爱普列特治疗良性前列腺增生的疗效观察

目的 :评价爱普列特 (Epristeride)治疗良性前列腺增生 (BPH)的安全性、有效性。 　方法 :14 1例诊断为BPH的病人 ,年龄 5 0～ 83岁 ,平均 (6 6 .18± 6 .4 1)岁。给予爱普列特片 5mg ,2次 /d口服 ,共 12 0d。以国际前列腺症状评分 (IPSS)、最大尿流率 (Qmax)、前列腺体积 (V)及剩余尿 (Ru)的变化率评分综合判断疗效。疗效分类 :显效、有效、改善和无效 ,以显效和有效计算有效率。　结果 :139例参加有效率统计 ,其中 :显效 37例 (2 6 .6 2 % )、有效 76例 (5 4 .6 8% )、改善 2 0例 (14 .39% )、无效 6例 (4.32 % ) ,有效率为 81.2 9%。不良反应共 7例 (5 .0 4 % ) :皮疹1例 (0 .72 % )、胃肠道反应 1例 (0 .72 % )、失眠 1例 (0 .72 % )、耳鸣 1例 (0 .72 % )、勃起功能障碍 3例 (2 .16 % ) ,2例因不良反应而停药 (1.4 4 % ) ,不参加统计有效率。未出现有临床意义的实验室指标异常。　结论 :爱普列特片是治疗BPH安全、有效的药物。     

爱普列特在治疗良性前列腺增生中的应用

良性前列腺增生（BPH）是老年男性的常见疾病之一，其发病率随年龄而递增。药物治疗在BPH的治疗中起到重要的作用。新近的MTOPS研究表明，联合应用5α-还原酶抑制剂和α-上腺素能受体阻滞剂可以有效地推迟急性尿潴留的发生时间和需要外科手术治疗的时间。     

爱普列特联合萘哌地尔治疗良性前列腺增生症疗效的临床研究

对于早、中期和不能耐受手术的良性前列腺增生症（BPH）患者,可选择药物治疗,常用药物为α-受体阻滞剂和5α-还原酶抑制剂。二者联合运用能否产生更好的临床效果？为此,我们采用随机、药物平行对照法,对2011年6月至2012年12月间我院门诊符合入围标准的80例BPH患者进行了分组研究。     

爱普列特治疗良性前列腺增生的有效性及安全性

目的 评价爱普列特治疗BPH的有效性和安全性.方法 采用随机、双盲、双模拟及安慰剂对照的多中心临床试验方法.分3组:爱普列特组10例,平均年龄(72±10)岁;非那雄胺(商品名:保列治)组13例.平均年龄(70±10)岁;安慰剂组16例,平均年龄(70±7)岁.3组患者接受治疗时间均为6个月.每月随访1次,随访评估内容包括IPSS、困扰评分、前列腺体积、尿流率、残余尿量、PSA及国际勃起功能评分问卷(IIEF-5)等,治疗前所有评估指标3组间比较差异均无统计学意义(P值均＞0.05).采用SAS 9.0统计学软件,双侧检验,计量数据组间比较采用t检验,计数数据组间比较采用χ~2检验,a=0.05.结果 爱普列特组IPSS评分F降50.0%±10.3%,与保列治组(37.0%±11.2%)比较差异无统计学意义(P=0.94),但均高于安慰剂组(22.0%±7.6%,P＜0.05);爱普列特组前列腺体积缩小40.0%±12.1%,明显高于保列治组(19.1%±7.3%,P=0.041)及安慰剂组(4.3%±3.2%,P=0.004),保列治组前列腺体积缩小百分比与安慰剂组比较差异无统计学意义(P=0.348).爱普列特组患者Q_(max)改善70.2%±13.9%,与保列治组(50.0%±9.7%)比较差异无统计学意义(P=0.630),但均显著高于安慰剂组(0.5%±0.8%,P＜0.05).其他几项评估指标3组间比较差异无统计学意义.结论 爱普列特能安全有效地治疗BPH,与保列治比较,缩小前列腺体积的疗效更快且更显著.     

