Sandhu Jaspreet S, Vaughan E Darracott
Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Drugs Aging. 2005;22(11):901-12. doi: 10.2165/00002512-200522110-00002.
The management of symptomatic benign prostatic hyperplasia (BPH) continues to evolve, with new techniques and forms of medical management being introduced and traditional surgical techniques being used less frequently. Medical management of BPH has evolved from nonspecific alpha-adrenoceptor antagonists to uroselective alpha-adrenoceptor antagonists and 5-alpha reductase inhibitors. Traditionally, alpha-adrenoceptor antagonists have been used for relief of lower urinary tract symptoms (LUTS) as a result of BPH and are known for their quick onset of action. 5-alpha Reductase inhibitors have proven useful for the prevention of BPH progression as measured by prostate volume, disease progression, incidence of acute urinary retention and the need for subsequent BPH-related surgery. Recent studies have shown that the combination of an alpha-adrenoceptor antagonist and a 5-alpha reductase inhibitor has significantly better efficacy than either drug alone or placebo. Currently, alpha-adrenoceptor antagonists are used in the acute setting or for short-term relief of LUTS. The combination of an alpha-adrenoceptor antagonist and a 5-alpha reductase inhibitor is used for the longer term management of BPH symptoms and to prevent progression of BPH and perhaps avoid surgical intervention.
有症状的良性前列腺增生（BPH）的管理方法不断发展，新的技术和药物管理形式不断涌现，传统手术技术的使用频率则有所降低。BPH的药物管理已从非特异性α-肾上腺素能受体拮抗剂发展到尿路选择性α-肾上腺素能受体拮抗剂和5-α还原酶抑制剂。传统上，α-肾上腺素能受体拮抗剂一直用于缓解BPH所致的下尿路症状（LUTS），并以起效迅速而闻名。5-α还原酶抑制剂已被证明对预防BPH进展有用，其衡量指标包括前列腺体积、疾病进展、急性尿潴留发生率以及后续进行BPH相关手术的必要性。最近的研究表明，α-肾上腺素能受体拮抗剂与5-α还原酶抑制剂联合使用的疗效明显优于单独使用任何一种药物或使用安慰剂。目前，α-肾上腺素能受体拮抗剂用于急性情况或短期缓解LUTS。α-肾上腺素能受体拮抗剂与5-α还原酶抑制剂联合使用则用于BPH症状的长期管理，以预防BPH进展，并可能避免手术干预。
