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植物疗法可能在减少不必要的前列腺活检方面发挥作用:两种不同植物治疗剂的探索性随机对照试验结果

Phytotherapy Might Have a Role in Reducing Unnecessary Prostate Biopsies: Results from an Exploratory, Randomized Controlled Trial of Two Different Phytotherapeutic Agents.

作者信息

Cai Tommaso, Tamanini Irene, Puglisi Marco, Bizzotto Leonardo, Rizzo Michele, Liguori Giovanni, Gallelli Luca, Palmieri Alessandro, Bjerklund Johansen Truls E

机构信息

Department of Urology, Santa Chiara Regional Hospital, 38122 Trento, Italy.

Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway.

出版信息

Clin Pract. 2024 Jan 23;14(1):188-197. doi: 10.3390/clinpract14010016.

Abstract

BACKGROUND

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.

METHODS

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).

RESULTS

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).

CONCLUSIONS

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.

摘要

背景

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。

方法

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。

结果

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)。

结论

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。

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