度他雄胺治疗良性前列腺增生的研究进展

良性前列腺增生(BPH)是中老年男性的常见病。目前,以5α还原酶抑制剂为主的药物治疗已经替代传统的经尿道前列腺切除术,成为多数BPH患者的首选治疗方案。本文就一种新型的5α还原酶抑制剂——度他雄胺对治疗BPH的研究进展进行综述。     

爱普列特联合多沙唑嗪嚓治疗中重度症状的前列腺增生

良性前列腺增生(BPH)是一种常见的男性老年病,其发病率随年龄增加而递增.药物治疗在BPH的治疗中起到重要的作用,可在很大程度上使部分病人的症状得到缓解,从而达到避免手术治疗的目的.通过检索国内外文献,尚无爱普列特联合多沙唑嗪治疗BPH的疗效报道.2010年3月至2010年7月,我们采用联合应用爱普列特与多沙唑嗪控释片治疗门诊BPH病人,初步观察疗效满意,报告如下.     

爱普列特减少前列腺电切术术中及术后出血的观察

<正>良性前列腺增生症(BPH)是老年男性常见疾病。药物治疗首选5-α还原酶抑制剂,爱普列特是目前新型反竞争5-α还原酶抑制剂;经尿道前列腺电切术(TURP)被公认为治疗BPH的金标准;服用爱普列特可减少术中及术后出血,效果满意。报道如下。     

爱普列特治疗Ⅱ型糖尿病患者BPH的临床疗效观察

目的：观察爱普列特治疗Ⅱ型糖尿病患者BPH的临床疗效与安全性.方法：选择合并BPH的Ⅱ型糖尿病患者60例,口服爱普列特片5 mg,每天2次,疗程4个月;同时按中国糖尿病防治指南进行规则的降糖治疗.采用国际前列腺症状评分（IPSS）、生活质量评分（QOL）、剩余尿量（Ru）、最大尿流率（Qmax）、前列腺体积（PV）和前列腺特异抗原（PSA）等指标评价其临床疗效.结果：与治疗前比较,治疗4个月后入选患者的IPSS、QOL、Ru、Qmax、PV和PSA均得到显著改善（P＜0.05）,总有效率为86.7%.治疗过程中,患者的血糖水平控制良好,未观察到明显的不良反应.结论：爱普列特治疗Ⅱ型糖尿病患者BPH具有较好的疗效与安全性.     

良性前列腺增生联合治疗回顾

单用α受体阻滞剂和5α还原酶抑制剂治疗的临床试验显示，前者对于控制由于良性前列腺增生引起下尿路症状有效，长期治疗可迅速提高最大尿流率，无论前列腺大小如何。后者可以有效减少前列腺大小，长期治疗可预防病情进展。不同的起效机制和功效领域使这两种药物联合治疗的临床疗效倍受关注。Mc—Vary进行了一项综述研究，     

新型5α-还原酶抑制剂爱普列特治疗良性前列腺增生的Ⅳ期临床研究

目的　探讨新型非竞争性 5α 还原酶抑制剂爱普列特 (epristeride)治疗良性前列腺增生(BPH)的有效性及安全性。　方法　采用多中心开放临床试验方法 ,对 2 0 0 6例BPH患者进行为期4个月的观察。口服爱普列特每日 2次 ,每次 5mg。　结果　给药后 4个月 ,国际前列腺症状 (IPSS)评分较治疗前平均降低 6 .12分 (2 8.8% ) ,P <0 .0 0 0 1;最大尿流率较治疗前平均增加 3.48ml/s(33.4% ) ,P <0 .0 0 0 1,前列腺体积平均缩小 4.91ml(11.6 % ) ,P <0 .0 0 0 1;剩余尿量平均减少 19.1ml(38.4% ) ,P <0 .0 0 0 1,差别均有极显著性意义。治疗总有效率 83.4%。临床不良反应发生率6 .6 3% ,多为轻中度。实验室检查异常发生率 2 .49%。　结论　爱普列特可明显改善BPH患者的排尿症状、缩小前列腺体积、增加尿流率、减少剩余尿量 ,不良反应发生率低 ,是一种安全有效的治疗BPH的新药。     

The clinical role of alpha-blockers in the treatment of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a highly prevalent condition that represents a significant health problem, which is likely to worsen as the population continues to age. α-1 adrenoceptor antagonists have been used in the treatment of this condition for well over 20 years and much is now known about their effects on the urinary tract. As these drugs have improved, their use as a first line treatment option in patients with lower urinary tract symptoms (LUTS), secondary to BPH, has continued to increase. This review details some of the background and rationale for the use of these drugs and, using the available information, compares their efficacy and tolerability profiles.     

