中医药治疗前列腺癌研究进展

Research Progress of TCM in the Treatment of Prostate Cancer

中医药治疗前列腺癌的主要研究方法有:方证研究、药物研究和其他中医药疗法等。方证研究分为:理论研究与临床研究;药物研究包括对中成药(复方苦参注射液、艾迪注射液、参芪扶正注射液、芪蓝胶囊等)的研究和对中药中有效成分(灵芝、丹参、雷公藤、白花蛇舌草等)的研究;其他中医药疗法研究包括:对针灸、贴敷、灌肠等疗法的研究。虽然中医药在前列腺癌的诊治中疗效明显,但对其治疗的作用、方式和机制研究的深度、广度仍不够,存在的问题有:(1)缺少大样本、多中心的临床研究,且多数临床研究无法做到随机或双盲,需进行长期随访以解决失访问题;(2)对于中药提取物的研究大多停留在实验阶段,且这些实验仅仅针对单个或几个靶蛋白、靶基因,或是一小段生物过程研究,无法形成一个较为完整的调节体系,应进行制剂的研发与临床研究的尝试;(3)中医辨证施治受医者经验的不同而存在差异,且遣方用药应遵循因人而异的原则,虽然个体化治疗是中医治疗的优势,但无法建立一个严格的诊疗规范供后人效仿。

The main research methods of TCM in the treatment of prostate cancer include formula-syndrome research,drug research and other therapies.The formula-syndrome research can be divided into theoretical research and clinical research.Drug research includes the study of Chinese patent medicines,such as Compound Kushen Injection,Aidi Injection,Shenqi Fuzheng Injection,Qilan Capsule,etc.),and the effective components such as Lingzhi(Ganoderma),Danshen(Radix Salviae Miltiorrhizae),Leigongteng(Radix Tripterygii Wilfordii),Baihuasheshecao(Herba Hedyotis Diffusae)etc.in Chinese medicinals.Other TCM therapies include acupuncture,application,enema and other therapies.Although TCM is effective in the diagnosis and treatment of prostate cancer,the depth and breadth of the research on the role,mode and mechanism of the treatment is still insufficient.The problems are as follows:(1)There is lack of large sample and multi-center clinical research,and most of the clinical researches cannot be randomized or double-blind,so long-term follow-up is needed to solve the problem of lost follow-up.(2)Most of the researches on the extracts of Chinese medicinals are still in the experimental stage,and these experiments only focus on single or several target proteins,target genes,or a small segment of biological process research,which cannot form a relatively complete regulatory system.(3)Although syndrome differentiation and treatment is different is based on different experiences of doctors,and choice of formulas and Chinese medicinals should follow the principle of individual differences.Although individualized treatment is the advantage of TCM treatment,it is impossible to establish a strict diagnosis and treatment standard for future generations to follow.