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良性前列腺增生的各种治疗选择:最新进展

Various treatment options for benign prostatic hyperplasia: A current update.

作者信息

Shrivastava Alankar, Gupta Vipin B

机构信息

Research Scholar, Jodhpur National University, Jodhpur, Rajasthan, India.

出版信息

J Midlife Health. 2012 Jan;3(1):10-9. doi: 10.4103/0976-7800.98811.

Abstract

In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems.

摘要

在良性前列腺增生(BPH)中,患者的整体生活质量会受到突然影响。这种疾病通常发生在40岁及以上,并且还与性功能障碍有关。因此,需要更新该疾病的当前用药情况。本综述提供了有关BPH可用药物的信息。还包括对BPH有一定改善作用的植物疗法。通过检索MEDLINE、PUBMED、Sciencedirect索引的英文文献以及科学会议论文集来确定相关文章。检索词为BPH、BPH的药物、BPH的药剂、BPH的联合疗法、BPH的植物疗法、阿育吠陀与BPH、阿育吠陀中的BPH治疗。发现的药物包括观察等待、α1肾上腺素能受体阻滞剂、5α还原酶抑制剂、联合疗法,如坦索罗辛 - 度他雄胺、多沙唑嗪 - 非那雄胺、特拉唑嗪 - 非那雄胺、托特罗定 - 坦索罗辛和罗非考昔 - 非那雄胺。草药疗法如舍尼通、虎耳草、紫参丸(ZSP)、巴西棕、黄柏、灵芝、锯叶棕、南瓜提取物和玛咖对BPH有一定改善作用也被纳入。除了这些关于阿育吠陀药物的讨论外,经尿道前列腺切除术(TURP)和微创治疗(MITs)也被包括在内。还讨论了新合成分子方面的最新进展。特定的α1肾上腺素能受体阻滞剂如坦索罗辛和阿夫唑嗪仍将是泌尿科医生缓解症状的首选。联合疗法药物在快速缓解症状、减少前列腺生长以及明显减少BPH相关手术需求的初始阶段作为首选仍需要更多研究来确定。由于缺乏适当证据,植物疗法没有获得太多优势。MITs和TURP费用高昂,且很少得到医疗保健系统的支持。

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