Pavone C, Abbadessa D, Tarantino M L, Oxenius I, Laganà A, Lupo A, Rinella M
UOS di Chirurgia Andrologica, Università degli Studi di Palermo, Italy.
Urologia. 2010 Jan-Mar;77(1):43-51.
Serenoa repens (saw palmetto) has been employed for the treatment of lower urinary tract symptoms (LUTS) for several years. Its mechanism of action is believed to be due to antiandrogenic, antiproliferative and antinflammatory properties. An association of Serenoa with the nettle "Urtica dioica" showing antiproliferative activity and the pine "Pinus pinaster" derivative, showing antinflammatory action, has been proposed in recent years. Such an action is hoped to act not only by reducing LUTS but also by preventing the development of prostate cancer.
During the years 2007 and 2008, 320 patients suffering from LUTS were treated with an association of Serenoa repens 320 mg, Urtica dioica 120 mg and Pinus pinaster 5 mg, named IPBTRE. This treatment was administered to all patients for a minimal duration of 30 days to a maximum of a year, either alone or in association with antibiotics or alpha-blockers, if needed. Outcome analysis was based on evaluation of symptoms, prostate volume and maximum flow rate (Qmax).
From a careful analysis of the data collected in our database, the following observations can be made: ages varied between 19 and 78 years. The patients were affected by BPH in 46% of cases, chronic prostatitis syndrome in 43%, chronic genital-pelvic pain in 7% and other conditions in 4%, the absolute numbers being 147, 138, 22 and 7 patients, respectively. No untoward side effect was reported in any case. Variations in symptom score could be fully evaluated only in 80 of 320 patients (25%), of whom 68 (85%) reported a significant benefit, with special reference to an improvement of pain, urgency, strangury and nocturia. Data on variations in prostate volume, as measured by digital rectal examination, were available in 84 (26.5%) patients. No significant change was observed. Qmax after treatment was measured in 83 (26%) patients. It did not show significant changes from the initial values.
The association tested in our study appeared to be safe and well tolerated. No changes in flow rate and prostate volume were observed, but a marked reduction of LUTS was observed in 85% of evaluable cases, especially with regard to pain and irritative symptoms. Whether or not such an association may display a prevention of prostate cancer, may be investigated in additional studies.
多年来，锯叶棕一直被用于治疗下尿路症状（LUTS）。其作用机制被认为是由于具有抗雄激素、抗增殖和抗炎特性。近年来，有人提出将锯叶棕与具有抗增殖活性的荨麻（Urtica dioica）以及具有抗炎作用的海岸松（Pinus pinaster）衍生物联合使用。希望这种联合用药不仅能减轻下尿路症状，还能预防前列腺癌的发生。
在2007年至2008年期间，320名下尿路症状患者接受了锯叶棕320毫克、荨麻120毫克和海岸松5毫克的联合用药治疗，该联合用药名为IPBTRE。所有患者接受该治疗的最短时间为30天，最长为一年，必要时可单独使用或与抗生素或α受体阻滞剂联合使用。疗效分析基于症状、前列腺体积和最大尿流率（Qmax）的评估。
通过对我们数据库中收集的数据进行仔细分析，可以得出以下观察结果：患者年龄在19岁至78岁之间。46%的患者患有良性前列腺增生（BPH），43%患有慢性前列腺炎综合征，7%患有慢性盆腔疼痛，4%患有其他疾病，绝对病例数分别为147例、138例、22例和7例。在任何情况下均未报告有不良副作用。仅在320名患者中的80名（25%）中可以全面评估症状评分变化，其中68名（85%）报告有显著改善，特别是在疼痛、尿急、尿痛和夜尿方面。通过直肠指检测量的前列腺体积变化数据在84名（26.5%）患者中可用。未观察到显著变化。在83名（26%）患者中测量了治疗后的Qmax。与初始值相比未显示出显著变化。
我们研究中测试的联合用药似乎安全且耐受性良好。未观察到尿流率和前列腺体积的变化，但在85%的可评估病例中观察到下尿路症状明显减轻，尤其是在疼痛和刺激性症状方面。这种联合用药是否可以预防前列腺癌，可能需要在进一步的研究中进行调查。
