전립선증식증(Benign Prostatic Hyperplasia)의 한의 임상 진료 현황 조사를 위한 온라인 설문 조사

백지수,신선미,조충식 대한한방내과학회 2023 大韓韓方內科學會誌 Vol.44 No.4

Objectives: This study investigated Korean medicine doctors’ perspectives on clinical practice patterns in the process of developing Korean medicine clinical practice guidelines for benign prostatic hyperplasia. Methods: A questionnaire was developed for Korean medicine doctors. A total of 323 oriental medicine doctors participated in the survey, which was live for a total of 9 days from September 22, 2022, to September 30, 2022. Results: Regarding awareness of treatments for benign prostatic hyperplasia, 63.8% of respondents showed high awareness of Korean medical treatments. However, items such as diagnostic criteria (17.7%), evaluation methods (17.0%), and Western medical treatments (22.9%) showed low recognition rates. In clinical practice, 76.2% of respondents were found to treat five or fewer patients with benign prostatic hyperplasia per month, and the average treatment period was 1 to 3 months for most at 41.2%. Korean medicine doctors diagnosed benign prostatic hyperplasia based on clinical features. The main interventions used were acupuncture, herbal medicine (prescription medicine), and moxibustion. This study has several limitations because of the low response rate for this survey; therefore, the participants are not representative of all Korean medicine doctors. In addition, because the study was conducted broadly on various topics related to benign prostatic hyperplasia, sufficient quality management was not carried out. Further studies that include a larger sample size and more in-depth studies on benign prostatic hyperplasia are needed. Conclusions: It is necessary to develop appropriate and reasonable Korean medicine clinical practice guidelines for benign prostatic hyperplasia.

전립선비대증 환자에서 조직 내 세균감염의 의미

최훈,박승철,정희종,조지현 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.10

Purpose: Benign prostatic hyperplasia (BPH) and prostatitis are the most common benign diseases of the prostate gland and over time affect a significant majority of men. We evaluated the relation between BPH and infection in prostatic tissue in men who underwent transurethral resection of the prostate (TURP). Materials and Methods: This prospective study included 63 consecutive patients diagnosed with BPH and scheduled for TURP. During the TURP, 1-2 g chips were collected after resection of the prostatic urethra, and specimens were transported to the laboratory in sterile saline. Homogenized specimens were incubated for 7 days. The patients were divided into 2 groups (group 1: culture positive, group 2: culture negative). We compared prostate volume, prostate calculi, serum prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual urine, and ratio of the transitional zone prostate to total prostate (transitional zone ratio). Results: Mean age was 72 years and mean serum PSA was 4.36 ng/dl. Group 1 included 7 patients (11.1%) and group 2 included 57 patients (88.9%). There were no significant differences in prostate volume, prostate calculi, serum PSA, IPSS, Qmax, or post-void residual urine between groups, but the transitional zone ratio was higher in group 1 (45.4%) than in group 2 (30.3%) (p<0.05). Conclusions: About 11% of the prostate tissue cultures showed bacterial growth. The transitional zone ratio was higher in patients with bacteria growth. Bacterial infection may be related to benign prostatic hyperplasia. Purpose: Benign prostatic hyperplasia (BPH) and prostatitis are the most common benign diseases of the prostate gland and over time affect a significant majority of men. We evaluated the relation between BPH and infection in prostatic tissue in men who underwent transurethral resection of the prostate (TURP). Materials and Methods: This prospective study included 63 consecutive patients diagnosed with BPH and scheduled for TURP. During the TURP, 1-2 g chips were collected after resection of the prostatic urethra, and specimens were transported to the laboratory in sterile saline. Homogenized specimens were incubated for 7 days. The patients were divided into 2 groups (group 1: culture positive, group 2: culture negative). We compared prostate volume, prostate calculi, serum prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual urine, and ratio of the transitional zone prostate to total prostate (transitional zone ratio). Results: Mean age was 72 years and mean serum PSA was 4.36 ng/dl. Group 1 included 7 patients (11.1%) and group 2 included 57 patients (88.9%). There were no significant differences in prostate volume, prostate calculi, serum PSA, IPSS, Qmax, or post-void residual urine between groups, but the transitional zone ratio was higher in group 1 (45.4%) than in group 2 (30.3%) (p<0.05). Conclusions: About 11% of the prostate tissue cultures showed bacterial growth. The transitional zone ratio was higher in patients with bacteria growth. Bacterial infection may be related to benign prostatic hyperplasia.

