Chen C, Zhao J, Gao K, Zhou E

2021 Nutrients

Extra virgin olive oil high in minor polar compounds significantly improves kidney function, reduces oxidative stress, inflammation, and ultimately benefits the body composition.

The research study tested two distinct types of extra virgin olive oils, namely Synergy with a high content and Luxolio with a medium content of minor polar compounds, on 40 patients suffering from kidney disease. The patients were administered a 40 mL dosage per day over nine weeks. Researchers assessed the impacts on renal functionality, oxidative stress, inflammation levels, and body composition, before and after a subsequent two-month wash out period. Additionally, the concentration of minor polar compounds in the oils was determined through high-performance liquid chromatography accompanied by diode-array detection and mass spectrometry (HPLC-DAD-MS).

The research showed improvements in kidney function indicators such as estimated glomerular filtration rate, albuminuria, azotemia, and uric acid. Further, the patients' lipid profile also improved, as did their inflammation parameters, erythrocyte sedimentation rate, C-reactive protein, and body composition. More notably, these beneficial effects were stronger and lasted longer in those patients who had been given the Synergy oil, indicating a sustained antioxidant and anti-inflammatory impact from EVOOs with higher concentrations of minor polar compounds.

Usefulness of Extra Virgin Olive Oil Minor Polar Compounds in the Management of Chronic Kidney Disease Patients Noce A, Marrone G, Urciuoli S, Di Daniele F, Di Lauro M, Pietroboni Zaitseva A, Di Daniele N, Romani A

2021 Scientific Reports

Lower testosterone levels in aging men correlate with a larger prostate volume.

The study analysed the relationship between testosterone levels and prostate size in aging, overtly healthy males. Data was collected from 416 men who underwent routine health exams and these individuals were revisited after a span of four years. Variables not only included testosterone levels and prostate size, but also examined associated obesity-related factors such as waist circumference, body mass index, and insulin levels.

The analysis focused on drawing correlations between various factors. Specifically, comparisons were made between men with lower testosterone levels and larger prostate sizes, and those with normal testosterone levels. Both initial prostate sizes and the change in size over the four-year period were evaluated in conjunction with testosterone levels. The role of testosterone levels was further intricately reviewed by adjusting for the age factor, to understand how this relationship may change over time.

In investigating the results, it was observed that men with lower testosterone did tend to have significantly larger prostates, and higher levels of obesity-related factors compared to those with normal testosterone levels. It was also found that there was a negative correlation between testosterone levels and prostate size, that is, as testosterone increased, prostate size showed a substantial decreasing trend.

Relationship between serum total testosterone and prostate volume in aging men Xia BW, Zhao SC, Chen ZP, Chen C, Liu TS, Yang F, Yan Y

2021 Journal of Renal Nutrition

Consuming coffee is associated with lower risks of developing chronic kidney disease, reaching end-stage kidney disease, and having albuminuria.

In this systematic review and meta-analysis, researchers conducted a comprehensive literature search through various databases, including PubMed/Medline, Web of Science, Embase by Elsevier, and the Cochrane Central Register of Controlled Trials by Wiley from 1960 until February 2020. Outcomes related to chronic kidney disease incidence, its progression, and mortality associated with this disease were evaluated and correlated with coffee consumption and the amount consumed. Quality assessment of the included studies was done using the Newcastle-Ottawa scale.

The analysis incorporated 12 studies, with a mix of prospective and cross-sectional studies, and a total of 505,841 subjects. Seven of these studies focused on the relationship between coffee consumption and the onset of chronic kidney disease. The finding was that consuming coffee was significantly correlated with a decrease in the risk for this disease, especially for individuals who took more than 2 cups of coffee per day. Furthermore, there was also a noteworthy lower risk of reaching end-stage kidney disease for coffee drinkers, as well as a decrease in the risk of albuminuria (a kidney disease marker). Finally, the risk of death related to chronic kidney disease was discovered to be lower in coffee consumers.

