1 acute bacterial prostatitis.

2. Chronic bacterial prostatitis.

The two different treatments for prostatitis are different. The first is infection, and then the cause of infection. The solution of the cause is as important as the treatment. After all, when you were normal, you would still be infected. If the cause is not solved, it will aggravate the recurrence.

In addition, it is necessary to combine symptoms to judge the problem in clinic. Some problems can't be reflected in the exam results, but they can't be ignored. Common related symptoms: frequent micturition, urgent micturition, waiting for micturition, occasional urine bifurcation, white urine dripping, turbid urine, burning pain in urine, frequent micturition, nocturnal emission, occasional swelling and stabbing pain in perineum, and occasional swelling and stabbing pain in pubic bone. Everyone needs to combine the test results according to their different symptoms.

Western medicine's solution to two different prostatitis;

1 acute bacterial prostatitis

(1) treatment principle acute bacterial prostatitis: broad-spectrum antibiotics are the main treatment, and symptomatic support treatment is given. Patients with urinary retention were treated with catheter or suprapubic cystostomy to drain urine, while patients with prostate abscess were treated with surgical drainage.

(2) The general treatment is to stay in bed for 3 ~ 4 days, drink water properly, and prohibit drinking and irritating food.

2. Chronic bacterial prostatitis

Treatment principle (1) Chronic bacterial prostatitis: oral antibiotics are the main treatment, and sensitive drugs are selected. The course of treatment is 4-6 weeks, and the curative effect should be evaluated in stages. If the curative effect is not satisfactory, switch to other sensitive antibiotics. Alpha blockers can be used to improve micturition symptoms and pain. Plant preparations, non-steroidal anti-inflammatory and analgesic drugs and M receptor blockers can also improve the corresponding symptoms.

(2) The main purpose of treatment is to relieve symptoms and improve the quality of life, and the evaluation of curative effect should focus on symptom improvement.

(1) generally treat abstinence and avoid spicy food; Avoid holding your urine for a long time, keep warm and strengthen physical exercise.

(2) Antibiotics, α-blockers, plant preparations and non-steroidal anti-inflammatory and analgesic drugs are commonly used in drug treatment, and other drugs are also effective in relieving symptoms.

Traditional Chinese medicine solution for acute and chronic prostatitis;

1. Grasp the characteristics of symptoms and pay attention to the details that cannot be ignored in local dialectics:

Bacterial prostatitis is a disease with damp heat, gland stagnation and poor excretion of gland fluid. Therefore, in the course of treatment, we should closely focus on the characteristics of blood stasis and turbidity resistance, and choose products that can remove blood stasis and turbidity, such as pangolin, Gleditsia sinensis, Trichosanthes root, Patrinia, Coicis Semen, Fritillaria thunbergii, Acorus gramineus and so on. In the process of syndrome differentiation, besides systemic syndrome differentiation, we should also pay attention to the local syndrome differentiation of prostate finger examination and various physical and chemical examinations.

(1) Patients with damp-heat syndrome have swollen prostate, burning sensation and piles of white blood cells;

(2) In patients with blood stasis syndrome, the prostate is hard and may have nodules, but the nodules are smooth. It is difficult to press EPS, and the red blood cells and lecithin bodies are obviously reduced.

2. Distinguish between cold and heat.

Damp-heat is a disease, which tends to suppress Yang Qi and hurt Yin and Yang, so it is necessary to distinguish between cold and heat deficiency and excess in treatment. Damp-heat inhibits Yang Qi, and the perineum, testicles and lower abdomen also have a sense of wind and cold in addition to clinical dehumidification heat syndrome; Dampness is more harmful to yang, but there are symptoms of yang deficiency such as cold feet, loose stool or whole body fear of cold; Excessive heat is easy to damage yin, and at the same time feel the symptoms of yin deficiency such as hand and foot heart fever, hot flashes, night sweats and dry mouth.

The general treatment principle is to clear damp-heat, remove blood stasis and remove turbidity. Clinical treatment can be based on syndrome differentiation, or clearing away heat and promoting diuresis, or promoting blood circulation and removing blood stasis, or excreting. The course of disease is long, and mixed symptoms of cold and heat may appear. Or injury to yin, or injury to yang, treatment requires cold and heat products and infusion, plus Erzhi Pill for yin injury, plus Fu and Gui for yang injury, etc.