Prostatic urethral length as a predictive factor for surgical treatment of benign prostatic hyperplasia: a prospective, multiinstitutional study

Kim, Bum Soo,Ko, Young Hwii,Song, Phil Hyun,Kim, Tae-Hwan,Kim, Ki Ho,Kim, Byung Hoon Asian Pacific Prostate Society 2019 Prostate international Vol.7 No.1

<P><B>Background</B></P><P>We hypothesized that prostatic anatomical factors may affect the progression of benign prostatic hyperplasia (BPH) and analyzed whether prostatic anatomical factors could be predictive of the risk of surgery.</P><P><B>Materials and methods</B></P><P>From February to October 2014, 679 men older than 40 years who had lower urinary tract symptoms and enlarged prostates were enrolled from five medical centers. Patients' medical characteristics, serum prostate-specific antigen levels, transrectal ultrasound (TRUS) results, and uroflowmetry were analyzed. Using TRUS in all patients, the total prostate volume, transitional zone volume, prostatic urethral length, transitional zone urethral length, intravesical prostatic protrusion, and prostatic urethral angle were measured. Logistic regression analysis was used to determine factors associated with the risk of surgery. Receiver operating characteristic curves were used to determine cutoff values for significant variables.</P><P><B>Results</B></P><P>Of 679 patients, 37 (5.4%) underwent BPH-related surgery. Prostatic urethral length and transitional zone urethral length were independently associated with the risk of surgery. Age, serum prostate-specific antigen levels, peak flow rate, postvoid residual urine, and other anatomical factors determined by TRUS were not statistically significant with respect to the risk of surgery. Using receiver operating characteristic curve–based predictions, the best cutoff values for prostatic and transitional zone urethral length were 4.53 cm (sensitivity: 83.3%, specificity: 61.6%) and 3.35 cm (sensitivity: 83.3%, specificity: 77.9%), respectively.</P><P><B>Conclusions</B></P><P>This study showed that patients with BPH with longer prostatic and transitional zone urethral lengths had a higher risk of surgery. Prostatic and transitional zone urethral length may be useful predictive factors for medical treatment failure in patients with BPH.</P>

