Chief physician Jia is the leader of urology in Guang 'anmen Hospital of Chinese Academy of Traditional Chinese Medicine. He is good at treating urology and andrology diseases with integrated traditional Chinese and western medicine, especially publishing many books and academic papers on the diagnosis and treatment of prostate diseases. (Left)
Zhang Yaqiang, chief physician of Guang 'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, is engaged in the treatment and research of urology and andrology combined with traditional Chinese and western medicine, especially in the treatment of chronic prostatitis with traditional Chinese medicine, and has published many papers. (right)
Hello, audience friends! This is CCTV's live program "The Road to Health". Today we are going to talk about prostate problems.
Moderator: What kind of organ is the prostate?
Jia: Prostate is a unique organ for men. Its main function is to secrete prostatic fluid, transport semen and excrete it, and control urine flow.
Moderator: How does the prostate achieve these functions?
Zhang Yaqiang: The main function of prostate is to secrete prostatic fluid, which is a part of semen, accounting for about 1/3 of semen. Prostate fluid contains many enzymes, which can promote semen liquefaction. The zinc content of prostate is much higher than that of other tissues. Zinc is an antibacterial defense factor of prostate, which can avoid the infection of external microorganisms, which is the main reason why the urinary tract infection rate of men is much lower than that of women. Let's take a look at the schematic diagram of the urogenital system. The tissue under the bladder is the prostate, like an inverted chestnut. The urethra and ejaculatory duct pass through the prostate.
Compere: What happens after prostate inflammation?
Jia: The prostate is under the bladder, and there is a rectum behind the bladder. The urethra and ejaculatory duct pass vertically in the middle. Therefore, once inflammation occurs, there will be edema and congestion, and the pressure increase is inevitable, and there will be symptoms such as urgency, frequent urination, dysuria and unclean urine. It may also cause ejaculation pain and ejaculation with blood. Because there are many sympathetic nerves around the prostate, when these nerves are stimulated, there will be a series of pains such as reflex pain. Pain below navel may be related to prostatitis. In addition, if the long-term treatment effect is not good, tension and anxiety will also cause symptoms of generalized neurosis.
Moderator: Is it normal for young people to suffer from this disease?
Zhang Yaqiang: Chronic prostatitis mostly occurs in young and middle-aged men. Many people tend to confuse prostatitis with prostatic hyperplasia, which mostly occurs after the age of 50. Prostatitis and benign prostatic hyperplasia have different causes, symptoms and treatment methods. The main symptom of benign prostatic hyperplasia is dysuria and no pain. The main treatment is surgical resection of benign prostatic hyperplasia tissue, taking medicine to shrink the prostate and relax the posterior urethral pressure. Prostatitis patients are mostly young people aged 30-35. Because you are in a period of vigorous sexual life, you are prone to congestion, and there will be symptoms of urgency, frequent urination and painful urination. Treatment usually adopts anti-inflammatory and analgesic methods.
Moderator: Is prostatitis divided into chronic and acute?
Zhang Yaqiang: Classification of Prostatitis
First, acute bacterial prostatitis
Second, chronic bacterial prostatitis
I. Three types of inflammatory chronic pelvic pain syndrome
B, three types of non-inflammatory chronic pelvic pain syndrome
The fourth category, asymptomatic prostatitis.
Compere: Are there different kinds of symptoms?
Jia: Yes, acute prostatitis is an acute attack, which is caused by bacterial infection. Therefore, in addition to local symptoms such as urgency, frequent urination, hematuria, etc., urine may not come out because of urethral compression. There will also be some systemic symptoms such as fever and fear of cold. The clinical symptoms of chronic prostatitis are mainly local pain, in addition to some nerve reflex pain or pain directly caused by inflammation. These symptoms are 1, urinary tract symptoms 2, pain symptoms 3, sexual dysfunction 4, mental and neurological disorders 5, and systemic immune response. Clinically, people often mistake these symptoms for sexually transmitted diseases.
