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[中医治疗良性前列腺增生的研究进展]

[Research progress of traditional Chinese medicine in treatment of benign prostatic hyperplasia].

作者信息

Li Sheng-Long, Lu Gang-Gang, Jin Guang-Wei, Yin Peng-Dong, Gong Mei-Sheng, Li Hui, Ma Xu, Li Xi-Xiang, Zhao Yuan-Bo, Tian Da-Cheng, Liang Yong-Lin, Zhao Yong-Qiang

机构信息

School of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine Lanzhou 730000, China.

Graduate School, Heilongjiang Academy of Chinese Medicine Harbin 150006, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2024 Nov;49(21):5817-5828. doi: 10.19540/j.cnki.cjcmm.20240729.501.

Abstract

Benign prostatic hyperplasia(BPH) is a common disease in middle-aged and elderly men, with lower urinary tract symptoms as the main manifestation, severely affecting the quality of life of patients. The pathogenesis of BPH is not yet fully understood, and there are still some challenges and limitations in western medicine treatment for BPH. Therefore, finding new and more effective treatment strategies is urgent. In recent years, many basic and clinical studies have confirmed the important role of traditional Chinese medicine in the treatment of BPH. This article reviews the progress of basic and clinical research in the treatment of BPH with traditional Chinese medicine, and believes that basic research mainly focuses on the active ingredients of Chinese medicine [regulating pathways such as NF-E2-related factor 2(Nrf2)/antioxidant response element(ARE), nuclear factor κB(NF-κB), epidermal growth factor receptor(EGFR)/signal transducer and activator of transcription 3(STAT3), phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR), p38 mitogen-activated protein kinase(p38 MAPK)/forkhead box O subtype(FOXO3a), etc.], single Chinese herbs(regulating inflammatory factors, oxidative stress-related proteins, cell cycle-related proteins, and apoptotic factors, etc.), and Chinese herbal compounds and patent medicines [regulating extracellular signal-regulated kinase(ERK1/2), transforming growth factor-β(TGF-β)/Smad, mitogen-activated protein kinase(MAPK), PI3K/Akt, Nrf2, trefoil factor 2(TFF2)/Wnt, interleukin-6(IL-6)/Janus kinase 2(JAK2)/STAT3, hypoxia-inducible factor 1α(HIF-1α)/vascular endothelial growth factor receptor(VEGFR), etc.], and then play a therapeutic role by inhibiting BPH cell proliferation, oxidative stress, inflammatory response, promoting apoptosis, and inhibiting epithelial-mesenchymal transition. Clinical studies mainly focus on internal treatment, external treatment, combined internal and external treatment, and integrated Chinese and western medicine treatment as the main methods, aiming to improve traditional Chinese medicine syndrome scores, prostate symptom scores, residual urine volume, effective bladder volume, sexual quality of life, increase average urine flow rate, maximum urine flow rate, and promote balance of sex hormone secretion. Through this research, it is hoped to provide some reference ideas for clinical research and drug development for BPH.

摘要

良性前列腺增生(BPH)是中老年男性的常见疾病,以下尿路症状为主要表现,严重影响患者生活质量。BPH的发病机制尚未完全明确,西医治疗BPH仍存在一些挑战和局限性。因此,寻找新的、更有效的治疗策略迫在眉睫。近年来,许多基础和临床研究证实了中药在治疗BPH中的重要作用。本文综述了中药治疗BPH的基础和临床研究进展,认为基础研究主要集中在中药活性成分[调节如核因子E2相关因子2(Nrf2)/抗氧化反应元件(ARE)、核因子κB(NF-κB)、表皮生长因子受体(EGFR)/信号转导和转录激活因子3(STAT3)、磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)/雷帕霉素靶蛋白(mTOR)、p38丝裂原活化蛋白激酶(p38 MAPK)/叉头框O亚型(FOXO3a)等信号通路]、单味中药(调节炎症因子、氧化应激相关蛋白、细胞周期相关蛋白和凋亡因子等)以及中药复方和中成药[调节细胞外信号调节激酶(ERK1/2)、转化生长因子-β(TGF-β)/Smad、丝裂原活化蛋白激酶(MAPK)、PI3K/Akt、Nrf2、三叶因子2(TFF2)/Wnt、白细胞介素-6(IL-6)/Janus激酶2(JAK2)/STAT3、缺氧诱导因子1α(HIF-1α)/血管内皮生长因子受体(VEGFR)等],进而通过抑制BPH细胞增殖、氧化应激、炎症反应、促进凋亡以及抑制上皮-间质转化发挥治疗作用。临床研究主要集中在内治法、外治法、内外合治法以及中西医结合治疗等主要方法,旨在提高中医证候评分、前列腺症状评分、残余尿量、有效膀胱容量、性生活质量,增加平均尿流率、最大尿流率,并促进性激素分泌平衡。通过本研究,希望能为BPH的临床研究和药物研发提供一些参考思路。

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