Abstract

Type III prostatitis (chronic prostatitis/chronic pelvic pain syndrome, CP/CPPS) is the most common type of prostatitis. "Blood stasis in the collaterals" is considered the core pathogenesis of CP/CPPS, with Kidney Qi deficiency as the root (underlying deficiency), and blood stasis, dampness–heat, and Qi stagnation as major pathological factors. The disorder is associated with multiple triggers, including external pathogenic factors, irregular diet, excessive sexual activity, and emotional injury.

Guided by "Collateral Disease Theory," Professor Sun Zixue treats CP/CPPS by emphasizing "unblocking the collaterals" (tongluo) and skillfully employing insect-based and vine-based medicinals to open obstruction and improve circulation within the collateral network. He has also developed the Jiedu Tongluo Suppository and the Yiyuan Tongluo Acupuncture method for this condition, achieving favorable clinical outcomes.

Key words: Type III prostatitis; collateral disease theory; Jiedu Tongluo Suppository; Yiyuan Tongluo Acupuncture; Sun Zixue

 

 

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1. Overview of Prostatitis and Type III Prostatitis (CP/CPPS)

Prostatitis is a common disease in young and middle-aged men. Type III prostatitis-also known as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)-is mainly characterized by a disease course longer than 3 months, recurrent pelvic-region pain, and abnormal urination symptoms. 1–21–21–2

Type III prostatitis is the most common subtype, accounting for approximately 90%–95% of all prostatitis cases. 333 In Type IIIA prostatitis, the leukocyte count in expressed prostatic secretion is increased, whereas in Type IIIB prostatitis it is not increased. 444

Given the complex etiology, chronicity, and tendency to relapse, Professor Sun Zixue considers that CP/CPPS matches the collateral-disease concept in traditional Chinese medicine (TCM), particularly the idea that "prolonged disease enters the collaterals." 555 Therefore, treatment should take "unblocking the collaterals" as the central therapeutic principle.

Professor Sun Zixue is a recipient of China's State Council Special Government Allowance, a first-batch "Zhongyuan Famous Doctor," a first-batch "Famous TCM Doctor of Henan Province," an Outstanding Expert of Henan Province, a second-level professor, chief physician, and doctoral supervisor. He has served as Honorary Director (3rd Committee) of the Reproductive Medicine Branch of the China Association of Chinese Medicine and Vice President of the Reproductive Medicine Branch of the World Federation of Chinese Medicine Societies, among other roles. With more than 30 years of clinical practice in andrology, he has accumulated rich experience. This article summarizes his academic viewpoints and clinical experience in treating CP/CPPS based on collateral-disease theory.

 

2. Formation and Development of Collateral Disease Theory

The formation of collateral disease theory has been a long historical process. In TCM, "collaterals" (luo) refer to the fine branches of the meridian system-namely "collateral vessels" (luomai). They function to transport Qi and blood, connect the viscera and limbs, and communicate the interior and exterior as well as the upper and lower parts of the body. Collaterals include floating collaterals, minute collaterals, yin collaterals, and yang collaterals.

The Lingshu · Maidu states: "The meridians are internal; branches running transversely are collaterals; the branches of collaterals are minute collaterals," which first proposed the concept of "collaterals" and laid the foundation for collateral disease theory.

On this basis, Zhang Zhongjing further developed the theory in Treatise on Cold Damage and Miscellaneous Diseases, proposing ideas such as "heat urgency injures the collaterals," "collaterals are vacuous," and "pathogen resides in the collaterals," and offering more clinically applicable methods for treating collateral disorders.

Ye Tianshi, in Clinical Guide to Medical Records, stated that "in the initial stage, Qi constraint is in the meridians; over time blood is damaged and enters the collaterals" and that "long-standing chronic diseases must be in the collaterals." He proposed the viewpoints of "prolonged disease enters the collaterals" and "prolonged pain enters the collaterals," and emphasized that collateral disease should be treated through the blood, using pungent, aromatic, moistening, and warming medicinals to regulate Qi dynamics, with harmonizing and freeing the blood vessels as the main method. 666 At this stage, collateral disease theory became increasingly mature.

