中医药治疗良性前列腺增生临床研究评述

Clinical Research on Treatment of Benign Prostatic Hyperplasia with Traditional Chinese Medicine:A Review

良性前列腺增生(BPH)是泌尿男科的常见疾病,主要表现包括前列腺腺体增大,膀胱出口梗阻和下尿路症状,严重影响中老年男性的生活质量。本病属于中医“癃闭”“精癃”的范畴,近年来多位医家根据学术典籍和自身的临床经验提出了对本病的认识,中医药治疗BPH的临床研究也呈现日益丰富的趋势。BPH基本的表现为年老肾气衰弱,膀胱气化不利,血行瘀阻不畅,病位在肾和膀胱,与肺、肾功能失调有关,本虚标实是基本病机特点。大量临床研究证明中医药能够改善BPH患者临床症状,提高生活质量,缩小前列腺体积,减少术后并发症,在临床应用中有确切疗效。此外中医药外治法如针刺疗法、艾灸、热水坐浴、穴位贴敷、肛门栓剂、灌肠疗法等也被广泛应用于临床,证明中医药治疗BPH方法多样。中西医融合治疗BPH优势互补,能够提高临床疗效,减少远期并发症的发生。该文将对近年来BPH中医病因病机和治疗进展进行评述,总结目前中医药临床治疗BPH研究现状,并从产出高质量临床研究、规范中医药临床诊治方案、结合前沿研究探索中医药机制三方面对中医药治疗BPH临床研究提出建议,以期推动中医药在本病治疗中的发展和应用。

Benign prostatic hyperplasia(BPH),a common disease in urology and andrology,is mainly manifested as enlarged prostate glands,bladder outlet obstruction,and lower urinary tract symptoms(LUTS),which seriously affects the quality of life of middle-aged and elderly men.This disease falls into the categories of"retention of urine"and"prostatic hypertrophy"in traditional Chinese medicine(TCM).In recent years,many doctors have put forward their understandings of BPH based on academic classics and their clinical experience.Clinical research on the treatment of BPH with TCM has become increasingly abundant.The basic pathogenesis of BPH lies in the disturbance of Qi transformation in the bladder and poor blood circulation due to kidney Qi deficiency in the aged.The disease is located in the kidney and the bladder and is related to the dysfunction of the lung and the kidney.It is basically characterized by deficiency in origin and excess in superficiality.A large number of clinical research reports have proved that TCM is efficient in alleviating the clinical symptoms of BPH patients,improving their quality of life,reducing the volume of the prostate,and decreasing postoperative complications.In addition,the external treatment methods of TCM,such as acupuncture therapy,moxibustion,hot water bathing,acupoint application,anal suppository,and enema therapy,are also widely used in clinical practice,demonstrating the diverse ways of TCM in treating BPH.TCM and western medicine complement each other's advantages in the treatment of BPH,thus enhancing the clinical efficacy and reducing the occurrence of long-term complications.This study reviewed the etiology,pathogenesis,and treatment progress of BPH with TCM in recent years,and summarized the current research status.From three aspects of producing high-quality clinical research,standardizing the clinical diagnosis and treatment of TCM,and combining cutting-edge research to explore the mechanism of TCM,it provided suggestions for clinical research on the treatment of BPH with TCM to promote the development and application of TCM in the treatment of this disease.