Post Date December, 03 2023
It is the wish of every patient to take medicine clearly. Chen Bo has been dealing with hospitals and doctors for a long time since he suffered from prostatic hyperplasia. However, after taking the medicine for so long, it worked very well, but he didn't know what kind of medicine he was taking and what effect it had. In fact, there are many patients like Chen Bo. It's not that they don't want to take medicine for nothing, but that they can't understand. Next, we will introduce the drugs for treating prostatic hyperplasia and how to choose them.
The prostate is the largest accessory gland in the male body. It is a single, solid and tough gland. It looks like an inverted chestnut. The center is penetrated by the beginning of the urethra. Its function is to secrete prostatic fluid, which is an important component of semen. From about 45 to 50 years of age, men have different degrees of prostate hyperplasia. Now with the prolongation of human life span, prostatic hyperplasia has become a common disease in elderly men. Recent statistics show that about 40% of the elderly over 60 years of age suffer from prostatic hyperplasia, excluding those patients with mild symptoms, inconspicuous signs and undetectable symptoms.
Because the prostate is located at the bladder opening of the urethra, its enlargement will compress the bladder opening and the posterior urethra. Thus, there will be different degrees of dysuria (or lower urinary tract obstruction symptoms). The purpose of treatment is to remove the resistance of urination. Generally speaking, the resistance of urination is caused by two reasons: first, the increase of prostate volume oppresses the urethra. The second is that the contraction and tension of the smooth muscle in the prostate capsule and gland are too large, which increases the resistance of urine excretion. Therefore, drug treatment should address these two factors.
In recent years, there are more than ten kinds of drugs for the treatment of prostatic hyperplasia, and new drugs are also emerging. In general, there are four kinds of drugs for treating prostatic hyperplasia:
1、 The drug that reduces the size of the prostate is related to a hormone in the blood called dihydrotestosterone, which is the testosterone secreted by the testis α－ It is converted from the action of reductase, thus inhibiting 5 α－ The role of reductase can reduce the production of testosterone, resulting in the decrease of its concentration in the blood and the reduction of prostate volume and the relief of obstructive symptoms. Its representative drug is Baoliezhi (prescription drug). Because BPH is a slow-developing disease, its reduction also takes a corresponding time. The treatment should last for at least 6 months before it can take effect, but it will proliferate again after stopping the drug.
2、 Smooth muscle relaxant Although some people have no obvious prostatic hyperplasia, the symptoms are very serious. The reason is often due to the excessive tension of the smooth muscle fibers in the prostate capsule and gland. If the tension of these muscle fibers is relieved and the smooth muscle of bladder neck, prostate and urethra are relaxed, the symptoms can be alleviated. This kind of medicine α－ Adrenal receptor blocker phenbenamine, represented by masanil (terazosin hydrochloride). However, these drugs can relax the smooth muscle in the blood vessels of the whole body, so postural hypotension may occur after taking them. In addition, there are side effects such as nasal congestion, dizziness, palpitation, headache, fatigue, blurred vision, and no ejaculation. Some of the new products, such as Gottlin, Hale and Santa, have a specific scope of action, and some are slow-release agents, which have a longer effect, less side effects, and can be taken less times per day, with obvious advantages.
3、 Plant medicine This kind of medicine is an effective ingredient extracted from African herbal medicine, saw palm fruit, pollen and other plants. It has the function of inhibiting testosterone in the gland or directly acting on proliferating cells to reduce gland edema. At present, Tongniaoling, Baoqianli, Baoqianli and Qianliekang, which are commonly used in clinical practice, belong to this class of drugs. In addition, Shenitong (Qianlietai) is made from pure pollen by extracting effective ingredients from broken shells, and its efficacy is faster and more obvious.
4、 In addition to the above drugs, other drugs for the treatment of benign prostatic hyperplasia include steroid drugs and sex hormone drugs, such as mepramycin, isonaton, and progesterone. However, due to the fact that it has been rarely used in clinical practice, it will not be repeated here.
So, how do patients with BPH choose drugs? Generally speaking, drug treatment is applicable to patients with obvious symptoms but not too serious. For example, there is no need to use great strength or other complications when urinating; Night urination (the number of urination after falling asleep at night) shall not exceed 3 times; Those who have not suffered from urinary retention for many times (unable to discharge urine at all); After examination, the urine flow rate (urine output per minute) has decreased to a certain extent, but the residual urine volume (residual urine volume in the bladder after urination) does not exceed 60 ml. If it is not within the above scope or is ineffective after drug treatment, it is necessary to remove the prostate, which is the most fundamental way to treat prostatic hyperplasia.
Although all kinds of drugs have their own functions, smooth muscle relaxants are usually combined with drugs that can reduce the volume of prostate in clinical practice. The purpose of this is that the former can reduce symptoms quickly, while the latter can gradually shrink the prostate. Of course, smooth muscle relaxants can also be used alone or combined with other drugs. Finally, it is particularly important to emphasize that because the condition of BPH changes greatly, some drugs for treating BPH should not be blindly increased in order to avoid adverse consequences.
