“Qianxian Tang” (Prostate Decoction) for Treating Prostate Diseases

Qianxian Tang is a contemporary TCM empirical formula for treating prostate diseases, from TCM Surgery. The formula is composed of: Danshen (Salvia) 10 g, Zelan (Lycopus) 10 g, Chishao (red Paeonia) 10 g, Taoren (peach kernel) 10 g, Wangbuliuxing (Vaccaria seed) 10 g, Honghua (safflower) 4.5 g, Ruxiang (frankincense) 4.5 g, Moyao (myrrh) 4.5 g, Qingpi (green tangerine peel) 6 g, Chuanlianzi (Melia toosendan fruit) 6 g, Baizhi (Angelica dahurica) 6 g, Xiaohuixiang (foeniculum) 3 g, Baijiangcao (Patrinia) 20 g, Pugongying (Dandelion) 20 g.

This formula can be used to treat the qi-stagnation and blood-stasis syndrome caused by chronic prostatitis or prostate cancer. Symptoms include distending discomfort and pain in the lower abdomen, perineum, testicles and lumbosacral region, incomplete urination and urinary retention; a dark tongue or stasis spots, white or thin-yellow coating, and a deep and rough pulse.

If the patient also has urinary irritation symptoms such as frequent and urgent urination, reduce Taoren and add Mabiancao (Verbena) 10–30 g, Baihuasheshecao (Oldenlandia) 10–30 g, and Zhizi (Gardenia) 6–15 g to clear heat and resolve toxin. If white discharge flows from the urethra after urination, add Tufuling (Smilax glabra) 30–60 g and Bixie (Dioscorea hypoglauca) 10–20 g to drain dampness and turbidity. If kidney yang is insufficient, with cold hands and feet, pain of the waist and knees, impotence and premature ejaculation, this formula may be used together with Jinkui Shenqi Wan. If kidney yin is insufficient, with steaming bone fever and night sweats, dry throat and mouth, and heat in the hands, feet and heart, this formula may be used together with Zhibai Dihuang Wan.

This formula easily injures the healthy qi; Chuanlianzi in the formula is toxic and must not be taken long-term, and should be stopped once the condition is relieved.

Not long ago, the husband of an ovarian-cancer patient I had treated came to me for a prescription because of perineal pain caused by prostatitis. The patient had a fissured tongue, loved drinking alcohol, and his symptoms worsened after drinking. I began with Wuwei Xiaoyin Yin combined with Er Cao Dan, prescribing: Jinyinhua (Honeysuckle) 30 g, Pugongying 12 g, Tiankuizi (Semiaquilegia) 12 g, Yejuhua (wild chrysanthemum) 12 g, Zihuadiding (Viola) 12 g, Huainiuxi (Achyranthes) 12 g, Cheqianzi (Plantago seed) 15 g, Yimucao (Leonurus) 15 g, Mohanlian (Eclipta) 15 g.

When the patient bought the herbs at the pharmacy, Tiankuizi was unavailable, so I had him replace it with Mudanpi (Moutan bark). After three doses, the pain was reduced and urination was stronger. He urinated twice each night and had difficulty falling asleep again afterward. I told him not to change the effective formula and to take another ten doses. After the ten doses, the patient reported that continuing the medicine had no obvious effect.

I therefore switched to a modified Wuling San combined with Er Cao Dan: Jinqiancao (Lysimachia) 30 g, Fuling (Poria) 10 g, Zhuling (Polyporus) 10 g, Zexie (Alisma) 10 g, Sheng Baizhu (raw Atractylodes) 20 g, Yimucao 30 g, Baimaogen (Imperata rhizome) 30 g, Cheqianzi 20 g, Hanliancao (Eclipta) 30 g. Three doses; the effect after taking them was poor.

I then prescribed the original Qianxian Tang. After taking it, the patient reported a marked effect, with symptoms clearly relieved, and asked whether he could take it long-term. I told him to stop the formula once symptoms were relieved, and in the future avoid spicy food, quit tobacco and alcohol, and guard against wind-cold, to prevent recurrence.

Chronic prostatitis and prostate cancer are both difficult to treat, with long courses, easy recurrence and difficult root cure; Qianxian Tang can only relieve the patient’s symptoms and is hard to achieve a root cure. When such a disease flares, improving the clinical symptoms is already a good result.

If the patient wants to take it long-term, the herbs in this formula may be ground into powder and made with refined honey into pills the size of a parasol tree seed; take 6–10 g each time with boiled water, twice a day. The medicinal force of pills is milder than that of decoctions, with fewer side effects over long-term use, and is suitable for patients with long courses and recurrent attacks.