Effect of Coffee Consumption on Renal Outcome: A Systematic Review and Meta-Analysis of Clinical Studies Kanbay M, Siriopol D, Copur S, Tapoi L, Benchea L, Kuwabara M, Rossignol P, Ortiz A, Covic A, Afsar B

2020 BJOG: An International Journal of Obstetrics & Gynaecology

Acupuncture appeared to be beneficial for treatment and prophylaxis of recurrent urinary tract infections.

Five RCTs involving 341 participants were included. Methodological quality of studies and strength of the evidence were low to moderate. The chance of achieving a composite cure with acupuncture therapies was greater than that with antibiotics. The risk of UTI recurrence was lower with acupuncture than with no treatment and sham acupuncture.

Acupuncture appeared to be beneficial for treatment and prophylaxis of recurrent urinary tract infections, noting the limitations of the current evidence. Given the growing challenge of antibiotic resistance, there is a need for high-quality RCTs of non-pharmacological interventions such as acupuncture.

Acupuncture for recurrent urinary tract infection in women: a systematic review and meta‐analysis Qin X, Coyle ME, Yang L, Liang J, Wang K, Guo X, Zhang AL, Mao W, Lu C, Xue CC, Liu X

2020 BJOG: An International Journal of Obstetrics & Gynaecology

Acupuncture appeared to be beneficial for treatment and prophylaxis of recurrent urinary tract infections.

Five RCTs involving 341 participants were included. Methodological quality of studies and strength of the evidence were low to moderate. The chance of achieving a composite cure with acupuncture therapies was greater than that with antibiotics. The risk of UTI recurrence was lower with acupuncture than with no treatment and sham acupuncture.

Acupuncture appeared to be beneficial for treatment and prophylaxis of recurrent urinary tract infections, noting the limitations of the current evidence. Given the growing challenge of antibiotic resistance, there is a need for high-quality RCTs of non-pharmacological interventions such as acupuncture.

Acupuncture for recurrent urinary tract infection in women: a systematic review and meta‐analysis Qin X, Coyle ME, Yang L, Liang J, Wang K, Guo X, Zhang AL, Mao W, Lu C, Xue CC, Liu X

2019 Acupuncture in Medicine

Meta-analysis showed that acupuncture was comparable to drugs in the reduction of overactive bladder symptoms.

Seven eligible trials involving 695 participants were included. Meta-analysis showed that acupuncture was comparable to drugs (tolterodine tartrate/solifenacin) in the reduction of micturition episodes over 24 hours, increase in voided volume of each micturition episode, and reduction of overactive bladder symptom score. In addition, acupuncture was not significantly different compared with placebo in the reduction of overactive bladder symptom score. No serious adverse events were reported.

Acupuncture for overactive bladder in adults: a systematic review and meta-analysis Mak TC, Chen HY, Cho WC

2019 BMJ Open

Chinese herbal medicine may be effective and safe for treating diabetic kidney disease, although evidence quality varies.

The systematic review and meta-analysis comprised randomized controlled trials comparing the use of oral Chinese herbal medicine (CHM) to a placebo, involving a comprehensive search strategy and selecting from over 7000 articles, resulting in 20 studies with a total of 2719 participants. Potential bias was minimized by only including studies that pitted CHM against a placebo. In addition, an a priori subgroups analysis was conducted to identify potential candidate formulae and frequently used herbs for further exploration.

Despite these measures, the overall evidence ranged from moderate to very low quality due to unclear randomization procedures, substantial variations in outcome measures, and reduced external validity. The latter was affected by factors such as multi-ingredient herbal formulae, brief follow-up periods, limited numbers of clinical events, and the inclusion of older patients with less advanced disease.

Chinese herbal medicine for diabetic kidney disease: a systematic review and meta-analysis of randomised placebo-controlled trials Zhang L, Yang L, Shergis J, Zhang L, Zhang AL, Guo X, Qin X, Johnson D, Liu X, Lu C, Xue CC, Mao W

2018 Medicine

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes.

Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients’ health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs.

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.

Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z.

2018 Medicine

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes.

According to the results of meta-analysis, acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB. Nevertheless, acupuncture is comparatively with few adverse reactions and safe. In the future, studies with high methodological quality and larger sample sizes are required.

Acupuncture for adults with overactive bladder Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z

2018 Medicine

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes.

According to the results of meta-analysis, acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB. Nevertheless, acupuncture is comparatively with few adverse reactions and safe. In the future, studies with high methodological quality and larger sample sizes are required.

Acupuncture for adults with overactive bladder Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z

2018 The Journal of Internal Korean Medicine

Moxibustion was found to be an effective and safe treatment improving symptoms and quality of life in patients with Benign Prostatic Hyperplasia.

The study used a randomized controlled trial method, comparing the effects of moxibustion and placebo treatment on Benign Prostatic Hyperplasia. Participants were divided into two groups: one that received the moxibustion treatment on specific acupuncture points, and another placebo group that received a sham treatment mimicking moxibustion without therapeutic effect. Outcome measures assessed were International Prostate Symptom Score, maximum urinary flow rate, quality of life index, and occurrence of adverse events.

The study found significant improvements in the moxibustion group in regards to the measured prostate symptom score and urinary flow rate when compared to the placebo group. The quality of life index was also significantly higher for the moxibustion group. Moreover, adverse events were rare and mild in both participant groups.

Moxibustion for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis Bae G, Lee S, Hong J, Lee I, Kim S, Choi J, Han C, Yun Y, Park S, Kwon J

2017 PLOS One

Acupuncture can significantly improve urological symptoms in the short term for men with benign prostatic hyperplasia.

The comprehensive study used a systematic review and a meta-analysis to measure both the therapeutic and adverse effects of acupuncture on benign prostatic hyperplasia (BPH) through randomized controlled trials. Independent reviewers analyzed and extracted data from various renowned databases including MEDLINE, EMBASE, The Cochrane Library, and several Chinese knowledge resources. The trials focused on BPH symptomatic men and reviewed the extent to which acupuncture treatment altered urological symptoms.

The results from eight separate randomized controlled trials involving 661 men were combined, showing statistical short-term (4-6 weeks) improvement in urological symptoms for BPH patients through the use of acupuncture. However, the medium-term follow-up (12-18 weeks) analysis did not indicate any significant effect. The beneficial effects were considerably noticeable in cases of moderate to severe BPH on the short-term follow-up endpoints. Nonetheless, the clinical significance of these changes necessitates rigorous and long-term follow-ups for validation.

Acupuncture for benign prostatic hyperplasia: A systematic review and meta-analysis Zhang W, Ma L, Bauer BA, Liu Z, Lu Y

2016 Medicine

Current evidence supports acupuncture as an effective treatment for chronic prostatitis/chronic pelvic pain syndrome-induced symptoms, particularly in relieving pain.

Real acupuncture was superior to sham acupuncture in improving symptoms (pain, voiding) and quality of life (Qof) domain subscores. Compared to sham acupuncture and medicine, acupuncture appears to be more effective at improving the global assessment. Two trials found that there is no significant difference between acupuncture and sham acupuncture in decreasing the IPSS score. Acupuncture failed to show more favorable effects in improving both symptoms and the Qof domain compared with medicine. Overall, current evidence supports acupuncture as an effective treatment for CP/CPPS-induced symptoms, particularly in relieving pain. Based on the meta-analysis, acupuncture is superior to sham acupuncture in improving symptoms and Qof. Acupuncture might be similar to medicine (Levofloxacinand, Ibuprofen, and Tamsulosin) in its long-term effects, but evidence was limited due to high ROB among included trials as well as potential heterogeneity. Acupuncture is associated with rare and slightly adverse events.

Systematic Review of Acupuncture for Chronic Prostatitis/Chronic Pelvic Pain Syndrome Qin Z, Wu J, Zhou J, Liu Z.

