Department of Urology, 'Saint John' Emergency Clinical Hospital, Vitan Barzesti 13, 042122 Bucharest, Romania.
Ther Adv Urol. 2011 Aug;3(4):193-8. doi: 10.1177/1756287211418725.
We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients' dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Multiple mechanisms of action have been attributed to this extract, including antiandrogenic action, an anti-inflammatory/anti-oedematous effect, prolactin signal modulation, and an antiproliferative effect exerted through the inhibition of growth factors. Regarding efficacy, European Association of Urology guidelines state that Serenoa repens extracts significantly reduce nocturia in comparison with placebo. However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses. Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile. Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled studies are required in order to demonstrate without doubt the true therapeutic value of these products. Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, and those considered to be food supplements.
我们在欧洲和北美都经历了对植物疗法制剂的兴趣复兴，尤其是由于患者对替代医学的不良反应感到不满。最常开处方和研究的此类制剂之一是锯棕榈浆果提取物。我们旨在回顾有关这种治疗良性前列腺增生的最重要的已发表数据。对有关使用锯棕榈提取物治疗良性前列腺增生的现有文章进行了综述。对文章进行了分析，以评估其相关性、科学价值和评估系列的规模。已经将多种作用机制归因于这种提取物，包括抗雄激素作用、抗炎/抗水肿作用、催乳素信号调节以及通过抑制生长因子发挥的抗增殖作用。关于疗效，欧洲泌尿外科学会指南指出，与安慰剂相比，锯棕榈提取物可显着减少夜间尿频。但是，由于产品的异质性和荟萃分析相关的方法学问题，指南委员会无法对男性下尿路症状的植物疗法提出具体建议。关于锯棕榈植物疗法的大多数已发表试验都证明了尿液状况的显着改善和有利的安全性特征。一些作者还认为，它可以显着改善勃起功能，并减少经尿道前列腺切除术的并发症，尤其是出血。锯棕榈提取物植物疗法的结果非常有希望。需要进行更多高质量的随机、安慰剂对照研究，以毫无疑问地证明这些产品的真正治疗价值。特别要注意区分已注册的制剂，这些制剂被视为药物，而被视为食品补充剂。