经尿道等离子前列腺剜除术治疗高龄高危前列腺增生症

目的 探讨经尿道等离子前列腺剜除术治疗高龄高危良性前列腺增生(BPH)患者的安全性及疗效.方法 将70例高龄高危BPH患者随机分为两组,每组35例,分别行经尿道等离子前列腺剜除术(TUPKEP)和传统的经尿道前列腺电切术(TURP).比较两组患者的手术时间、出血量、前列腺腺体切除重量、术后膀胱冲洗时间、术后住院天数、术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)等指标.对两组指标进行统计学分析.结果 TUPKEP组在手术的出血量、手术时间、术后膀胱冲洗时间以及术后的住院时间要明显小于TURP组(P＜0.05);TUPKEP组前列腺腺体切除重量大于TURP组(P＜0.05);两组患者术后随访3个月,残余尿、国际前列腺症状评分、生活质量评分差异均无显著性意义(P ＜0.05);TUPKEP组术后最大尿流率大于TURP组,两组比较有显著性差异(P＜0.05).结论 TUPKEP治疗BPH疗效确切,且安全性较好,特别适用于高龄高危的患者.     

前列腺动脉栓塞术治疗良性前列腺增生远期疗效

目的探讨前列腺动脉栓塞术(PAE)治疗良性前列腺增生(BPH)的远期临床疗效。方法对38例BPH患者行PAE治疗后进行36个月以上随访,比较手术前后国际前列腺症状评分(IPSS)、生活质量(QOL)评分、最大尿流率(Q_(max))、剩余尿(RU)、前列腺特异抗原(PSA)及国际勃起功能指数(IIEF)变化,并采用经直肠CDFI检测前列腺动脉收缩期峰值速度(V_(max))、舒张期速度(V_(min))及阻力指数(RI),以MRI观测前列腺体积(PV)。结果 PAE技术成功率100%(38/38),临床成功率84.21%(32/38)。PAE前后IPSS、QOL评分、Q_(max)、RU、PSA、PV、V_(max)、V_(min)及RI总体差异均有统计学意义(P均0.05),术前与术后各时间点两两比较差异均有统计学意义(P均0.05),术后各时间点两两比较差异均无统计学意义(P均0.05)。随访第48个月3例PV较术前增大约3.44%;4例尿路梗阻症状加重,RU增多,夜尿次数增多,内部血流信号丰富,予以第2次PAE治疗。结论 PAE治疗BPH远期疗效稳定、可靠。     

PKRP与TURP治疗良性前列腺增生症的疗效比较

目的观察经尿道前列腺等离子切除术（PKRP）治疗良性前列腺增生症（BPH）的疗效及并发症,并与经尿道前列腺电切术（TURP）进行比较。方法回顾分析采用PKRP、TURP治疗的768例BPH患者,分别收集两组患者年龄、国际前列腺症状评分（IPSS）、剩余尿量（RUV）、最大尿流率（Qmax）、生活质量评分（QOL）、手术时间、术中出血量、术后尿管留置时间、住院天数、术后并发症发生率资料并进行统计分析。结果两组病例年龄、前列腺重量及术前IPSS、RUV、Qmax和QOL比较差异均无统计学意义（P〉0.05）。两组在手术成功率、平均住院时间、术后平均留置尿管时间、术中出血量和冲洗时间方面无统计学差异（P〉0.05）;两组在手术时间、并发症发生率方面有统计学差异（P〈0.05）。结论PKRP治疗BPH的近期临床疗效与TURP相当,临床上可根据患者情况和适应证选择不同方法,以获得更好的临床疗效。     

Phytotherapy in the treatment of benign prostatic hyperplasia

There are numerous plant extracts that have been used for the treatment of benign prostatic hyperplasia and voiding dysfunction. While some extracts show promise, their efficacy has not been adequately proven in long-term, double-blind, placebo-controlled trials. In addition, the mechanism of action remains poorly defined.     

