GamalEl Din Sameh Fayek, Abdel Salam Mohamed Ahmed, Mohamed Mohamed Shokr, Ahmed Ahmed Ragab, Motawaa Ahmed Tarek, Saadeldin Omar Ayman, Elnabarway Ramzy Raafat
1 Department of Andrology & STDs, Cairo University, Cairo, Egypt.
2 Department of Andrology & STDs, Beni Suef University, Beni Suef, Egypt.
Urologia. 2019 May;86(2):74-78. doi: 10.1177/0391560318802160. Epub 2018 Sep 25.
Aging is associated with a series of morphological and functional modifications that leads to reduced physiological efficiency and atrophy of various organs and systems. Tribulus terrestris induces its effect in fertility and sexual functions through the steroidal saponins, particularly the dominant saponins protodioscin. We aimed in this study to evaluate the efficacy and safety profiles of Tribulus terrestris in aging males with partial androgen deficiency who suffered from erectile dysfunction and lower urinary tract symptoms. A total of 70 randomized aging patients with erectile dysfunction and lower urinary tract symptoms were recruited from June 2017 to March 2018 from our andrology outpatient clinic. Thirty-five patients (group A) received Tribulus terrestris three times daily for 3 months and the other 35 patients (group B) received placebo. The mean of aspartate transaminase was elevated in group A after 3 months of receiving Tribulus terrestris (26.5 (before), 27.8 (after), respectively, p = 0.03). Moreover, there were significant elevations in the means of both total testosterone together with the score of the validated Arabic index of erectile function (5-item version of the International Index of Erectile Function) (2.2, 10.7 (before), 2.7, 16.1 (after), p < 0.001, p < 0.001, respectively). Finally, the mean of the total prostate-specific antigen was elevated in this group (1.4 (before), 1.7 (before), p = 0.007, respectively). Interestingly, there were no worsening of the lower urinary tract symptoms in group A as there was no change in the mean score of the international prostate symptom score, which was used to assess these symptoms before and after treatment (mean 14.4 (before), 14.6 (after), p = 0.67, respectively). In sum, this study replicates the findings of previous reports about the robust effect of this herbal medicine in elevating the testosterone level and improving the sexual function of patients who suffered from erectile dysfunction with partial androgen deficiency.
衰老与一系列形态和功能改变相关，这些改变会导致生理效率降低以及各个器官和系统的萎缩。刺蒺藜通过甾体皂苷，特别是主要皂苷原薯蓣皂苷，对生育能力和性功能产生影响。我们在本研究中的目的是评估刺蒺藜对患有勃起功能障碍和下尿路症状的部分雄激素缺乏老年男性的疗效和安全性。2017年6月至2018年3月，我们从男科门诊招募了70例患有勃起功能障碍和下尿路症状的随机分组老年患者。35例患者（A组）每天服用刺蒺藜3次，共3个月，另外35例患者（B组）服用安慰剂。服用刺蒺藜3个月后，A组的天冬氨酸转氨酶平均值升高（分别为26.5（服药前）、27.8（服药后），p = 0.03）。此外，总睾酮平均值以及经过验证的阿拉伯勃起功能指数（国际勃起功能指数5项版）得分均有显著升高（分别为2.2、10.7（服药前），2.7、16.1（服药后），p < 0.001，p < 0.001）。最后，该组总前列腺特异性抗原平均值升高（分别为1.4（服药前），1.7（服药后），p = 0.007）。有趣的是，A组下尿路症状没有恶化，因为用于评估治疗前后这些症状的国际前列腺症状评分平均值没有变化（分别为平均14.4（服药前），14.6（服药后），p = 0.67）。总之，本研究重复了先前报告的结果，即这种草药对提高睾酮水平和改善患有部分雄激素缺乏勃起功能障碍患者的性功能有显著效果。
