Post Date December, 03 2023
Some patients with BPH may stop growing or even shrink when they reach a certain age or through effective drug treatment, which is the theoretical basis for non-surgical treatment of BPH.
In the treatment of benign prostatic hyperplasia, drugs mainly act in two ways.
The first is to relax the bladder neck, prostate capsule and gland to reduce or relieve the functional obstruction caused by prostatic hyperplasia.
Because there are abundant α Sympathetic nerve receptor, the sympathetic nerve excitation in the body will lead to the contraction and tension increase of the prostate body. It can be seen that the lower urinary tract obstruction caused by prostatic hyperplasia not only increases the mechanical compression of the gland, but also includes the so-called dynamic factors of the contraction and tension increase of the prostate capsule and smooth muscle in the prostate gland. If the urethra is compared to a hose, it is not only mechanically compressed by the surrounding prostate tissue, but also tightened and difficult to expand by the smooth muscle like a rubber band hidden in the prostate. Phenobenzylamine and other drugs used earlier in clinical practice are non-selective α Receptor blocker, because it can not only block the α 1 receptor can also block the smooth muscle of blood vessels α 2 receptors, which may cause side effects such as dizziness and orthostatic hypotension in patients and be selectively α Receptor blockers, such as cortisol and prazosin, have been widely used and have a positive effect. After further research, scientists will α 1 receptor is divided into α 1A、 α 1B and α 1D3 subtypes, found that more than 90% of 11 receptors in prostate matrix, capsule and bladder neck are α Type 1A. At present, doctors have found that a drug called tamsulosin hydrochloride is superselective α 1A receptor blocker, for other parts α The effect of receptor 1 is very small, so it may be a good drug to treat the dynamic factors of BPH.
Another way of treatment is to reduce or eliminate mechanical obstruction factors by shrinking the prostate.
It is obviously an effective treatment for the etiology to make the hyperplastic prostate atrophy smaller. In recent years, the use of more anti-hormone drugs Baoliezhi is a very representative one. The molecular structure of Baoliezhi is similar to that of testosterone and DHT, which can be compared with 5 α- The competitive binding of reductase can reduce the level of dihydrotestosterone in serum by 65% and the level of dihydrotestosterone in prostate tissue by 90% by blocking the conversion of ketone into dihydrotestosterone (the latter is an important factor to promote prostate hyperplasia). Therefore, it can make the gland no longer proliferate, or even shrink. However, it usually takes more than 6 months of continuous medication to be effective. Clinically, some patients often use drugs for 1 to several years. In addition to lowering dihydrotestosterone, another drug that blocks the combination of dihydrotestosterone and prostate estrogen receptor has also been developed successfully. This is the Sheniton, also known as Qianlietai, extracted by Swedish scientists from barley pollen. This drug can effectively block the binding of dihydrotestosterone and prostate androgen receptor. It can be understood that since the sex hormone can not combine with the prostate after medication, although dihydrotestosterone is not reduced in the prostate, the possibility of prostate hyperplasia is greatly reduced. This natural pollen extract has no side effects, can be taken for a long time, and has the advantage of not reducing the level of dihydrotestosterone, thus having no effect on sex hormones.
(Intern editor: Huang Junda)
