癃畅颗粒治疗良性前列腺增生症的临床观察及对BCL-2基因表达影响的研究
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摘要
目的:探讨癃畅颗粒治疗前列腺增生症的临床疗效及对bcl-2基因表达的影响,从而进一步探讨癃畅颗粒治疗前列腺增生的作用机制。
     方法:选择80例前列腺增生症患者随机分为两组,治疗组40例,口服癃畅颗粒:对照组40例,口服癃闭舒,1个月为1个疗程,两组均治疗3个疗程。对治疗前后临床症状、IPSS、最大尿流率、残余尿量、前列腺体积等指标进行对照分析。实验部分采用大鼠去势后注射丙酸睾酮致前列腺增生法造模,灌胃给药后30d处死。摘取前列腺组织并测量湿重,采用PV两步法对癃畅颗粒和癃闭舒干预的大鼠前列腺增生组织进行bcl-2基因检测及组织病理学观察。
     结果:临床观察:治疗组总有效率为78.4%,对照组总有效率为64.7%经x~2检验分析,(P<0.05),两组疗效比较有显著性差异。治疗组疗后临床症状、IPSS、QOL、最大尿流率、残余尿量、前列腺体积均有明显改善,经t检验分析(P<0.05),治疗后两组疗效比较有显著性差异。实验研究表明:前列腺湿重:空白组0.61±0.03;模型组0.95±0.04;癃闭舒组0.73±0.02;癃畅颗粒低剂量组0.80±0.05;癃畅颗粒中剂量组0.78±0.07;癃畅颗粒高剂量组0.68±0.03;与模型组比较P<0.05。前列腺指数,各组分别为:0.143±0.006;0.226±0.008;0.172±0.004;0.199±0.012;0.181±0.010;0.168±0.003;与模型组比较P<0.05。癃畅颗粒对BPH大鼠前列腺上皮细胞bcl-2基因表达影响(平均光密度),各组分别为:0.089±0.010;0.131±0.005;0.093±0.015;0.109±0.001;0.097±0.003;0.091±0.003;与模型组比较P<0.05。
     结论:
     1.癃畅颗粒治疗前列腺增生症疗效显著,且疗效优于癃闭舒。
     2.癃畅颗粒能够有效缩小模型大鼠前列腺湿重,减轻病理变化。其作用机制可能为下调大鼠前列腺bcl-2基因表达促进前列腺细胞凋亡。
Objective:
     To investigate the Longchangkeli treatment of benign prostatic hyperplasia and the clinical efficacy of bcl-2 gene expression to explore the impact of particles on the treatment of retention of urine Chang mechanism of benign prostatic hyperplasia.
     Methods:
     80 cases of benign prostatic hyperplasia were randomly divided into two groups,treatment group,40 cases of oral Longchangkeli;40 cases of the control group,oral Longbishu,one month a course of treatment for the two groups are the treatment of 3 courses.Of clinical symptoms before and after treatment,IPSS,maximum urinary flow rate,residual urine volume,prostate volume,such as comparative analysis of indicators.Some experiments using rats injected testosterone propionate after castration-induced prostatic hyperplasia law model,after oral administration of 30d executed.Removal of prostate tissue wet weight was measured using two-step method of PV particles and infirmity infirmity closed Chang Shu intervention organizations prostatic hyperplasia in rats bcl-2 gene testing.
     Resulsts:
     Clinical observation:In the treatment group,the total effective rate 78.4%.In the control group,the total effective rate was 64.7%.With X~2 test, the difference between the two groups significant(P<0.05),which show that the effect of Longchangkeli is better than the control group in treatment.The experimental results show that wet weight of prostate:blank group 0.61±0.03; model group 0.95±0.04;Longbishu group 0.73±0.02;the low dose of Longchangkeli 0.80±0.05;the normal dose of Longchangkeli 0.78±0.07;the high dose of Longchangkeli 0.68±0.03;compared with model group P<0.05. Prostate index:blank group 0.143±0.006;model group 0.226±0.008; Longbishu group 0.172±0.004;the low dose of Longchangkeli 0.199±0.012; the normal dose of Longchangkeli 0.181±0.010;the high dose of Longchangkeli 0.168±0.003;compared with model group P<0.05.Expression effect study of Longchangkeli on prostate's bcl-2 in benign prostate hyperplasia rats(average optical density):blank group 0.089±0.010;model group 0.131±0.005;Longbishu group 0.093±0.015;the low dose of Longchangkeli 0.109±0.001;the normal dose of Longchangkeli 0.097±0.003; the high dose of Longchangkeli 0.091±0.003;compared with model group P<0.05.
     Conclusion:
     1.The Longchangkeli can obviously alleviate the symptoms and signs of the BPH.The results show that the effect of Longchangkeli on the BPH was superior to that of Longbishu.
