沙巴棕的脂类提取物在治疗良性前列腺增生患者下尿路症状的作用

1、BENIGN PROSTATIC HYPERPLASIA1667 improved significantly more(p0.049with Permixon(2.9versus1.9with tamsulosin.The superiorityof Permixon in reducing irritative symptoms appeared as soon as month3and was maintained up to month12(p0.03.CONCLUSION:Permixon320mg/day was shown to be slightly superior to t

2、amsulosin0.4mg/day in reducing LUTS in severe BPH patients after3months and up to12months of treatment.Editorial Comment:At first glance the results of this study suggest that the phytotherapeuticagent Serenoa repens is as good as if not better than tamsulosin(0.4mg dailyin men withsevere lower urin

3、ary tract symptoms.This study is a good example of how a faulty study designmay lead to inaccurate conclusions.Most worrisome was the lack of a placebo arm in this study.The importance of a placebo arm in phytotherapeutic trials cannot be overstated.It does nottake a medical degree for a patient to

4、discern easily between a Serenoa repens tablet and a tamsulosin tablet.Issues such as pill size and odor are easily recognizable.Those of us who are investigators in the Complementary and Alternative Medicine for Urological Symptoms trialhave struggled with creating a clinical trial that incorporate

5、s a nonrecognizable placebo agent.While the results of the study should not be ignored,I would strongly suggest tempering the conclusions drawn by its authors.Until proved otherwise by a rigorous clinical trial includingthe use of a placebo,the relative efficacy of phytotherapeutic agents versus an-

6、blocker remains to be determined.StevenA.Kaplan,M.D.The Role of a Lipido-Sterolic Extract of Serenoa Repens in the Management of Lower UrinaryTract Symptoms Associated With Benign Prostatic HyperplasiaG.S.G ERBER AND J.M.F ITZPATRICK,Division of Urology,University of Chicago Medical School,Chicago,I

7、llinoisBJU Int,94:338344,2004OBJECTIVE To examine the clinical profile of medication derived from a lipido-sterolic extract of Serenoarepens(saw palmettofor managing lower urinary tract symptoms(LUTSassociated with benign prostatic hyperplasia(BPH.METHODS We reviewed clinical trials involving extrac

8、ts of S.repens,focusing on thebenefit/risk ratio in patients with BPH.RESULTS S.repens extract significantly reduces the symptoms ofBPH,increases urinary flow,improves the quality of life and is well tolerated.CONCLUSION Analysis ofthe overall clinical database indicates that extract of S.repens may

9、 be considered a viable first-line therapyfor treating LUTS.Editorial Comment:This is a nice review of the data set of Serenoa repens in the treatment ofLUTS secondary to BPH.This article includes a hypothesis of how this agent works in the prostate and its clinical efficacy.It would be inappropriat

10、e to cast aside these clinical trials that demonstrate efficacy with Serenoa repens.It appears to be more than just a placebo effect.Whatis debatable is the magnitude of the effect.I have always believed that these agents have been commercially successful because they are primarily used to treat qua

11、lity of life disorders suchas voiding and erectile dysfunction.No drastic untoward side effects have heretofore been reported.Patients attitudes are,“Why not try it?”However,questions remain concerninglong-term durability,reproducibility of the data and the effects of these agents on BPH pro-gressio

12、n.Nevertheless,many believe phytomedicines are effective,and it is our obligation to investigate whether these observations are scientifically valid in long-term,placebo controlledclinical trials.StevenA.Kaplan,M.D.Three-Year Follow-Up of Feedback Microwave Thermotherapy Versus TURP for Clinical BPH

13、:A Prospective Randomized Multicenter StudyL.W AGRELL,S.S CHELIN,J.N ORDLING,J.R ICHTHOFF, B.M AGNUSSON,M.S CHAIN,T.L ARSON, E.B OYLE,J.D UELUND,K.K ROYER,H.A GEHEIM AND A.M ATTIASSON,Department of Urology,Uppsala University Hospital,Uppsala,SwedenUrology,64:698702,2004OBJECTIVES:To compare,in a pro

14、spective randomized multicenter study,the efficacy and safety of transurethral microwave thermotherapy with ProstaLund Feedback Treatment(PLFT,using the Core-Therm device,with transurethral resection of the prostate(TURP36months after treatment.METHODS:The study was conducted at10centers in the Unit

15、ed States and Scandinavia.A total of154patients withbenign prostatic hyperplasia were randomized to PLFT or TURP in a2:1ratio.The treatment outcome was evaluated on the basis of the International Prostate Symptom Score(IPSS,the quality-of-life question (QOLof the IPSS,peak urinary flow rate(Qmax,urodynamics,a