Cai Tommaso, Tamanini Irene, Puglisi Marco, Bizzotto Leonardo, Rizzo Michele, Liguori Giovanni, Gallelli Luca, Palmieri Alessandro, Bjerklund Johansen Truls E
Department of Urology, Santa Chiara Regional Hospital, 38122 Trento, Italy.
Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway.
Clin Pract. 2024 Jan 23;14(1):188-197. doi: 10.3390/clinpract14010016.
We aimed to evaluate the impact of two different phytotherapeutic agents on decision making regarding prostate biopsy for patients with higher-than-normal prostate-specific antigen (PSA) levels.
From June 2022 to May 2023, all patients attending two urological institutions due to higher-than-normal PSA levels were randomized to receive either oral capsules of Curcuma Longa, Boswellia, Pinus pinaster and Urtica dioica (Group A) or Serenoa Repens 320 mg (Group B) for 3 months. At the follow-up visit after 3 months, all patients underwent PSA tests and multiparametric magnetic resonance imaging (mpMRI).
In the per-protocol analysis, data from 66 patients in Group A and 76 in Group B were analyzed. Fifty patients in Group A (75.7%) showed a significant reduction in total PSA compared to forty-nine in Group B (64.4%) ( < 0.001). Twenty-eight patients had PI-RADS III or higher in mpMRI: twelve in Group A and fourteen in Group B. Twenty-three patients (34.8%) in Group A and fifty-nine (77.6%) in Group B ( < 0.001) underwent prostate biopsy based on the mpMRI findings and PSA values. Three patients in Group A showed a significant reduction in total PSA values while having positive mpMRI findings (6%) compared with nine in Group B (19.5%) ( < 0.001). On the contrary, 7 patients in Group A did not show significant reduction in total PSA values and had negative mpMRI findings (43%) compared to 22 in Group B (81.4%) ( < 0.001).
In conclusion, a three-month course of a combination of Curcuma Longa, Boswellia, Pinus pinaster and Urtica dioica seems to be an interesting tool to avoid unnecessary prostate biopsies among men with higher-than-normal PSA levels.
我们旨在评估两种不同的植物治疗剂对前列腺特异性抗原(PSA)水平高于正常的患者进行前列腺活检决策的影响。
2022年6月至2023年5月,所有因PSA水平高于正常而到两家泌尿外科机构就诊的患者被随机分为两组,一组接受含有姜黄、乳香、海岸松和荨麻的口服胶囊(A组),另一组接受320毫克锯叶棕果实提取物(B组),为期3个月。3个月后的随访中,所有患者均接受了PSA检测和多参数磁共振成像(mpMRI)检查。
在符合方案分析中,分析了A组66例患者和B组76例患者的数据。A组50例患者(75.7%)的总PSA显著降低,而B组为49例(64.4%)(<0.001)。28例患者的mpMRI结果为PI-RADS III级或更高:A组12例,B组14例。根据mpMRI结果和PSA值,A组23例患者(34.8%)和B组59例患者(77.6%)(<0.001)接受了前列腺活检。A组3例患者在mpMRI结果为阳性时总PSA值显著降低(6%),而B组为9例(19.5%)(<0.001)。相反,A组7例患者总PSA值未显著降低且mpMRI结果为阴性(43%),而B组为22例(81.4%)(<0.001)。
总之,姜黄、乳香、海岸松和荨麻联合使用三个月的疗程似乎是避免PSA水平高于正常的男性进行不必要前列腺活检的一种有效手段。