Modern physicians summarize collateral disorders as a category of syndromes in which various factors cause collateral obstruction, leading to impaired Qi–blood movement. 777 Academician Wu Yiling proposed a "three-dimensional network system" theoretical framework, highly generalizing collateral characteristics: collateral branches diverge and cross, subdivide layer by layer, have fine and narrow structures, distribute in a net-like pattern, differentiate into yin and yang, and course between interior and exterior. 888 Thus, collateral disease theory has formed a relatively complete theoretical system.

 

 

 

3. Relationship Between Collateral Disease Theory and CP/CPPS

CP/CPPS is long-standing, stubborn, and prone to relapse, with recurrent pelvic pain as its main symptom. These features align with the collateral-disease characteristics of "prolonged disease enters the collaterals" and "prolonged pain enters the collaterals." In addition, collaterals subdivide progressively and are fine, narrow, and tortuous; Qi and blood flow slowly within them. This leads to the pathomechanism of "deep entry over time, difficult exit, easy stagnation, and easy stasis." 999

Clinically, collateral disorders can be summarized as "chronic, painful, stasis-related, difficult-to-treat, and unusual." 101010 These features match the clinical presentation of CP/CPPS.

TCM does not have an organ term exactly corresponding to the "prostate." In ancient texts it was referred to as the "essence chamber" (jingshi) or "male uterus" (nanzi bao). Modern TCM researchers suggest that the prostate's morphology and physiological function fit the "extraordinary fu-organs" (qiheng zhi fu), which "resemble fu in form, resemble zang in function, and both store and discharge." 111111 The prostate stores and secretes prostatic fluid; its storage function resembles the zang organs' "storing essence without leakage," while its secretory function resembles the fu organs. Therefore, it is classified as an extraordinary fu-organ and is characterized by "using free flow as its function," 121212 which implies a tendency toward stasis when flow is blocked.

Modern anatomical observations indicate that the prostate has special structural features: its ducts enter the urethra at right or oblique angles, and there are many sinus-like blind ducts. Such structures weaken drainage power, making substances prone to accumulation at the outlet; over time this causes outlet obstruction, impairs drainage of prostatic fluid, and contributes to congestion and inflammation. Meanwhile, arteries supplying the prostate are relatively larger, whereas veins are often fine and tortuous; during inflammation this predisposes to microcirculatory stagnation and blood stasis. 131313 When Qi movement is impeded and blood flow is obstructed, stasis accumulates in the collaterals; because collaterals are narrow and tortuous and flow is slow, obstruction worsens, leading to prostate swelling, perineal pain, and related symptoms.

In summary, the prostate's physiological and pathological characteristics-together with its anatomical structure-predispose it to "easy stasis," and the clinical features and pathogenesis of CP/CPPS are closely related to collateral disease theory.

4. "Collateral Obstruction by Stasis" as the Core Mechanism of CP/CPPS

TCM does not use the disease name "CP/CPPS." Based on its manifestations, it can be categorized under "turbid essence" (jingzhuo), "white turbidity" (baizhuo), or "white discharge" (baiyin).

Professor Sun Zixue holds that "collateral obstruction by stasis" is the core mechanism of CP/CPPS, with Kidney Qi deficiency as the root, and blood stasis, dampness–heat, and Qi stagnation as pathological factors. The condition is associated with multiple causes such as external six pathogens, dietary irregularities, excessive sexual activity, and emotional injury.

4.1 Kidney Qi deficiency as the root

The Suwen · Wei Lun states: "Endless thinking, unfulfilled desires, excessive sexual fantasy, and excessive intercourse lead to slackening of the 'ancestral sinews' and result in sinew atrophy and white discharge." This indicates that excessive sexual fantasy and overindulgence are among the causes.

