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中药治疗良性前列腺增生症患者的效果:台湾全国队列研究。

Effects of Chinese herbal medicine in patients with benign prostatic hyperplasia: A nationwide cohort study in Taiwan.

机构信息

Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan, Republic of China.

School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan, Republic of China.

出版信息

Int J Urol. 2022 Jul;29(7):623-630. doi: 10.1111/iju.14853. Epub 2022 Mar 14.

Abstract

OBJECTIVES

Benign prostatic hyperplasia affects elderly males, with progression presenting the risk of urinary complications and eventual surgical intervention. We aimed to evaluate the effects of Chinese herbal medicine in patients with benign prostatic hyperplasia.

METHODS

This retrospective cohort study analyzed claims data in Taiwan's National Health Insurance Research Database from 2001 to 2013. A total of 4142 patients newly diagnosed as benign prostatic hyperplasia were enrolled and divided into cohorts of Chinese herbal medicine users and nonusers by performing 1:1 propensity score matching. The risk of benign prostatic hyperplasia-related complications was assessed by the Cox proportional hazard model. The cumulative incidence of benign prostatic hyperplasia-related surgeries was assessed by Kaplan-Meier method.

RESULTS

During the study period, the risk of benign prostatic hyperplasia-related complications was lower in the Chinese herbal medicine cohort than non-Chinese herbal medicine cohort with an adjusted hazard ratio of 0.82 (95% confidence interval 0.73-0.92) after controlling for multiple variables. Subgroup analysis revealed that Chinese herbal medicine users had a significantly lower risk of urinary tract infection (adjusted hazard ratio 0.67, 95% confidence interval 0.50-0.89) and urinary retention (adjusted hazard ratio 0.83, 95% confidence interval 0.72-0.97). In addition, Chinese herbal medicine users also had a lower incidence rate of benign prostatic hyperplasia-related surgery (32.14 vs 40.20, adjusted hazard ratio 0.74, 95% confidence interval 0.61-0.89) and a longer surgery-free interval than non-Chinese herbal medicine users (3.98 vs 3.00 mean person-year, P < 0.001). Data revealed Salviae miltiorrhizae and Ji-Sheng-Shen-Qi-Wan as the most commonly prescribed Chinese herbal medicine by traditional Chinese medicine practitioners.

CONCLUSIONS

Our study demonstrated that Chinese herbal medicine might have effects in the benign prostatic hyperplasia-related complications and surgeries in patients with benign prostatic hyperplasia.

摘要

目的

良性前列腺增生影响老年男性,其进展会带来尿路并发症的风险,并最终需要手术干预。我们旨在评估中草药在良性前列腺增生患者中的作用。

方法

本回顾性队列研究分析了 2001 年至 2013 年台湾全民健康保险研究数据库中的理赔数据。共纳入 4142 例新诊断为良性前列腺增生的患者,并通过 1:1 倾向评分匹配将他们分为中草药使用者和非使用者队列。使用 Cox 比例风险模型评估良性前列腺增生相关并发症的风险。使用 Kaplan-Meier 方法评估良性前列腺增生相关手术的累积发生率。

结果

在研究期间,与非中草药组相比,中草药组良性前列腺增生相关并发症的风险较低,调整后的风险比为 0.82(95%置信区间 0.73-0.92),控制了多个变量后。亚组分析显示,中草药使用者尿路感染(调整后的风险比 0.67,95%置信区间 0.50-0.89)和尿潴留(调整后的风险比 0.83,95%置信区间 0.72-0.97)的风险显著降低。此外,中草药使用者良性前列腺增生相关手术的发生率也较低(32.14 比 40.20,调整后的风险比 0.74,95%置信区间 0.61-0.89),且无手术间隔时间长于非中草药使用者(3.98 比 3.00 平均人年,P<0.001)。数据显示丹参和济生肾气丸是中医最常开的中草药。

结论

我们的研究表明,中草药可能对良性前列腺增生患者的良性前列腺增生相关并发症和手术有作用。

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