전립선비대증 환자에서 5알파환원효소 억제제 투여가 Survivin과 Bcl-2의 발현에 미치는 영향

차우헌,장태정,이경섭 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.3

Purpose: A 5-alpha-reductase inhibitor(5αRI) can induce apoptosis and decrease the prostatic volume in patients with benign prostatic hyperplasia (BPH). In this study we assessed the expression of survivin and bcl-2 in the epithelium of BPH patients treated with finasteride. Materials and Methods: Group 1 consisted of 39 patients who underwent transurethral resection of the prostate(TURP) without medication and Group 2 consisted of 31 patients who underwent TURP and were treated with finasteride for more than three months. The mean age of both groups of patients was 73.03±7.02 years and 74.71±5.99 years, respectively. Immunohistochemical staining for survivin, bcl-2 and ki-67 was performed in prostatic tissues. The percentage of cells that expressed survivin and bcl-2 were classified into four categories based on the staining intensity. The expression of ki-67 in nuclei using 10 random cells per specimen was obtained. The relationship between 5αRI and the expression of survivin, bcl-2 and ki-67 was analyzed. Results: The total mean prostate volume of group 1 patients and group 2 patients was 45.51ml and 37.23ml, respectively (p<0.001) and the mean serum total prostate-specific antigen(PSA) level of group 1 patients and group 2 patients was 5.09ng/ml and 3.75ng/ml, respectively(p=0.105). Decreased expression of survivin and bcl-2 in specimens from group 2 patients was observed as compared to the level of expression in group 1 patients(p<0.001, p=0.001). Expression of ki-67 determined in samples from both groups was not significantly different(p=0.345). Conclusions: We suggest that finasteride may induce apoptosis of prostatic epithelial cells in BPH patients by reducing the expression of survivin and bcl-2. These findings may indicate a reduction of prostatic volume. (Korean J Urol 2008;49:242-247) Purpose: A 5-alpha-reductase inhibitor(5αRI) can induce apoptosis and decrease the prostatic volume in patients with benign prostatic hyperplasia (BPH). In this study we assessed the expression of survivin and bcl-2 in the epithelium of BPH patients treated with finasteride. Materials and Methods: Group 1 consisted of 39 patients who underwent transurethral resection of the prostate(TURP) without medication and Group 2 consisted of 31 patients who underwent TURP and were treated with finasteride for more than three months. The mean age of both groups of patients was 73.03±7.02 years and 74.71±5.99 years, respectively. Immunohistochemical staining for survivin, bcl-2 and ki-67 was performed in prostatic tissues. The percentage of cells that expressed survivin and bcl-2 were classified into four categories based on the staining intensity. The expression of ki-67 in nuclei using 10 random cells per specimen was obtained. The relationship between 5αRI and the expression of survivin, bcl-2 and ki-67 was analyzed. Results: The total mean prostate volume of group 1 patients and group 2 patients was 45.51ml and 37.23ml, respectively (p<0.001) and the mean serum total prostate-specific antigen(PSA) level of group 1 patients and group 2 patients was 5.09ng/ml and 3.75ng/ml, respectively(p=0.105). Decreased expression of survivin and bcl-2 in specimens from group 2 patients was observed as compared to the level of expression in group 1 patients(p<0.001, p=0.001). Expression of ki-67 determined in samples from both groups was not significantly different(p=0.345). Conclusions: We suggest that finasteride may induce apoptosis of prostatic epithelial cells in BPH patients by reducing the expression of survivin and bcl-2. These findings may indicate a reduction of prostatic volume. (Korean J Urol 2008;49:242-247)

전립선비대증에서 나타나는 조직학적 염증소견의 의미

김현우,김상훈,김세웅,정규인,민기옥,조수연 대한비뇨의학회 2009 Investigative and Clinical Urology Vol.50 No.2

Purpose: Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate surgery specimens. We evaluated the correlation between the symptoms of benign prostatic hyperplasia (BPH) and the grades of inflammation in surgical specimens of patients who had undergone operation for BPH without any evidence of clinical prostatitis. Materials and Methods: Seventy five patients with BPH, who had gone through transurethral resection of the prostate (TURP) at our department from March 2004 to May 2007, were retrospectively studied. Of the 75 patients, 57 patients were pathologically diagnosed as having a BPH with prostatitis and 18 patients had the only BPH (group G0). Chronic inflammation was graded as I (group G1: scattered inflammatory cell infiltrate within the stroma without lymphoid nodules), II (group G2: nonconfluent lymphoid nodules) or III (group G3: large inflammatory areas with confluence of infiltrate). The serum prostate-specific antigen (PSA) level, PSA density (PSAD), International Prostate Symptom Score (IPSS) and maximum urinary flow rate were compared among the grades of inflammation. Results: In the patients had undergone TURP, prostatic inflammation was found in 76% (57/75). The storage symptoms of IPSS and PSAD were significantly correlated to the extent of inflammation in each groups (p<0.05). No significant correlations were observed between PSA, size of prostate, voiding symptoms, quality of life (QoL) of IPSS, and maximum urinary flow rate. Conclusions: The extent of chronic inflammation had considerably more relationship with storage symptoms than voiding symptoms and with the increased PSAD. These findings suggest that the subclinical prostatitis may be one of the factors of storage symptoms of BPH patients and postoperative maintained lower urinary tract symptoms. Purpose: Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate surgery specimens. We evaluated the correlation between the symptoms of benign prostatic hyperplasia (BPH) and the grades of inflammation in surgical specimens of patients who had undergone operation for BPH without any evidence of clinical prostatitis. Materials and Methods: Seventy five patients with BPH, who had gone through transurethral resection of the prostate (TURP) at our department from March 2004 to May 2007, were retrospectively studied. Of the 75 patients, 57 patients were pathologically diagnosed as having a BPH with prostatitis and 18 patients had the only BPH (group G0). Chronic inflammation was graded as I (group G1: scattered inflammatory cell infiltrate within the stroma without lymphoid nodules), II (group G2: nonconfluent lymphoid nodules) or III (group G3: large inflammatory areas with confluence of infiltrate). The serum prostate-specific antigen (PSA) level, PSA density (PSAD), International Prostate Symptom Score (IPSS) and maximum urinary flow rate were compared among the grades of inflammation. Results: In the patients had undergone TURP, prostatic inflammation was found in 76% (57/75). The storage symptoms of IPSS and PSAD were significantly correlated to the extent of inflammation in each groups (p<0.05). No significant correlations were observed between PSA, size of prostate, voiding symptoms, quality of life (QoL) of IPSS, and maximum urinary flow rate. Conclusions: The extent of chronic inflammation had considerably more relationship with storage symptoms than voiding symptoms and with the increased PSAD. These findings suggest that the subclinical prostatitis may be one of the factors of storage symptoms of BPH patients and postoperative maintained lower urinary tract symptoms.