The Treatise on the Causes and Symptoms of Diseases states: "Overwork damages the Kidney; Kidney Qi becomes deficient and cold… the bladder becomes cold and the Kidney is damaged; therefore urine is white and turbid." This suggests that Kidney Qi deficiency is a key mechanism.

Excessive sexual activity may deplete Kidney essence, weaken consolidation, and impair Kidney yin and yang; constitutional deficiency may also lead to Kidney Qi depletion. If Kidney yang is deficient, it fails to warm and activate the channels and cannot propel Qi and blood; stagnation develops and transforms into stasis, obstructing the collaterals. If Kidney yin is deficient, minister fire flares; deficient heat scorches the blood and produces stasis, which blocks the collaterals. Thus, Professor Sun emphasizes that Kidney Qi deficiency is fundamental, and blood stasis is both a pathological product and a pathogenic factor.

4.2 Blood stasis, dampness–heat, and Qi stagnation as pathological factors

Overconsumption of rich, greasy foods can generate internal dampness–heat, or external dampness–heat can invade; dampness–heat descends to the essence chamber and impedes Qi–blood movement, leading to turbid essence and stasis obstructing the collaterals.

Yilin Gaicuo · Jikuai states: "When blood is heated, it is煎熬 (decocted/scorched) into masses." Dampness–heat can "refine" blood into stasis, and stasis obstruction of collaterals can trigger the disease.

Yilei Yuanchong states: "Excessive worry makes yin and yang indistinct; clear and turbid mix; urine becomes white and turbid." Excessive rumination can cause Liver Qi constraint; Qi stagnation fails to move blood, leading to stasis obstruction in the collaterals.

Thus, dampness–heat, Qi stagnation, and blood stasis caused by various factors constitute key pathological factors of CP/CPPS.

 

5. Treating CP/CPPS Based on Collateral Disease Theory

5.1 Syndrome differentiation with an emphasis on unblocking collaterals

Professor Sun states that CP/CPPS commonly presents clinically as:

dampness–heat with stasis obstruction,

Liver Qi constraint,

Kidney deficiency with collateral obstruction,

yin deficiency with hyperactive fire.

These often appear in combinations with mixed deficiency and excess (e.g., Kidney deficiency with dampness–heat; Liver constraint with Kidney deficiency; Liver–Kidney yin deficiency). Because "collateral obstruction by stasis" is the core mechanism, treatment should combine syndrome differentiation with tongluo (unblocking the collaterals).

When collaterals are deficient (luo xu), "unblocking plus supplementation" (tongbu) should be used-supporting the upright Qi while unblocking the collaterals-echoing Ye Tianshi: "In general, when collaterals are deficient, unblocking with supplementation is most appropriate." When collaterals are excessive/blocked by pathogens (luo shi), pathogen-expelling tongluo methods should be used, such as clearing heat and draining dampness with tongluo, dispelling stasis with tongluo, and regulating Qi with tongluo.

5.1.1 Clearing heat and draining dampness to expel pathogens and unblock collaterals

Dampness is a yin pathogen; it is heavy, turbid, and prone to lingering in channels and collaterals, obstructing Qi dynamics. The Suwen · Yin Yang Ying Xiang Da Lun says: "Cold damages form; heat damages Qi." When dampness and heat combine, heat assists dampness and damages Qi, while dampness' sticky turbidity makes heat difficult to remove. As stated in Differentiation of Dampness-Heat: when dampness and heat are separate, disease is mild and slow; when they intermix, disease is severe and rapid.

Professor Sun believes dampness–heat contributes to collateral obstruction. Treatment should focus on clearing heat and draining dampness, assisted by herbs that transform stasis and unblock collaterals. Commonly used medicinals include: Gentianae Radix et Rhizoma (Longdancao), Gardeniae Fructus (Zhizi), Scutellariae Radix (Huangqin), Plantaginis Semen (Cheqianzi), Dioscoreae Hypoglaucae Rhizoma (Mianbixie), Polygoni Avicularis Herba (Bianxu), Dianthi Herba (Qumai), Phellodendri Cortex (Huangbai), Coicis Semen (Yiyiren), Taraxaci Herba (Pugongying), Salviae Miltiorrhizae Radix et Rhizoma (Danshen), Patriniae Herba (Baijiangcao), Sargentodoxae Caulis (Daxueteng), etc. Longdancao is particularly effective for dampness–heat in the middle and lower burners; because it is bitter and cold, dosage should be small-Professor Sun often uses no more than 5 g and avoids prolonged use, stopping once the condition is controlled.