     2.Longchangkeli can effectively reduce the model of rat prostate wet weight,reduce the pathological changes.Its mechanism of rat prostate may be reduced bcl-2 gene expression in the promotion of prostate cell apoptosis.
引文
1 Bostwick DG·Pathology of benign prostatic hyperplasia[M]·Text-book of benign prostatic hyperplasia·Edited by Roger Kirby,ISASMedical Me-dia·Ltd,1996:91-104.
    2 徐建,沈薇薇,李艳.355名离退休人员不同年龄段患病状况分析.解放军预防医学药志,2005,5(23):358-359.
    3 莫乃新,吕忠,吴莲芬等.前列腺增生症发病情况的调查[J].中华泌尿外科杂志,1999,(20):11.
    4 马昶云,杨亚璋,杨开舜.360例离退休干部体检分析报告.大理医学院学报,1999,1(8):60-62.
    5 何学积,谢雄辉等.大理地区前列腺增生发病率调查报告.医学信息,1996,(1):5-7.
    6 汪秀英,王惠新,陈茂杰等.793例老年男性泌尿生殖系统疾病住院情况分析.中国校医,2005,6(19):615-616.
    7 Grundy SM、Sleeman JI、Kifkind WB,、t al.Cholesterol loweringin theelderly population[J].Arch Intern Med:1999,159:1 670-1 678.
    8 颜纯海,单玉喜.前列腺增生症中孕激素受体检测.中华内分泌杂志,1995,11:225.
    9 王继忠,毛铺德,曾德朗等.前列腺增生雌激素受体血管内皮细胞生长因子表达的研究.川北医学院学包,2000,1(15):11-13.
    10 Bataineh ZM,Bani Hani IH,,Al-Alami JR.Saudi Med J,2002;23(2):218-220.
    11 Feng P,Li TL.Guan ZX,et al.Mol Urol,2000;4(1):31-36.
    12 李妍,张庆林.异株蕁麻根治疗良性前列腺增生的研究及应用进展,国外医学中医中药分册 2004;26(1):146-148.
    13 刘士廉,郑德先.细胞凋亡及其基因惆控.基础医学与临床,1994,3(14):1-4.
    14 Ellis R E,Yuan JY Horvits HRR,Mechanisms and Functions of Cell Death,Annu Rev Cell Biol,1991,7:663.60.Bowen ID,Bowen SM.Programmed cell death in tumors and tissues.Ed.Chapman and Hall,1990.1-100.
    15 Westin P,Brandstrom A,Damber JE,et al.Catration plus oestrogentreatment indues but castration alone suppresses epithelial cell apop-tosis in an androgensensitive rat prostatic adeNOcarciNOma.Br J Can-cer,1995,72:140-145.
    16 Thompson CB.Science 1995;267:1 456.62.Thompson CB.Science 1995;267:1456.
    17 Berry SJ,et al.EndocriNOI 1984;114:511
    18 王晓麟.前列腺增生与细胞凋亡.男性学杂志,1997,4(11):238-241.
    19 Cazals-Hatem D,Louie D,Tana.ka S,et al.Molecu-lar cloning and DNA sequence analysis of cDNA en-coding Chicken homolog of the bcl-2 oncoprotein.Biochim Biophys Acta,1992,1132:109-113.
    20 Cao X,Rodarte C,Zhang L,et al.Bcl2/bcl-xl inhibitor engenders apoptosis and increases chemosensitivity in mesothelioma.Cancer Biol Ther2007;6(2):246-252
    21 Moller C,KarlbergM,Abrink M,et al.Bcl-2 and bcl-xl are indispensable for the late phase of mast cell development from mouse embryonic stem cells.Exp Hematol 2007;35(3):385-393
    22 Staecker H,LiuW,Malgrange B,et al.Vector-mediated delivery of bcl-2 prevents degeneration of auditory hair cells and neurons after injury.ORL J Otorhinolaryngol Relat Spec 2007;69(1):43-50
    23 Amarnath D,Li X,Kato Y,et al.Gene expression in individual bovine somatic cell cloned embryos at the 8-cell and blastocyst stages of preimplantation development.J Reprod Dev 2007;53(6):1247-1263
    24 Gareskog M,Cederberg J,Eriksson UJ,etal,Maternal diabetes in vivo and high glucose concentration in vitro increases apoptosis in rat embryos.Reprod Toxicol 2007;23(1):63-74
    25 Boelhauve M,Sinowatz F,Wolf E,et al.Maturation of bovine oocytes in the presence of leptin improves development and reduces apoptosis of in vitro-produced blastocysts.Biol Reprod 2005;73(4):737-744
    26 Eom TY,Roth KA,Jope RS.Neural precursor cells are protected from apoptosis induced by tropbic factor withdrawal or genotoxic stress by inhibitors of glycogen synthase kinase 3.J Biol Chem 2007;282(31):22856-22864
    27 Monniaux D.Oocyte apoptosis and evolutiou of ovarian reserve.Gynecol Obstet Fertil 2002;30(10):822-826
    28 Cho HJ,Kim JK,Kim KD,et al.Upregulation of bcl-2 is associated with cisplatin-resistance via inhibition of bax translocation in human bladder cancer cells.Cancer Lett 2006;237(1):56-66
    29 Baghdassarian N,Bertrand Y,Ffrench P,et al.Role of bcl-2 and cell cycle regulatory proteins for corticosensitivity assessment in childhood acute lymphoblastic leukaemia.Br J Haematol.2000;109(1):109-116
    30 Coffey DS,Ripoll E,Sugimura Y,et al.Animal models of benign prostatic hyperplasia.ln Codkett ATK,Aso Y,Chatelain C,et al(eds).The international consultation on benign prostatic hyperplasia(BPH)[M].Paris,1999.45(3):271-275.