3. Treatment based on syndrome differentiation

(1) damp-heat syndrome

① Clinical manifestations: The course of this type is short. Frequent micturition, urgent micturition, dysuria, excessive micturition, burning sensation in urine, yellow-red urine color, discomfort or pain in perineum, anus and posterior urethra, milky secretion at the urethral orifice at the end of micturition or defecation, accompanied by bitter taste, dry mouth, burning anus, dry stool or loose stool. Prostate slightly enlarged, tender, fever; EPS microscopy showed that white blood cells were piled up or had a full field of vision, and lecithin bodies were not significantly reduced. The positive rate of EPS bacterial culture is high. The tongue is red, the coating is yellow and greasy, and the pulse is slightly slippery.

② Syndrome analysis: Damp-heat is the disease, with excessive secretion and stagnation. Therefore, the evil of damp-heat stays in the prostate, and the prostatic fluid is secreted more and the excretion is not smooth. At the end of urination or defecation, there are often milky white secretions at the urethral orifice. The prostate catheter is directly located on both sides of the seminal vesicle at the bottom of the prostate urethra and communicates with the posterior urethra. Dampness and heat spread to the urethra, causing frequent micturition, urgency, dysuria, burning sensation of urethra, incomplete micturition and other symptoms. Prostate is adjacent to rectum, and when damp heat spreads to rectum, rectal irritation symptoms such as discomfort or pain and burning sensation appear; Damp-heat enters the collaterals and hinders qi and blood, so the prostate is slightly swollen, tender and feverish. Bitter mouth and dry mouth, Huang Chi in urine, stagnant stool, yellow greasy tongue coating and slightly slippery pulse are common signs of damp heat.

(3) Treatment of clearing away heat and toxic materials, eliminating dampness and resolving turbidity.

④ The prescription "Shicheng Biqing Fenyin" was modified. Remove heat and toxic materials from Cortex Phellodendri, and remove dampness; Rhizoma Dioscoreae Septemlobae and Semen Plantaginis clear away dampness and heat; Acorus gramineus eliminates dampness and turbidity; Salvia miltiorrhiza cools blood and promotes blood circulation. Adding Rhizoma Polygoni Cuspidati, Herba Patriniae, Caulis Sargentodoxae, and Flos Lonicerae with the functions of clearing away heat and toxic materials, promoting blood circulation, and eliminating carbuncle, is helpful for clearing damp-heat in prostate, promoting qi circulation, and promoting blood circulation; Rhizoma Smilacis Glabrae and Herba Dianthi have the functions of clearing away heat and toxic materials, promoting diuresis and removing dampness, and are helpful for the dissipation of damp heat in urethra without flowing into prostate. There is a way for the dissipation of damp heat in prostate, that is, from urethra. Dry stool, use rhubarb; For those with obvious tingling, add peach kernel, red peony root, pangolin and other products to remove blood stasis; Dry mouth, combined with Fructus Trichosanthis, can not only nourish yin and promote fluid production, but also remove blood stasis and turbidity. Generally, the drug dose of leukocytes in full field is slightly larger.

(2) Blood stasis syndrome

① The clinical manifestations of this type are longer, and it is more common for those who have received prostate injection treatment. The pain is obvious. It is common that the perineum and posterior urethra sting, resulting in pain in testicles, penis, groin or lower abdomen, frequent urination, discomfort in urination, urinary retention, urethral sting during urination, and milky white secretion at the urethral orifice are uncommon. The frequency of sexual life is often reduced by pain (mainly ejaculation pain). Mental depression, accompanied by anxiety, anxiety, insomnia and dreaminess. Prostate feels hard, normal or small in size, or has nodules, but the nodules are smooth; EPS is hard to be squeezed out. Microscopically, white blood cells can be accumulated, but unlike damp-heat type, red blood cells and lecithin bodies can also be seen. Dark tongue and astringent pulse.

② Syndrome analysis: The prostate is hot and humid for a long time, with unconsciousness, blocked blood circulation, blood stasis, prostate hardening and even nodules. Blood stasis, pain, perineum and posterior urethra tingling, testicles, penis, groin or lower abdomen pain, urethral tingling when urinating; Sexual life is also very painful, because prostate blood stasis, ejaculation contraction is unfavorable. Due to blood stasis in the prostate, decreased secretion of glandular fluid, poor excretion of glandular ducts, and rare milky secretion at the urethral orifice, EPS is difficult to be squeezed out. Because of prostate pain, patients are restless, worried, insomnia and dreamy. Blood stasis leads to collateral injury, and EPS microscopy often shows red blood cells, dark tongue and unsmooth pulse, which is the tongue pulse of blood stasis.