Modern pharmacological studies suggest such medicinals have anti-inflammatory effects; for example, Longdancao has anti-inflammatory and analgesic actions and can reduce inflammatory responses caused by various bacteria. 141414 Clinically, some physicians have used heat-clearing, dampness-draining, and blood-activating formulas to reduce prostatic inflammation and improve local/systemic symptoms. 151515

5.1.2 Soothing the Liver, relieving constraint, regulating Qi, and unblocking collaterals

The ascending/descending and entering/exiting of Qi depends on the Liver's coursing and discharge; normal Qi–blood circulation is closely related to the Liver. Professor Sun holds that Liver constraint leads to Qi stagnation, and Qi stagnation leads to poor blood flow. Because veins entering the prostate are fine and tortuous-similar to the tortuous nature of collaterals-stagnant Qi–blood readily forms stasis here; when stasis blocks collaterals, CP/CPPS occurs.

Treatment often uses modified Chaihu Shugan San to soothe the Liver and move Qi. He frequently adds Litchi Semen (Lizhike) and salt-processed Citrus seed (Yan Juhé) to regulate Qi, soothe the Liver, and guide medicinals to the affected site. Adjustments are made based on cold/heat: for heat, pair with Moutan Cortex (Mudanpi), Paeoniae Radix Rubra (Chishao), Pheretima (Dilong), etc.; for cold, combine with Angelicae Sinensis Radix (Danggui) and Chuanxiong Rhizoma (Chuanxiong) to regulate Qi and activate blood for pain relief. He also often combines "wind-dispersing" medicinals with Liver-soothing herbs because their dispersing, moving nature enhances Qi-moving and constraint-relieving effects. 161616

Modern research indicates that Chaihu Shugan San may act through multiple targets related to protein kinases (e.g., AKT1, MAPK3), inflammatory mediators (e.g., IL-6, IL-2, IL-1β, ALB), and growth factor pathways (e.g., SRC, EGFR, KDR), thereby inhibiting inflammation, reducing growth-factor release from immune cells, decreasing inflammation and fibrosis, improving antioxidative defense, and activating chemokine signaling pathways in chronic prostatitis. 171717

5.1.3 Tonifying Kidney Qi and supporting the upright to unblock collaterals ("unblocking-with-supplementation")

The Kidney is the congenital foundation. When Kidney essence is deficient, it cannot generate sufficient Kidney Qi; the propelling force of Qi weakens, Qi–blood movement slows, and stasis obstructs the collaterals.

Based on the mechanism of "Kidney deficiency with collateral obstruction," Professor Sun developed the Yishen Tongluo Formula for this pattern of CP/CPPS. Common ingredients include Astragali Radix (Huangqi), Cuscutae Semen (Tusizi), Epimedii Herba (Yinyanghuo), Rehmanniae Radix Preparata (Shudihuang), Salvia miltiorrhiza (Danshen), Hirudo (Shuizhi), Cyathulae Radix (Chuanniuxi), Litchi Semen (Lizhike), Angelicae Dahuricae Radix (Baizhi), and Jiu Xiang Chong (Aspongopus).