Moderator: What are the causes of these symptoms?
Zhang Yaqiang: Inducing Factors
First, prostate congestion: abnormal sexual life, alcoholism, perineal pressure.
Second, microbial infection: bacteria, mold, virus, chlamydia, trichomonas.
Third, urine reflux: urine flows back to the prostate.
Fourth, psychological factors: tension, anxiety, depression.
Five, autoimmune factors
Moderator: How to prevent prostatitis?
Zhang Yaqiang: Prevention of Chronic Prostatitis
1, actively and thoroughly treat urinary tract infection.
Step 2 regulate sex life
3. Pay attention to daily life, prevent overwork and prevent colds.
4, abstain from alcohol, avoid spicy diet
5. Drink plenty of water, urinate frequently and hold your urine for a short time.
6. Avoid sedentary and long-term cycling.
7. Patients with chronic prostatitis who have been cured should take a hot bath every night to prevent recurrence.
Moderator: From the perspective of Chinese medicine, how should prostatitis be treated?
Jia: No matter which treatment method, the principle of treatment is the same, which is to promote the smooth drainage of prostate and eliminate edema and inflammation. Traditional Chinese medicine classifies prostatitis as stranguria and white turbidity. Chinese medicine believes that the symptom of urgent urination and frequent urination is damp-heat in the lower coke, and the treatment is to clean up the damp-heat in the lower coke. Local pain, such as testicular pain, stomachache and perineal pain, is regarded by Chinese medicine as qi stagnation and blood stasis, and the treatment mainly adopts methods such as regulating qi, promoting blood circulation and relieving pain. Symptoms such as backache and leg weakness, listlessness, and sexual dysfunction are considered by Chinese medicine to be kidney deficiency, which is treated by tonifying the kidney.
Moderator: Please tell us about the methods of comprehensive treatment of prostatitis.
Jia: Comprehensive therapy.
1, TCM syndrome differentiation and treatment
2. Integrated traditional Chinese and western medicine treatment
3. Other therapies: traditional Chinese medicine decoction, anal administration, prostate injection, prostate massage, hot water sitz bath, acupuncture treatment, physical therapy and dietotherapy.
Moderator: For the treatment of prostatitis, does the hospital develop related drugs besides conventional drugs?
Zhang Yaqiang: According to the characteristics of chronic prostatitis, our hospital developed prostate soup. The prescription is mainly based on promoting blood circulation and removing blood stasis, supplemented by drugs for detoxifying, promoting diuresis and tonifying kidney.
Moderator: Mr. Li from Hangzhou, 36 years old. I have been suffering from prostatitis for 5 years. After many treatments, the effect is not good. I heard that prostate massage also has an effect. I want to try, but I can't go to the hospital often. Can I have a prostate massage? How?
Jia: Let's look at a picture: put your index finger into the anus, first touch the general situation of the prostate, such as shape, size and smoothness, and then massage on both sides, 3-5 times on each side. Do not squeeze the prostate locally, because it is not only painful, but also harmful to the drainage of the prostate. Massage yourself at home. If you don't do it right, you won't get the massage effect. It is recommended to go to the hospital for medical guidance.
Moderator: Mr. Wu from Yunnan, aged 30. I have recently felt swelling around my anus. Do you have prostatitis?
Zhang Yaqiang: Prostatitis is mainly manifested as perineal discomfort. If it is uncomfortable around the anus, you should first go to the anorectal department to rule out anorectal diseases such as hemorrhoids and perianal inflammation. After ruling out the possibility of these diseases, you can check the prostatic fluid. If inflammation is found, you can diagnose prostatitis.
Moderator: Mr. Yang from Sichuan, aged 33. I have had prostatitis for many years. Will it develop into prostate cancer?
Jia: Prostatitis and prostate cancer are completely different things. There is no necessary causal relationship between the two because of different reasons.
