Moxibustion as an adjunct for lower urinary tract symptoms associated with benign prostate enlargement A randomized controlled pilot trial

Background: Benign prostatic enlargement (BPE) causes discomfort in daily life, including lower urinary tract symptoms (LUTSs) caused by the enlarged prostate, and requires long-term management as a chronic, irreversible disease. To improve LUTS, certain complementary therapies have been used with or without doctors' directions. Conventional treatments and complementary therapies tend to be combined unsystematically, depending on patient preference; thus, research for safe and efficient combination therapy is warranted. Methods: Twenty-nine participants were randomly assigned to an integrative group (IG, n = 15) or a conventional group (CG, n = 14). The IG received moxibustion (twice weekly for 4 weeks, at the acupuncture points SP6, LR3, and CV4) and conventional medication for 4 weeks, followed by conventional medication alone for 8 weeks. The CG received conventional medication alone for 12 weeks. The outcome measures were International Prostate Symptom Score (IPSS), patient's global impression of changes (PGIC), maximum urinary flow rate (Q(max)), postvoid residual urine volume (PVR), and frequency-volume chart. Results: Total IPSS (IG, -2.4 +/- 4.2; CG, 0.9 +/- 4.0; P = .039), PGIC-A (IG, 3.5 +/- 1.0; CG, 2.2 +/- 1.0; P = .001), and PGIC-B (IG, 3.5 +/- 0.1; CG, 4.7 +/- 0.6; P = .004) were significantly improved in the IG compared with the CG, 4 weeks after baseline. Among the IPSS items, incomplete emptying (IG, -0.6 +/- 0.7; CG, 0.4 +/- 1.2; P = .019), straining (IG, -0.6 +/- 0.8; CG, 0.2 +/- 1.2; P = .046), and nocturia (IG, -0.8 +/- 1.4; CG, 0.1 +/- 1.0; P = .045) showed significant differences. The Q(max) and PVR volume did not differ significantly at 12 weeks after the baseline. Conclusion: Moxibustion can be considered an adjunct therapy to improve LUTS in BPE patients. A full-sized randomized controlled trial would be feasible with comparator modifications and an extended study period. The study design should include a placebo group and narrow the eligibility to subjects who do not respond well to conventional treatments.