This formula may reduce prostatic compression of the urethra, improve dysuria, lower WBC counts in prostatic fluid, increase lecithin bodies, improve prostatic function, and thereby improve symptoms and quality of life in CP/CPPS patients. 181818

Studies suggest Yishen Tongluo Formula may treat CP/CPPS by participating in immune regulation and improving inflammatory cytokine cascades-reducing serum TNF-α, IFN-γ, IL-1β, IL-6, etc., lowering SIgA, VCAM-1, and WBC in prostatic fluid, and increasing SPL. 191919

5.1.4 Nourishing yin, clearing deficient fire, transforming stasis, and unblocking collaterals

The Suwen · Tiaojing Lun states: "Yang deficiency leads to external cold; yin deficiency leads to internal heat." Yin deficiency with internal heat can be a cause. If internal heat is not cleared and tongluo is used indiscriminately, upright Qi may be damaged, worsening stasis.

Professor Sun believes this pattern often results from excessive sexual activity causing depletion of Kidney essence and Kidney yin, leading to hyperactivity of minister fire. In addition to herbs, patients should reduce sexual frequency to prevent repeated prostatic congestion during erection, which may aggravate disease. Common medicinals include Shudihuang, Shanzhuyu, Shanyao, Huangbai, Zhimu, Cheqianzi, Fuling, Zexie, Mudanpi, Chishao, Danshen, Daxueteng, Baijiangcao, etc. Zhimu and Huangbai are particularly effective for nourishing yin and clearing fire, often paired with sweet-cold or pungent-bitter blood-activating herbs to enhance the yin-nourishing effect. 202020

 

5.2 Skillful use of insect and vine medicinals: "reaching the collaterals"

Professor Sun frequently combines insect-based and vine-based medicinals when treating CP/CPPS.

Insect medicinals are "flesh-and-blood" substances that can search and free the channels, drive out stasis, and unblock collaterals; their collateral-unblocking force is often considered stronger than that of botanical medicinals. Professor Sun commonly uses Hirudo (Shuizhi), Pheretima (Dilong), and Jiu Xiang Chong. Hirudo is salty and enters the Liver channel, with functions of breaking blood and unblocking the channels and dispelling stasis masses. Dilong is salty, entering the Liver, Spleen, and Bladder channels, with effects of unblocking collaterals and promoting urination; it is often used in dampness–heat with stasis. Jiu Xiang Chong regulates Qi and relieves pain, warms the middle, and supports yang; it is used when Liver constraint and Kidney deficiency coexist. Because Hirudo is strongly stasis-dispelling, it is added when stasis is severe.

Vine medicinals resemble the body's channel network in form, and by the method of "correspondence by analogy," they are thought to both dispel collateral pathogens and guide medicinals to the affected site. 212121 Professor Sun often uses Sargentodoxae Caulis (Daxueteng) and Spatholobi Caulis (Jixueteng). Daxueteng clears heat and toxins and activates blood to unblock collaterals; Jixueteng nourishes and invigorates blood. When combined appropriately, vine medicinals can strengthen tongluo effects and guide therapy to the prostate region.

 

5.3 Integrating internal and external therapies to enhance efficacy

Based on years of experience, Professor Sun developed the Jiedu Tongluo Suppository and the Yiyuan Tongluo Acupuncture method, used together with oral herbal therapy for CP/CPPS, and achieved good results. 22–2322–2322–23

5.3.1 Jiedu Tongluo Suppository

The suppository is mainly composed of Rhei Radix et Rhizoma (Dahuang), Hirudo (Shuizhi), Phellodendri Cortex (Huangbai), Paeoniae Radix Rubra (Chishao), Salvia miltiorrhiza (Danshen), Corydalis Rhizoma (Yanhusuo), Olibanum (Ruxiang), and Myrrha (Moyao). It functions to clear heat and toxins and activate blood to unblock collaterals.

Chief medicinals: Dahuang (clears heat, drains fire, detoxifies) and Shuizhi (dispels stasis, unblocks channels).

Deputy medicinals: Chishao (breaks stasis and promotes urination), Huangbai (clears dampness–heat in the lower burner), Danshen (invigorates blood and generates new), Ruxiang and Moyao (invigorate blood and reduce swelling)-enhancing detoxification and stasis-dispelling.

Assistant medicinal: Yanhusuo moves Qi within blood and blood within Qi, treating pain throughout the body-enhancing analgesic effect.