Moderator: Is it possible for patients with prostatitis who have been cured to relapse?
Zhang Yaqiang: Prostatitis is a chronic disease. Patients who have been cured should be actively prevented, and it is best to return to the clinic regularly.
Moderator: Mr. Li from Beijing, male, 34 years old, what symptoms should he consider to get prostatitis?
Jia: Young adults aged 30-35 are at the peak of the disease. Specific symptoms include urinary tract symptoms, pain symptoms, sexual dysfunction, mental and neurological disorders and systemic immune response.
Moderator: Mr. Zhang from Chongqing, aged 39. I am a foreign patient. He suffered from prostatitis for 3 years and was treated with Chinese patent medicine for 2 months. Now my symptoms have basically disappeared and all the tests are normal. Do I need to continue my treatment?
Zhang Yaqiang: The cure standard of prostatitis should be asymptomatic for more than 3 months, with the possibility of recurrence. It is suggested that the patient continue to receive treatment to consolidate the curative effect.
Moderator: Mr. Han from Gansu, 24 years old. I have been suffering from prostatitis for two years. I got married at the beginning of this year. My wife is not pregnant now. Can prostatitis lead to infertility?
Jia: General prostatitis will not affect fertility, but severe prostatitis will affect semen liquefaction, which is not conducive to sperm movement. It is recommended that patients go to the hospital to check the severity of prostatitis.
Moderator: Mr. He from Dalian, 2 1 year old. I often masturbate. I'm not married. Can it cause prostatitis?
Zhang Yaqiang: Masturbation can cause prostate congestion, and repeated prostate congestion can lead to prostatitis. This kind of bad behavior should be avoided.
Moderator: Mr. Wang from Beijing is 40 years old this year. I have been suffering from prostatitis for many years, and I haven't recovered yet. Can it cause prostatic hypertrophy?
Jia: The reasons are different. Prostatic hyperplasia is an aging phenomenon, while prostatitis is caused by bacterial infection or urine reflux. Therefore, prostatitis itself does not cause prostatic hypertrophy.
Moderator: Mr. Chen from Jiangxi, 26 years old. I have chronic prostatitis. What effect does Chinese medicine enema have?
Zhang Yaqiang: Chinese medicine enema is one of the commonly used methods in clinic, and the effect is good. This therapy can directly act on the prostate, but also has a warming effect, which can improve local microcirculation and relieve symptoms.
Moderator: Mr. Wang from Henan, 48 years old. I suffer from prostatitis, prostatic hypertrophy and frequent urination every night. How should this situation be treated?
Jia: For this kind of patients, both prostatitis and prostatic hyperplasia should be treated. Contraction of prostatic hyperplasia tissue and reduction of local pressure are beneficial to the discharge of urine and drainage of prostatic fluid, and are beneficial to both prostatic hyperplasia and prostatitis.
Moderator: Mr. Li from Henan, aged 23. I got urethritis a few years ago, and now it has become prostatitis. I have been taking medicine, but the effect is not good. Can I have an operation?
Zhang Yaqiang: Because the prostate is the largest accessory gonad of men, it is closely related to reproduction and fertility. If the prostate is surgically removed, it will bring more pain to the patient. At present, the treatment of prostatitis still needs drug treatment, which is the most basic treatment principle.
Moderator: Mr. Liu from Shandong is 37 years old. I have gonorrhea. Later, the examination found that the prostate was inflamed. The doctor said it was caused by gonorrhea. Is that so? How to treat it?
Jia: This situation is also possible. Because there is no thorough treatment at first, it will also cause prostatitis. Gonococcal prostatitis and gonococcal urethritis are treated the same.
Moderator: Finally, I would like to remind all male friends that when you find the symptoms of prostatitis, don't be ashamed to see a doctor because you think it is a sexually transmitted disease, or believe in the contents of some small advertisements in informal hospitals, which may cause more serious consequences.
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