Kumar Vijay L, Wahane Vishal D
Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Med Sci. 2008 Apr;62(4):167-75.
Benign prostatic hyperplasia (BPH) is a common problem in aging men, which is associated with lower urinary tract symptoms. This condition is dependent on the presence of androgens for its progression, and medical therapy is the first-line treatment for BPH patients with moderate-to-severe symptoms and includes the use of either alpha 1-adrenergic blockers or 5alpha-reductase inhibitors. Adrenergic blocking drugs reduce the dynamic component while the 5alpha-reductase inhibitors reduce the static component of bladder outlet obstruction in BPH. By inhibiting the generation of active form of testosterone, viz., dihydrotestosterone, the 5alpha-reductase inhibitors not only reduce the symptoms of BPH but also decrease the need for surgery and further progression of BPH. Besides, prolonged use of combination of 5alpha-reductase inhibitors and alpha 1-adrenergic blockers has been found to be more beneficial than either of the two drugs given alone. This review gives a brief account of rationale and efficacy of treatment by 5alpha-reductase inhibitors in the management of BPH.
良性前列腺增生（BPH）是老年男性的常见问题，与下尿路症状相关。这种疾病的进展依赖于雄激素的存在，药物治疗是中重度症状BPH患者的一线治疗方法，包括使用α1肾上腺素能阻滞剂或5α还原酶抑制剂。肾上腺素能阻断药物减少动态成分，而5α还原酶抑制剂减少BPH中膀胱出口梗阻的静态成分。通过抑制活性形式睾酮即二氢睾酮的生成，5α还原酶抑制剂不仅减轻BPH症状，还减少手术需求和BPH的进一步进展。此外，已发现长期联合使用5α还原酶抑制剂和α1肾上腺素能阻滞剂比单独使用这两种药物中的任何一种更有益。本综述简要介绍了5α还原酶抑制剂治疗BPH的原理和疗效。
