Fujiuchi Yasuyoshi, Watanabe Akihiko, Fuse Hideki
Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama.
Hinyokika Kiyo. 2008 Jun;54(6):463-6.
At present, patients with lower urinary tract symptoms, including storage symptoms, caused by prostatic disease are predominantly treated with alpha1-adrenoceptor antagonist and anticholinergic agents. However, some patients are not improved by this treatment. We investigated the efficacy of Goshajinkigan in 25 patients with prostatic disease in whom pollakisuria was not improved by treatment with drugs for lower urinary tract symptoms. The urinary frequency was significantly improved both in the daytime and at night. The parameters of uroflowmetry, the residual urine volume, the international prostate symptom score and QOL score were also improved after therapy. It was considered that the pollakisuria was improved by Goshajinkigan induced activation of spinal kappa-opioid receptors, which inhibited the micturition reflex via blunting of bladder sensation. The inhibition of C-fiber and the down regulation of Fos protein in the pontine micturition center were also suggested to be related with improvement ofpollakisuria. Chinese herbal medicine therapy is different in various aspects from Western medicine. Clarification of the mechanisms of Chinese herbal medicine and Sho (patient status in Chinese herbal medicine) is awaited.
目前，由前列腺疾病引起的下尿路症状（包括储尿症状）患者主要采用α1肾上腺素能受体拮抗剂和抗胆碱能药物进行治疗。然而，一些患者经此治疗后并无改善。我们对25例前列腺疾病患者进行了调查，这些患者的尿频症状经下尿路症状治疗药物治疗后未得到改善。治疗后，白天和夜间的尿频症状均有显著改善。尿流率参数、残余尿量、国际前列腺症状评分和生活质量评分在治疗后也有所改善。据认为，尿频症状的改善是由于五苓散激活了脊髓κ-阿片受体，该受体通过减弱膀胱感觉来抑制排尿反射。C纤维的抑制以及脑桥排尿中枢中Fos蛋白的下调也被认为与尿频症状的改善有关。中药疗法在各个方面都与西药不同。期待对中药及证（中医术语，指患者状态）的作用机制有更清晰的认识。