Office treatment of benign prostatic hyperplasia

The less invasive procedures described herein are suitable for use in the office setting. Improvement in symptoms and quality of life are similar to that achieved with TURP. With the exception of TUIP, flow rate improvement is less than with TURP. TURP, however, tends to produce a "super normal" flow rate, which may be unnecessary. Patients are concerned regarding symptoms and quality of life and the avoidance of complications. In regard to decreased complications, less invasive procedures have an advantage. The main concern with these new treatments, with the exception of TUIP, is durability. Treatment failure may lead to other treatments, thereby increasing overall management costs. In this regard, it must be remembered that there is a significant treatment failure rate with TURP. Although patients failing less invasive treatments are likely to be offered other treatments, this is less likely after an adequate TURP. Therefore, when results are compared, it may be more appropriate to evaluate failure rates based on symptoms and quality of life rather than on the use of additional treatments. More patient follow-up for a longer period of time will be required before a definite answer is available on durability. All of the procedures described herein can be performed to a variable extent using topical anesthesia. TUNA has been performed using topical lidocaine alone but frequently requires intravenous sedation/analgesia and, in some instances, a regional block. If the patient can tolerate rigid cystoscopy fairly well, topical anesthesia alone may suffice. Similar requirements for anesthesia apply to ILC with the Nd:YAG or indigo systems. Using the Targis (T3) microwave device, Peterson and co-workers reported that 60% of patients were treated with topical urethral lidocaine alone, whereas 40% also received oral Toradol. Djavan (personal communication) using the Targis (T3) device randomized patients to topical urethral anesthesia alone or combined with intravenous sedoanalgesia. Pain was evaluated using a 0 to 10 visual analog scale score. At the commencement of treatment, the mean score was 1.4 in the topical anesthesia alone group and 1.3 in the sedoanalgesia group. During therapy, the score increased to a peak at 30 minutes of 2.2 and 2.0 in the topical and sedoanalgesia groups, respectively. After this, the visual analog score declined, falling to 0.2 and 0.1, respectively, by 1 hour following treatment. This study shows that microwave treatment with the Targis (T3) system is well-tolerated using topical urethral anesthesia alone. No difference was observed between outcomes in the two groups. Capital and operating costs as well as reimbursement issues are important in the introduction of these treatments into the office; however, until more information is available on the durability of results, the cost-effectiveness of these newer treatments remains unclear.     

Laser treatment of benign prostatic hyperplasia

To evaluate the role of lasers that allow acute removal of obstructing tissue in the surgical treatment of benign prostatic hyperplasia (BPH). A MEDLINE search over the last 6 years focused on randomized trials, large case series and review articles. A total of more than 4,000 patients were analyzed with respect to the morbidity and outcome, and the advantages and disadvantages of the various lasers. Laser treatment of BPH has evolved from coagulation to enucleation. Blood loss is significantly reduced as compared to transurethral resection and open prostatectomy. Ablative/vaporizing techniques have recently become popular again with the marketing of new high-powered 80 W potassium-titanyl-phosphate (KTP) and 100 W holmium lasers. Vaporization immediately removes obstructing tissue, but tissue specimen cannot be obtained. KTP short-term results are promising, but long-term results and randomized trials are lacking. Postoperative volume reduction is less than with holmium laser enucleation of the prostate (HoLEP), and the KTP laser can be used for BPH treatment only. HoLEP allows whole lobes of the prostate to be removed. Prostates of all sizes can be operated on. It is at least as safe and effective as TURP and open prostatectomy, with significantly lower morbidity, as shown by several well-designed randomized clinical trials. It provides specimen for histological evaluation. In addition, the holmium laser can be used for the endourological treatment of stones, strictures and tumors. HoLEP appears to be a size-independent new “gold standard” in the surgical treatment of BPH.