Modern studies suggest that because the prostate is close to the rectum, rectal administration can increase drug concentration in the prostate. 242424 Therefore, suppositories may have certain advantages in treating prostate diseases.

5.3.2 Yiyuan Tongluo Acupuncture method

Two groups of acupoints are used alternately.

Group 1 main points: Guanyuan (CV4), Taichong (LR3), etc.

Group 2 main points: Shenshu (BL23), Geshu (BL17), etc.

Points are selected based on syndrome differentiation. Guanyuan and Shenshu tonify the Kidney and strengthen original Qi to support upright Qi; Taichong and Geshu transform stasis and unblock collaterals to expel pathogens. Together, they tonify the Kidney, benefit Qi, transform stasis, and unblock collaterals. Needling is used to free the channels and harmonize Qi and blood, suitable for collateral obstruction due to various causes.

 

6. Treating Before Disease: Preventing Progression and Relapse

CP/CPPS is chronic and prone to relapse; prevention and rehabilitation care are crucial. Professor Sun follows the TCM principle of "treating before disease," including "preventing progression once ill" and "preventing relapse after recovery." 252525

In early CP/CPPS, timely treatment and appropriate use of blood-activating tongluo medicinals help prevent formation of stasis due to pathological factors and reduce obstruction of collaterals in the essence chamber, thereby delaying or preventing disease progression.

After initial recovery, Professor Sun prevents relapse through three aspects: pharmacotherapy, daily care, and psychological intervention. At this stage, residual pathogens may remain while upright Qi has not fully recovered; Qi, blood, yin, and yang are not yet harmonized. Thus, upright Qi should be supported to address collateral deficiency, and tongluo methods used to eliminate residual obstruction-consistent with "when upright Qi is strong inside, pathogens cannot invade."

Clinically, depending on patient presentation, he may recommend herbal teas using Huangqi, Gouqizi, Danshen, Danzhuye, Mianbixie, Dengxincao, Jinyinhua, and corn silk, etc., and may combine Jiedu Tongluo Suppository to strengthen tongluo effects and prevent relapse.

Lifestyle advice includes: avoid prolonged sitting, avoid alcohol, avoid excessive sexual activity, avoid spicy/grilled foods, perform pelvic floor (anal-lift) exercises, and consider dietary support such as eating 1–2 apples daily.

Because CP/CPPS is long-standing, recurrent pain or lower urinary tract symptoms can lead to anxiety. Psychological intervention can relieve anxiety, promote smooth Liver Qi, and thereby promote blood flow-helping keep collaterals open and reducing relapse risk.

 

7. Cistanche (Rou Cong Rong) as a Reader-Friendly Bridge: How TCM "Tonifies the Kidney" and Supports Male Vitality (Supplementary Perspective)

For Western readers, a key challenge is that "Kidney" in TCM is not identical to the anatomical kidney in biomedicine; it is a functional system related to growth, reproduction, endocrine-like vitality, and foundational energy. Within this framework, Cistanche (Rou Cong Rong; Cistanches Herba) is traditionally categorized as a tonic that "warms and tonifies Kidney yang," and it is widely discussed in the context of male vitality.

From a modern research perspective, reviews of Cistanches Herba describe its major chemical constituents and summarize pharmacological activities (e.g., neuroprotective, anti-inflammatory, antioxidative, and immunomodulatory potentials), providing a plausible biological basis for why it is studied for conditions involving chronic inflammation and functional decline. (pubmed.ncbi.nlm.nih.gov)

In consumer-facing education and product marketing, Cistanche is also promoted for prostate and male health support (for example, claims around urinary comfort, vitality, and prostate-related symptoms). These materials can help readers understand how TCM tonics are positioned in integrative health narratives, but they should be interpreted cautiously because marketing content is not equivalent to clinical trial evidence. (xjcistanche.com)

How to integrate this into the "collateral disease" framework (interpretive integration):

When CP/CPPS is viewed as "root deficiency (Kidney Qi/Kidney yang) with branch excess (stasis, dampness–heat, Qi stagnation)," tonic herbs such as Cistanche may be discussed as supporting the root, while tongluo and heat-clearing strategies address the "branch."