(3) Treatment of removing blood stasis and turbidity, softening and resolving hard mass.

④ Jiawei Fuyuan Huoxue Decoction. Rhubarb (mostly cooked rhubarb), pangolin, peach kernel, safflower, angelica, removing blood stasis and dredging collaterals, softening and resolving hard mass, pangolin has the function of expelling turbidity; In order to strengthen excretion and restore gland secretion function, wax gourd seeds, Fritillaria thunbergii, Sargentodoxa, and Patrinia scabiosaefolia are added for detoxification. Bupleurum introduces various drugs into the liver meridian, soothing the liver and relieving depression, removing blood stasis and clearing heat with Trichosanthes root, and discharging turbidity. For patients with prostate nodules, Guizhi Fuling Pill is added with leech and turmeric to break blood stasis and disperse stagnation; For those with obvious tingling, Radix Notoginseng is added; Amber powder is added to those with obvious urethral tingling; For patients with mental depression, add keel oyster, or take it alternately with Chaihu keel oyster soup, or take antelope horn powder appropriately.

(3) Cold-heat syndrome

① Clinical manifestations: The course of this type is long, often lasting for several months or years, with urethral discomfort, frequent micturition, excessive micturition, discomfort or pain in perineum and testis, and the pain sometimes wanders, or in the lower abdomen, less abdomen, or in the lower back and sacrum. Accompanied by soreness of the waist and knees, cold in the lower abdomen, perineum and testicles, cold in the feet, or fever, hot flashes, night sweats and dry mouth in the hands and feet; Spermatorrhea, hyposexuality, impotence, premature ejaculation. General weakness, listlessness, anxiety, insomnia, dreaminess, forgetfulness, even fear, inferiority, anger, and even suicidal tendencies; Dry or turbid stool, clear and yellow when urinating. Prostate palpation is normal or too big, too small, too hard, EPS is easy to get, microscopic examination shows that lecithin bodies are obviously reduced, white blood cells are too many and too few, the tongue is dark, and the pulse is thin or thin.

② Syndrome analysis: The symptoms of this type are complicated, including cold syndrome, heat syndrome, yin deficiency syndrome and yang deficiency syndrome, and mental depression is obvious. These symptoms are sometimes absent, and clinical syndrome differentiation needs to grasp the characteristics of pathogenesis. Damp heat inhibits Yang Qi, and then testicles, perineum and lower abdomen are afraid of cold; Hurt the sun be the spirit, will be cold feet loose stool; Fever, hot flashes, night sweats and dry mouth in hands and feet during yin injury; Frequent micturition, excessive micturition and uncomfortable micturition are still damp-heat; Pain vacillation is a symptom of blood stasis and qi stagnation; Mental depression and sexual dysfunction are a series of symptoms of depression and depression caused by the long course of disease and the failure to improve the symptoms of prostatitis. Dark tongue, thin pulse or thin pulse are tongue pulses that occur with time.

③ Treating cold and heat, removing blood stasis and removing turbidity.

④ Prescription of Coix lacryma-jobi Fuzi Patrinia Powder. In this prescription, coix seed is used to promote diuresis and expel turbidity, aconite root is used to promote yang and regulate qi, and Patrinia herb is used to clear heat and detoxify, remove blood stasis and expel turbidity. Adding Flos Lonicerae, Herba Taraxaci, Rhizoma Smilacis Glabrae, Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, Radix Angelicae Sinensis and Caulis Spatholobi for clearing away heat and toxic materials, nourishing blood and promoting blood circulation; Winter melon seeds and pangolin remove blood stasis and turbidity. Yin deficiency, combined with Erzhi pill; For patients with yang deficiency, cassia twig and aconite root are added to warm the vital gate, promote blood circulation and remove stasis; If the pain is obvious, combine Fuyuan Huoxue decoction or add notoginseng; For patients with mental depression, if anxious, symptomatic treatment. Use Chaihu plus Gulong Muli Decoction, Lily Dihuang Decoction, Magnolia Pinellia Decoction, Ganmai Jujube Decoction, Ganmai Jujube Decoction, Sini Powder, etc. Treat prostatitis after the depression is relieved.