용적이 큰 전립선비대증 환자에서 복강경 단순 전립선절제술의 초기 경험

김병환,류동수,오태희 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.5

Purpose: Simple prostatectomy has been a mainstay of therapy for patients with large prostatic adenoma. We describe laparoscopic approach for resection of large prostatic adenoma as an alternative to open simple prostatectomy. Materials and Methods: From July 2006 to May 2007 we performed Laparoscopic simple prostatectomy on 10 patients who were diagnosed with clinically benign prostate hyperplasia(maximal urine flow rate(MFR) ≤10ml/sec, International Prostate Symptom Score(IPSS) ≥12 scores, and prostate weight ≥75g). The steps of our extraperitoneal 5 port technique were longitudinal cystotomy, subcapsular plane development, enucleation of the obstructing prostatic adenoma, insertion of Spongospan into the prostatic fossa, traction of 22Fr balloon catheter and suture repair of cystotomy. Results: We successfully performed the operation in all cases without conversion. The mean patient age is 68.1 years old(60-73). The mean preoperative PSA, prostate volume were 8.8ng/ml(1.8-16.9), 97g(74.1- 120.6). The mean operating time and estimated blood loss were 204min (160-275) and 720ml(300-1,200). The resected mass weight was 45.5g (23-70). There were no major complications. The mean hospitalization stay and drain remove days were 11.3 days(9-14) and 5.6 days(4-8). The mean preoperative MFR, IPSS/quality of life(QoL) and were 2.8ml/sec(0-9.6), 25/5(14-35/4-6) and 270ml(250-310). At 3 months postoperatively, the mean MFR, IPSS/QoL and residual urine volume were 15.6ml/sec(12-23), 10/2.6(5-12/2-4) and 16.75(10-40). Conclusions: Laparoscopic simple prostatectomy could be a useful method for the treatment of large benign prostate hyperplasia. However, more experiences and comparative studies are needed to document the safe and effect compared to open prostatectomy and transurethral resection of prostate. (Korean J Urol 2008;49:418-423) Purpose: Simple prostatectomy has been a mainstay of therapy for patients with large prostatic adenoma. We describe laparoscopic approach for resection of large prostatic adenoma as an alternative to open simple prostatectomy. Materials and Methods: From July 2006 to May 2007 we performed Laparoscopic simple prostatectomy on 10 patients who were diagnosed with clinically benign prostate hyperplasia(maximal urine flow rate(MFR) ≤10ml/sec, International Prostate Symptom Score(IPSS) ≥12 scores, and prostate weight ≥75g). The steps of our extraperitoneal 5 port technique were longitudinal cystotomy, subcapsular plane development, enucleation of the obstructing prostatic adenoma, insertion of Spongospan into the prostatic fossa, traction of 22Fr balloon catheter and suture repair of cystotomy. Results: We successfully performed the operation in all cases without conversion. The mean patient age is 68.1 years old(60-73). The mean preoperative PSA, prostate volume were 8.8ng/ml(1.8-16.9), 97g(74.1- 120.6). The mean operating time and estimated blood loss were 204min (160-275) and 720ml(300-1,200). The resected mass weight was 45.5g (23-70). There were no major complications. The mean hospitalization stay and drain remove days were 11.3 days(9-14) and 5.6 days(4-8). The mean preoperative MFR, IPSS/quality of life(QoL) and were 2.8ml/sec(0-9.6), 25/5(14-35/4-6) and 270ml(250-310). At 3 months postoperatively, the mean MFR, IPSS/QoL and residual urine volume were 15.6ml/sec(12-23), 10/2.6(5-12/2-4) and 16.75(10-40). Conclusions: Laparoscopic simple prostatectomy could be a useful method for the treatment of large benign prostate hyperplasia. However, more experiences and comparative studies are needed to document the safe and effect compared to open prostatectomy and transurethral resection of prostate. (Korean J Urol 2008;49:418-423)