In other words: tonify (support function) + unblock (improve flow)-a layered strategy that is often easier for Western readers to conceptualize than a single-mechanism model.

Note: If you want, I can add a short "Safety & Interaction" paragraph for Western readers (e.g., pregnancy, anticoagulants, chronic disease medications), but I would need either (a) your preferred sources, or (b) permission to add reputable external sources.

 

8. Conclusion

CP/CPPS is a common disorder in young and middle-aged men. It is chronic, prone to relapse, and may be complicated by sexual dysfunction and psychological disorders. Because its etiology is complex, it is difficult to explain by a single cause or mechanism, and purely biomedical treatment may be limited. TCM's combination of internal and external therapies offers certain advantages.

Guided by collateral disease theory, Professor Sun Zixue constructs a CP/CPPS diagnostic and therapeutic system centered on tongluo (unblocking the collaterals). He flexibly uses two major strategies-supporting upright Qi to unblock collaterals and expelling pathogens to unblock collaterals-and created the Jiedu Tongluo Suppository and Yiyuan Tongluo Acupuncture method. Combined with oral herbal therapy, this integrated approach (internal–external combination, acupuncture plus herbs) enhances therapeutic outcomes and provides a useful clinical paradigm for CP/CPPS.

 

References

111 Shao Yuzhen, Sun Zixue, Li Pengchao, et al. Efficacy observation of mang-needle therapy for Type IIIB prostatitis patients with the dampness–heat and stasis obstruction pattern. Zhen Ci Yan Jiu (Acupuncture Research), 2024(3):296–301.
222 Zhai Zhaoyong, Sun Zixue, Zhang Yizheng, et al. Clinical efficacy of Bixie Qianlie'an Pills combined with conventional therapy in Type IIIB prostatitis patients with the Kidney deficiency, dampness–heat, and collateral obstruction pattern. Yiyao Luntan Zazhi (Journal of Medical Forum), 2024, 45(14):1544–1548, 1553.
333 Rossotti R, Travi G, Bana NB, et al. A case of chronic bacterial prostatitis due to Mycoplasma genitalium. Sex Transm Infect, 2023, 99(8):571–573.
444 Zhang Minjian, Chang Degui, Bin Bin, et al. Guidelines for integrated Chinese and Western medicine diagnosis and treatment of chronic prostatitis. Zhongguo Nankexue Zazhi (Chinese Journal of Andrology), 2023, 37(1):3–17.
555 Zhang Zhiduo, Jiang Xiaofeng, Shi Xiaowei, et al. Discussion on vibrational abdominal manipulation for chronic prostatitis based on collateral disease theory. Beijing Zhongyiyao, 2024, 43(12):1427–1430.
666 Du Ji, Jin Baofang. Ye Tianshi's collateral disease theory and microcirculation research. Journal of Yunnan University of Chinese Medicine, 2025, 48(1):16–19, 34.
777 Feng Wei, Chen Zhigang. The course and current status of collateral disease theory. Beijing Zhongyiyao, 2009, 28(8):603–606.
888 Li Hongrong, Wu Yiling. Inheritance and innovation of collateral disease research. Journal of Nanjing University of Chinese Medicine, 2022, 38(12):1075–1085.
999 Yuan Jingyun, Wu Xiaodong, Mou Dongxiao, et al. Diagnosis and treatment ideas for gynecological masses based on collateral disease theory. World Chinese Medicine, 2024, 19(2):191–195.
101010 Chang Fuye, Wang Yongyan. Analysis of collateral disease syndrome differentiation. Journal of Beijing University of Chinese Medicine, 2003, 26(6):9–11.
