Abstract

This paper reviews and analyzes the literature on traditional Chinese medicine (TCM) for benign prostatic hyperplasia (BPH) over the past decade. TCM therapies-including oral herbal decoctions, acupuncture, moxibustion, tuina massage, and comprehensive interventions-show definite clinical efficacy. They significantly relieve patients' clinical symptoms and improve objective laboratory indices. This review summarizes therapeutic effects, identifies limitations in recent TCM research for BPH, and proposes future research priorities and directions.

Keywords: urinary retention; benign prostatic hyperplasia; acupuncture; moxibustion; tuina massage; TCM herb for prostate health

 

 

 

1. Introduction

Benign prostatic hyperplasia (BPH), commonly called prostate enlargement, involves abnormal overgrowth of prostate tissue leading to increased prostate volume. An enlarged prostate does not always cause symptoms; however, when it compresses the urethra and bladder neck and restricts urinary flow, it triggers difficult urination, frequent nighttime urination and other discomforts. In severe cases, it can lead to urinary retention, hydronephrosis, urinary tract infection, and renal impairment, severely reducing quality of life.

BPH affects more than 50% of middle‑aged men, and prevalence rises with age: approximately 70% in men aged 60–70 and up to 90% in those over 80.

Modern management of BPH relies mainly on surgery and pharmaceuticals, but outcomes vary widely and have clear limitations:

Surgical treatment carries high risk, multiple contraindications, and a notable recurrence rate.

Oral medications show inconsistent efficacy and frequent adverse reactions.

By contrast, TCM offers diverse, well‑tolerated, and clinically effective approaches for BPH and is widely used in clinical practice. This retrospective analysis of TCM for BPH aims to provide new strategies and research insights for clinical diagnosis and treatment.

 

 

2. TCM Disease Classification of BPH

BPH is a modern medical term and not directly named in ancient TCM texts, but its clinical manifestations match descriptions of long bi (urinary retention), lin syndrome (stranguria), and jing long (prostatic stagnation) in classical Chinese medical literature.

The earliest record appears in Huangdi Neijing (The Yellow Emperor's Internal Classic):

"One with long bi urinates dozens of times a day; this is due to deficiency."

"When middle qi is insufficient, urinary and bowel functions change."

Later scholars further clarified:

Bi: gradual onset, dribbling urine, frequent voiding

Long: acute anuria, complete urinary blockage

In TCM, BPH is treated mainly as long bi, with core patterns including:

damp‑heat accumulation

blood stasis obstruction

liver qi stagnation

spleen‑kidney qi deficiency

kidney‑yang insufficiency

TCM treatment follows the principle: formula follows pattern, method follows pathogenesis-rooted in clear understanding of etiology and mechanism.

 

3. TCM Etiology and Pathogenesis of BPH

BPH occurs mostly in men over 50. Its location is the genital chamber (prostate), closely related to the kidney, sanjiao, and bladder.

Classical TCM states:

"Disease of long bi is due to evil damaging the kidney."

"Sanjiao: excess causes long bi; deficiency causes enuresis."

"Bladder disease leads to urinary blockage; unsmooth bladder causes bi; uncontrolled bladder causes enuresis."

The core pathogenesis of BPH is:

Root deficiency: aging‑related spleen‑kidney depletion, kidney qi insufficiency, sanjiao qi transformation failure, bladder opening‑closing dysfunction

Excess in the branch: concurrent damp‑heat, blood stasis, and qi stagnation

Thus, BPH is a typical root‑deficiency and branch‑excess disorder.

 

4. TCM Treatment Principles for BPH

TCM treats BPH based on pattern differentiation:

Deficiency: tonify

Excess: drain

Mixed deficiency‑excess: tonify the root and eliminate the branch

Main principles:

Tonify deficiency: focus on tonifying the kidney to balance yin and yang, restore bladder control

Expel excess: prioritize regulating drainage in line with the idea "six fu‑organs function by unobstruction"

For deficiency: tonify spleen and kidney, warm kidney yang, activate qi to unblock waterways

For excess: activate blood, resolve stasis, clear damp‑heat, warm and transform phlegm

 

5. TCM Clinical Therapies for BPH

5.1 Oral TCM Herbal Therapy

5.1.1 Spleen‑Kidney Qi Deficiency

Jianpi Bushen Huoxue Decoction (30 cases)

Ingredients: Huangqi, Dangshen, Baizhu, Shudihuang, Shanyao, Shanzhuyu, Yizhiren, Fuling, Chenpi, Tubiechong, Rougui, Zhebeimu, Chuanniuxi, Wangbuliuxing, Taoren

Result: total effective rate 90.00%

Yishen Tonglong Formula (61 cases)

Result: total effective rate 98.36%

5.1.2 Kidney‑Yang Deficiency

Jinkui Shenqi Pill modified + acupoint application (50 cases)

