云南白药用于降低非特异性升高PSA及早期前列腺癌筛查的作用分析

目的 探讨云南白药是否能够降低非特异性升高的患者血清PSA水平，提高前列腺穿刺结果阳性率，减少不必要的穿刺。方法 选取2012年以来因体检发现PSA升高来本院泌尿外科就诊且年龄大于50岁，4 μg /mL

Effect of yunnan baiyao therapy on non-specific elevated PSA and prostate biopsy

Objective To evaluate whether a six months course of Yunnan Baiyao therapy would lower serum prostate specific antigen (PSA) and affect outcome of prostate biopsy.Methods In this randomized,prospective and non-blinded clinical trial,we recruited eligible 96 asymptomatic patients who were older than 50 years old and with PSA of 4 ～20 ng/mL in our center.All patients were treated with Yunnan Baiyao for 6 months.PSA tests,digital rectal examination (DRE) and ultrasonography(US) were conducted in the following 1,2,3,6 months.Six months later,patients were divided into two groups according to their treatment response:group 1 with reduced PSA level (defined as a decrease in PSA by at least 20％) and group 2 with no response.Twenty-one and 29 patients from group 1 and group 2 were randomly assigned respectively and underwent transrectal ultrasound-guided prostate biopsy.Results The average PSA decreased significantly compared with baseline value after a course of 6 months treatment,with a change of 2.05 ng/mL,about a reduction rate of 22.2％ (P ＜0.05).Of those who received biopsy,1 case in group 1 and 6 cases in group 2 were diagnosed with prostate cancer (4.76％ vs.20.7％,P ＜0.05).The sensibility and specificity of PSA reduction of ≥20％ was 85.71％ and 46.51％ respectively.Conclusions Yunnan Baiyao may contribute to decline of elevated PSA caused by non-malignant lesions and improve positive prostate biopsy ratio,thereby avoiding unnecessary prostate biopsy.However,the outcome should be further validated by multicenter,large sample and long-term follow-up clinical trial.