111111 Yu Xudong, Zhang Yaosheng. Theoretical origins and connotation of "male uterus (nanzi bao)." Journal of Traditional Chinese Medicine, 2023, 64(16):1721–1724.
121212 Sun Zixue, Zhang Yunshan, Li Pengchao, et al. Diagnostic and therapeutic thinking on benign prostatic hyperplasia based on collateral disease theory. Shizhen Guoyi Guoyao, 2018, 29(12):2986–2987.
131313 Li Haisong, Han Fuqiang, Wang Bin. A preliminary discussion on collateral disease in andrology. Journal of Beijing University of Chinese Medicine, 2009, 32(10):719–720.
141414 Qin Congcong, Zhang Shimin, Li Yuqing. Historical evolution of Gentiana (Longdan) processing and studies on chemical constituents and pharmacological effects. Zhonghua Zhongyiyao Xuekan, 2026, 44(1):133–139.
151515 Chen Yishen, Hong Zhongsi, Zhan Hongrui, et al. Clinical observation of Qingre Lishi Huayu Decoction combined with Shenitong in chronic abacterial prostatitis. Zhongyaocai, 2014, 37(7):1311–1313.
161616 Sun Zixue, Li Pengchao. Application of "wind medicinals" in the treatment of erectile dysfunction. Journal of Traditional Chinese Medicine, 2017, 58(13):1155–1156.
171717 Zhu Xiaoyun, Ba Yuanming. Network pharmacology study on Chaihu Shugan San in chronic prostatitis. China Medical Herald, 2021, 18(9):30–34, 47.
181818 Sun Zixue, Zhang Jiaming, Chen Jianshe, et al. Efficacy evaluation of Yishen Tongluo Formula for Type III prostatitis with Kidney deficiency and collateral obstruction pattern. Chinese Journal of Integrated Traditional and Western Medicine, 2020, 40(11):1345–1349.
191919 Zhang Hua, Sun Zixue. Clinical observation of Yishen Tongluo Formula in chronic prostatitis with Kidney deficiency and blood stasis pattern. Chinese Journal of Experimental Traditional Medical Formulae, 2018, 24(21):182–187.
202020 Sun Zixue, Li Pengchao, Men Bo, et al. Men Chengfu's experience in treating benign prostatic hyperplasia from stasis. Zhonghua Zhongyiyao Xuekan, 2019, 37(10):2314–2317.
212121 Xiao Mingzhi, Zhang Shiwen, Pang Xinxin, et al. Six methods of using vine medicinals. Zhonghua Zhongyiyao Zazhi, 2025, 40(3):1470–1473.
222222 Zeng Qingyun, Wang Shengyue, Wu Qingheng, et al. Efficacy evaluation of Qianlie suppository in Type III prostatitis with dampness–heat and stasis obstruction pattern. Chinese Journal of Andrology, 2025, 39(2):85–89.
232323 Sun Zixue, Li Xinyang, Chen Jianshe, et al. Qianlie suppository combined with tamsulosin sustained-release capsules in benign prostatic hyperplasia with dampness–heat and stasis obstruction pattern: a clinical observation. Zhonghua Zhongyiyao Xuekan, 2023, 41(5):1–5.
242424 Qu Tao, Zhang Hua, Chen Jianshe. Qianlie Shutong capsules combined with Qianliekang enema decoction in Type III chronic prostatitis with dampness–heat and stasis obstruction pattern. Zhongchengyao, 2020, 42(5):1199–1203.
252525 Sun Zixue, Li Pengchao. Prevention and treatment of chronic prostatitis based on the TCM concept of "treating before disease." Liaoning Journal of Traditional Chinese Medicine, 2018, 45(7):1401–1403.

 

Supplementary (Cistanche-related, non-clinical marketing/education sources):

XJ Cistanche (news/education page): "Say Goodbye to Prostate Problems with Cistanche …" (xjcistanche.com)

Alibaba product listing page (commercial): "Herbal Cistanche Prostate Supplement …" (alibaba.com)

Academic overview of Cistanches Herba (pharmacology/PK review): PubMed entry (pubmed.ncbi.nlm.nih.gov)