Efficacy of Alpha Blocker Treatment According to the Degree of Intravesical Prostatic Protrusion Detected by Transrectal Ultrasonography in Patients with Benign Prostatic Hyperplasia

박희영,이주용,박성열,이승욱,김용태,최홍용,문홍상 대한비뇨의학회 2012 Investigative and Clinical Urology Vol.53 No.2

Purpose: To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH). Materials and Methods: A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months. Results: The mean age of the patients was 65.01±7.38 years. Mean IPPs were 0.90±1.39 mm (group A, n=90), 6.92±1.10 mm (group B, n=24), and 16.60±4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p<0.05), but not with IPSS/QoL score (p>0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved. Conclusions: Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP. Purpose: To analyze the effectiveness of tamsulosin 0.2 mg once daily for 3 months according to the degree of intravesical prostatic protrusion (IPP) in patients with benign prostatic hyperplasia (BPH). Materials and Methods: A total of 134 BPH patients over 40 years of age treated with tamsulosin 0.2 mg between January 2007 and January 2009 were enrolled retrospectively. The patients were classified into three groups according to the degree of IPP: below 5 mm (group A), between 5 and 10 mm (group B), and over 10 mm (group C). Prostate volume, prostate-specific antigen (PSA), prostatic urethral length (PUL), and prostatic adenoma urethral length (PAUL) were evaluated before treatment. International Prostate Symptom Score and Quality of Life (IPSS/QoL), maximal urine flow rate (Qmax), and postvoid residual (PVR) volume were measured before treatment, and improvement in the three groups was compared after 3 months. Results: The mean age of the patients was 65.01±7.38 years. Mean IPPs were 0.90±1.39 mm (group A, n=90), 6.92±1.10 mm (group B, n=24), and 16.60±4.06 mm (group C, n=20). Prostate volume, PUL, PAUL, PSA, Qmax, and PVR showed significant correlations with IPP (p<0.05), but not with IPSS/QoL score (p>0.05). Comparison of parameters before and after 3 months showed that medication improved total IPSS and subscores (p<0.001), QoL (p<0.001), Qmax (p<0.001), and PVR (p=0.030) in group A. In group B, it improved total IPSS (p=0.01), irritative subscore (p<0.001), and obstructive subscore (p=0.03). In group C, only total IPSS (p=0.01) and irritative score (p<0.001) were significantly improved. Conclusions: Tamsulosin may be more effective in improving symptom scores and Qmax in patients with mild IPP than in those with moderate or severe IPP.

황금(黃芩)이 전립선비대증(前立腺肥大症) Rat에 미치는 영향

김진성,한양희,김용성,Kim, Jing-Sung,Han, Yang-Hee,Kim, Young-Seong 대한한방내과학회 2009 大韓韓方內科學會誌 Vol.30 No.2

Objective : In benign prostatic hyperplasia, dihydrotestosterone acts as a potent cellular androgen and promotes prostate growth. Inhibiting enzyme 5${\alpha}$-reductase, which is involved in the conversion of testosterone to the active form dihydrotestosterone, reduces excessive prostate growth. Recently Scutellaria baicalensis has been related reports about the effect of baicalein on anti-proliferation of the prostate gland. In this study, we investigated the effects of Scutellaria baicalensis on cytopathological alterations and expression of 5${\alpha}$-reductase in the rat model of benign prostatic hyperplasia induced by castration and testosterone treatment. Methods : Sprague-Dawley rat were treated with testosterone after castration for induction of experimental benign prostatic hyperplasia, which is similar to human benign prostatic hyperplasia in histopathological profiles. Scutellaria baicalensis as an experimental specimen, and finasteride as a positive control, were administered orally. The prostates were evaluated by histopathological changes, testosterone levels, and the expression of 5${\alpha}$-reductase genes. Results : While prostates of control rats revealed severe acinar gland atrophy and stromal proliferation, the rats treated with Scutellaria baicalensis showed a diminished range of tissue damage. In the reverse transcription-polymerase chain reaction(RT-PCR) of 5${\alpha}$-reductase genes. Scutellaria baicalensis inhibited the expression of 5${\alpha}$-reductase genes. Conclusions : These findings suggest that Scutellaria baicalensis may protect glandular epithelial cells and also inhibit stromal proliferation in association with the suppression of 5${\alpha}$-reductase. From theses results, we suggest that Scutellaria baicalensis could be a useful remedy agent for treating benign prostatic hyperplasia.