2016 Scientific Reports

Acupuncture may be recommended for the treatment of chronic prostatitis/chronic pelvic pain syndrome with relatively rare incidence of adverse events.

Based on decreases in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, a network meta-analysis indicated that electro-acupuncture, acupuncture, alpha-blockers, antibiotics, and dual therapy are superior to placebo in decreasing this score. Additionally, electro-acupuncture and dual therapy were more effective than alpha-blockers in decreasing the total NIH-CPSI total score. Other network meta-analyses did not show significant differences between interventions other placebo. The incidence of adverse events of acupuncture was relatively rare (5.4%) compared with placebo (17.1%), alpha-blockers (24.9%), antibiotics (31%) and dual therapy (48.6%). Overall, rank tests and safety analyses indicate that electro-acupuncture/acupuncture may be recommended for the treatment of chronic prostatitis/chronic pelvic pain syndrome.

Network Meta-Analysis of the Efficacy of Acupuncture, Alpha-blockers and Antibiotics on Chronic Prostatitis/Chronic Pelvic Pain Syndrome Qin, Z., Wu, J., Tian, J. et al.

2016 International Urogynecology Journal

Some comparative trials showed the benefit of acupuncture to be comparable with antimuscarinic treatment for overactive bladder.

Initial animal studies suggest several biochemical mechanisms of action underlying the effect of acupuncture on overactive bladder (OAB) suppression. The experience in humans includes two case series and six comparative trials. All studies demonstrated subjective improvement in OAB symptoms, and some reported objective improvement in urodynamic studies. Notably, some comparative trials showed the benefit of acupuncture to be comparable with antimuscarinic treatment.

Despite their limitations, existing studies serve as a promising foundation for suggesting a role for acupuncture as an alternative therapy for OAB. Further well-designed studies are required to investigate optimal technique and their outcomes.

The role of acupuncture in managing overactive bladder; a review of the literature Forde JC, Jaffe E, Stone BV, Te AE, Espinosa G, Chughtai B.

2015 Evidence-Based Complementary and Alternative Medicine

We cautiously suggest that acupuncture therapy could demonstrate better clinical efficacy than pharmacological treatment or placebo treatment in treating nocturnal enuresis.

In summary, the results of this study suggest that acupuncture therapy demonstrate better clinical efficacy than pharmacological treatment or placebo treatment in treating NE. Due to the low methodological qualities of included trials, the findings of current study should be interpreted with caution. Therefore, to further assess the potential beneficial effect of acupuncture therapy for NE, additional RCTs with rigorous experimental design, large-scale high quality methodological control, long follow-ups, and strict reporting specification are required.

Efficacy of Acupuncture in Children with Nocturnal Enuresis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Lv ZT, Song W, Wu J, et al.

2013 Asian Journal of Andrology

Chinese herbal medicine appears to be more effective than Western medication in improving quality of life and reducing prostate volume in benign prostatic hyperplasia patients.

The method utilized in this research involved the systematic review of randomized controlled trials from diverse electronic databases. These trials were focused on comparing Chinese herbal medicine, in standalone or supplementary use with Western medication, against placebo or solely Western medication. All trials reviewed pertained to benign prostatic hyperplasia. Outcomes measured included changes in patients' urological symptoms, urodynamic measures, prostate volume and the occurrence of adverse events.

The analysis revealed that Chinese herbal medicine was superior to Western medicines in terms of improving patients' quality of life as well as reducing the size of the prostate. Furthermore, the occurrence and frequency of adverse events in patients treated with Chinese herbal medicines were found to be similar to those observed in placebo groups and lesser compared to groups treated with Western medication. However, due to the limited number of trials and their methodological quality, the evidence supporting the efficacy of Chinese herbal medicine remains weak.

Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials Ma CH, Lin WL, Lui SL, Cai XY, Wong VT, Ziea E, Zhang ZJ