Gerber G S, Zagaja G P, Bales G T, Chodak G W, Contreras B A
Department of Surgery, University of Chicago Pritzker School of Medicine, Illinois, USA.
Urology. 1998 Jun;51(6):1003-7. doi: 10.1016/s0090-4295(98)00143-5.
To assess the effects of saw palmetto on voiding symptoms and urodynamic parameters in men with lower urinary tract symptoms (LUTS) presumed secondary to benign prostatic hyperplasia (BPH).
Fifty men with previously untreated LUTS and a minimum International Prostate Symptom Score (IPSS) of 10 or greater were treated with a commercially available form of saw palmetto (160 mg twice per day) for 6 months. The initial evaluation included measurement of peak urinary flow rate, postvoid residual urine volume, pressure-flow study, and serum prostate-specific antigen (PSA) level. Patients completed an IPSS, serum PSA was determined, and flow rate was measured every 2 months during the course of the study. A urodynamic evaluation was repeated at the completion of the 6-month trial.
The mean IPSS (+/-SD) improved from 19.5+/-5.5 to 12.5+/-7.0 (P <0.001) among the 46 men who completed the study. Significant improvement in the symptom score was noted after treatment with saw palmetto for 2 months. An improvement in symptom score of 50% or greater after treatment with saw palmetto for 2, 4, and 6 months was noted in 21% (10 of 48), 30% (14 of 47), and 46% (21 of 46) of patients, respectively. There was no significant change in peak urinary flow rate, postvoid residual urine volume, or detrusor pressure at peak flow among patients completing the study. No significant change in mean serum PSA level was noted.
Saw palmetto is a well-tolerated agent that may significantly improve lower urinary tract symptoms in men with BPH. However, we were unable to demonstrate any significant improvement in objective measures of bladder outlet obstruction. Placebo-controlled trials of saw palmetto are needed to evaluate the true effectiveness of this compound.
评估锯叶棕对推测因良性前列腺增生（BPH）继发下尿路症状（LUTS）男性患者排尿症状和尿动力学参数的影响。
50例既往未治疗的LUTS男性患者，国际前列腺症状评分（IPSS）至少为10分或更高，接受市售锯叶棕制剂（160毫克，每日两次）治疗6个月。初始评估包括测量最大尿流率、排尿后残余尿量、压力-流率研究以及血清前列腺特异性抗原（PSA）水平。患者完成IPSS评估，测定血清PSA，并在研究过程中每2个月测量一次尿流率。6个月试验结束时重复进行尿动力学评估。
46例完成研究的男性患者中，平均IPSS（±标准差）从19.5±5.5改善至12.5±7.0（P<0.001）。锯叶棕治疗2个月后症状评分显著改善。锯叶棕治疗2、4和6个月后，症状评分改善50%或更高的患者分别为21%（48例中的10例）、30%（47例中的14例）和46%（46例中的21例）。完成研究的患者最大尿流率、排尿后残余尿量或最大尿流时逼尿肌压力无显著变化。血清PSA平均水平无显著变化。
锯叶棕是一种耐受性良好的药物，可能显著改善BPH男性患者的下尿路症状。然而，我们未能证明膀胱出口梗阻的客观指标有任何显著改善。需要进行锯叶棕的安慰剂对照试验以评估该化合物的真正疗效。