Significantly improved IPSS, QOL, OABSS, Qmax, and residual urine volume

Remarkably higher response rate than Western medicine alone

Guifu Tongluo Decoction (38 cases)

Total effective rate 84.21%

Yanghe Sanleng Decoction (50 cases)

Total effective rate 94%

5.1.3 Kidney‑Yin Deficiency

Ziyin Tongbi Decoction (30 cases)

Improves symptoms, urinary flow rate, residual urine, and prostate volume

Total effective rate 86.67%

5.1.4 Damp‑Heat Accumulation

Shumitong Capsules (80 cases)

Total effective rate 87.5%, significantly better than the control

Qingli Tonglin Huayu Decoction (80 cases)

Total effective rate 81.5%

5.1.5 Kidney Deficiency with Blood Stasis

Guiyi Tonglong Formula (36 cases)

Superior to tamsulosin in improving urodynamic and inflammatory indices

Bushen Xiaolong Decoction (50 cases)

Significantly better IPSS, QOL, Qmax, residual urine, and TCM symptom scores

 

5.2 External TCM Therapies

5.2.1 Herbal Retention Enema

Custom herbal enema formulas (120 cases)

Clear damp‑heat, cool blood, resolve stasis, unblock the orifices

Total effective rate up to 94%

 

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5.2.2 Moxibustion

Salt‑separated moxibustion (Shenque, Guanyuan, Zhongji, etc.): total effective rate 91.11%

Herbal cake moxibustion on Du meridian: superior to tamsulosin for kidney deficiency + blood stasis

Du moxibustion: total effective rate 91.4% for elderly kidney‑yang deficiency

Abdominal cake moxibustion: total effective rate 90.9%, low recurrence

5.2.3 Sitz Bath, Fumigation, and Massage

Herbal sitz bath + self‑designed Yixian Decoction: total effective rate 88.89%Local prostate massage + herbal sitz bath: total effective rate 97.5%

5.3 Comprehensive TCM Therapy

Herbs + acupuncture + anal lifting exercise: better efficacy than herbs alone

Warm acupuncture + Yishen Huayu Formula: total effective rate 91.9% vs. 70.3% in the control

All regimens improve:

IPSS (International Prostate Symptom Score)

QOL (Quality of Life)

Qmax (peak urinary flow rate)

Residual urine volume

Prostate volume

PSA and hormone balance

 

6. Cistanche tubulosa: A Premium TCM Herb for Prostate Health

Why Cistanche tubulosa Stands Out

We are Chengdu Wecistanche Bio‑Tech Co., Ltd., the world's largest manufacturer specializing in Cistanche tubulosa extract with a full industrial chain:

200,000‑mu standardized plantation base

GMP‑certified production workshop

15,000‑ton fresh herb storage capacity

Advanced ultrafiltration and nanofiltration purification technology

Our Cistanche tubulosa extract has far higher active content than ordinary Cistanche:

Echinacoside ≥ 25%–32%

Acteoside ≥ 9%–12%

Total phenylethanol glycosides ≥ 60%–75%

Cistanche Benefits for BPH & Male Health

Scientific research (PubMed‑supported) confirms:

Potent anti‑inflammatory & antioxidantInhibits TNF‑α, IL‑6, and oxidative stress; relieves prostate swelling and pelvic discomfort.→ TCM herb for frequent urination & pelvic pain

Improves urinary functionTonifies kidney qi, smoothes bladder function, reduces frequent nighttime urination, weak stream, and incomplete emptying.→ TCM herb for weak urine flow & nocturia

Supports male hormone balanceUpregulates StAR, CYP11A1, CYP17A1, and HSD17β3 to enhance testosterone synthesis.→ TCM herb for low energy & low libido

Enhances sperm quality & fertilityImproves sperm count, motility, and morphology; reduces abnormal forms.→ TCM herb for male fertility support

Safe for long‑term useGentle on digestion, no notable side effects-ideal for daily prostate maintenance.

Suitable For

Men 35+ with BPH‑related urinary discomforts

Those with frequent nighttime urination, slow flow, dribbling

Men concerned about prostate health, energy, and vitality

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7. Summary and Outlook

BPH prevalence is rising with global aging. TCM has recognized and treated this condition for more than 2,000 years with stable efficacy, good safety, and diverse modalities.

Current limitations:

Insufficient basic research

Small sample sizes

Lack of large‑scale multi‑center trials

No unified TCM protocol

Future directions:

High‑quality evidence‑based research

Standardized TCM herbal formulas

Precision pattern differentiation

Development of high‑potency botanical extracts such as Cistanche tubulosa

Premium Cistanche tubulosa extract-with its high echinacoside and acteoside content-represents a modern, science‑backed evolution of TCM for prostate health, male vitality, and urinary comfort.

 

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