전립샘비대증 환자에서 전립샘용적와 발기부전과의 관계

김민석(Min Seok Kim),조원진(Won Jin Cho),임동훈(Dong Hoon Lim),김철성(Chul-Sung Kim),이철갑(Chul-Gab Lee),노준(Joon Rho) 조선대학교 의학연구원 2020 The Medical Journal of Chosun University Vol.45 No.2

Common symptoms of aging include degradation of male sexual function and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). There is no systematic report that prostatic hyperplasia causes sexual dysfunction. In addition, since both prostatic hyperplasia and erectile dysfunction are related to age, it is difficult to directly link prostate hyperplasia and erectile dysfunction. The relationship between prostate volum and erectile dysfunction due to prostate hyperplasia is controversial, but the exact mechanism of integration is still being considered. Age and age-adjusted LUTS severity are decreasing factors of erectile function. With BPH therapy, increase of urinary symptoms and quality of life are well-known, but there are controversies over the sexual function according to the treatment method. The purpose of this study is to evaluate the correlation between prostate volume and erectile dysfunction in patients with symptoms of urinary tract depression caused by benign prostatic hyperplasia. 50 subjects with BPH, and before initiating BPH treatment that may affect erectile function, quantification of erectile function is conducted in 5 questions to all respondents using the International Index of Erectile Function (IIEF-5). The Pearson correlation coefficient between prostate volume and IIEF-5 score was -0.039 (p-value-0.784). Therefore, as the volume of the prostate increases, erectile dysfunction is not related to evil. The results of IIEF-5 appear to be unregulated in the case of the prostate volume or the rate of increase in the prostate volume, and there is no change in the IIEF score.

해김사(海金沙)가 Rat의 전립선비대에 미치는 영향

이두현,이장식,김용성,Lee, Doo-Hyun,Lee, Jang-Sik,Kim, Young-Seung 대한한방내과학회 2010 大韓韓方內科學會誌 Vol.31 No.3

Objective : In benign prostatic hyperplasia, dihydrotestosterone acts as a potent cellular androgen and promotes prostate growth. Inhibiting enzyme $5{\alpha}$-reductase that is involved in the conversion of testosterone to the active form dihydrotestosterone reduces this excessive prostate growth. The mechanism on benign prostatic hyperplasia is substantiating evidence to support the clinical value in the evaluation of therapeutic efficacy. In this study, we investigated the effects of Lygodium japonicum on cyto-pathological alterations and expression of $5{\alpha}$-reductase in the rat model of benign prostatic hyperplasia induced by castration and testosterone treatment. Methods : Sprague-Dawley rats were treated with testosterone after castration for induction of experimental benign prostatic hyperplasia, which is similar to human benign prostatic hyperplasia in histopathological profiles. Lygodium japonicum as an experimental specimen, and finasteride as a positive control, were administered orally. The prostates were evaluated by histopathological changes and testosterone levels. Also, the prostates were observed by hematological alterations of AST, ALT, ${\gamma}$-GTP, BUN and creatinine. Results : The rats treated with Lygodium japonicum showed a diminished range of luminal cell and duct epithelial cell damage. The stromal elements and connective tissue proliferation of Lygodium japonicum treated group as compared to the control group decreased. Conclusions : These findings suggest that Lygodium japonicum may protect the glandular epithelial cells. We concluded that Lygodium japonicum could be a useful remedy agent for treating the benign prostatic hyperplasia.