    31 聂勇、郭贤坤,等.输精管结扎术后犬前列腺细胞凋亡与Bcl-2,Bax基因表达[J].实用医学进修杂志 2006,34(1):31-37.
    32 祝海、宋卫青、周荣祥.前列腺中凋亡抑制基因Bcl-2的表达研究[J].中国实验诊断学 2002,6(2):82-84.
    33 ErbersdoblerA,FriritzH,SchnogerS etal Tumourgrade,proliferation apoptosip micmvessel density,p53,and bcl-2 in prostate cancers differences between tumnours located in the trairsition zone and in the peripheral zone[J].EurUrol 2002,41(1):40-46
    34 蔡文清,秦同文,黎玮,等.Bcl-2、Bax和cmyc基因在前列腺增生症中的表达及意义[J]中华实验外科杂志,2000,17(5):433-435.
    35 孙宏斌、夏术阶.前列腺移行带及外周带细胞增殖和凋亡的研究[J].中华男科学杂志,2007,13(2):110-113.
    36 王晓峰,叶海之,姜辉,等.雄激素对良性前列腺增生组织中Bcl-2 m RNA 表达的影响[J].中华外科杂志,2000,38(3):198-200.
    37 李秀群,林甲宜.蝮蛇抗栓酶治疗良性前列腺增生症32例.安徽医学,1999,5(20):33.
    38 治疗前列腺增生的新型药物Lonidamine.信息广角,2005,11(29):527.
    39 赵建业.戴福寿教授以活血法治疗前列腺增生症经验[J].福建中医药,2004,35(2):21-22.
    40 叶科贵.辩证论治前列腺增生症67例.河南中医,2006,26(7):43-44.
    41 韩伍龙.从痰瘀论治前列腺增生症30例.四川中医,2001,19(10):46.
    42 张关荣.从瘀辨治前列腺增生52例.四川中医,1997,15(10):27.
    43 张智琳.从肺论治男科病初探.中国医药学报,2004,8(19):487-488.
    44 陈金荣,侯思理.前列腺增生从气血痰水论治探讨.中国医药学报,1999,5(14):48-50.
    45 刘亮.补气化瘀法治疗前列腺增生继发尿潴留.中国中医急症,2005,4(14):378.
    46 朱源北.补肾活血法治疗老年瘾闭的体会.黑龙江中医药,2006,7,15:28.
    47 樊学中.软坚散结化瘀降浊清热利湿法治疗前列腺增生症217例.新中医,1999,12(31):26-27.
    48 李富玉,许彦来,张少林.自制路通颗粒治疗老年前列腺增生症63例.实用医药杂志,2007,1(24):64-65.
    49 马军.双虎通关汤治疗前列腺增生致急性尿潴留21例[J].中国中医急症,2004,13(8):503.
    50 王振新.自拟三甲汤治疗急性尿潴留21例[J].四川中医,2001,19(8):49.
    51 李松林,王明礼.启癃汤保留灌肠治疗前列腺增生尿潴留35例[J].陕西中医,1997,18(4):152.
    52 李发旺,田宁,常丽雪.消潴汤治疗急性尿潴留32例[J].实用中西医结合杂志,1996,9(6):366.
    53 刘容芬.前列腺肥大并发急性尿潴留从瘀治验[J].山东中医杂志,1994,13(4):179.
    54 刘昌海,宁效枝.补中益气汤化裁治疗前列腺增生致尿潴留18例[J].实用中西医结合杂志,1996,9(4):227.
    55 黄源鹏,吴锦发.中医络病理论与良性前列腺增生关系探析.中华中医药杂志,2006,1(21):45-46.
    56 贾士安.胡遵达主任医师治疗前列腺增生症的经验[J].中医药研究,1995,11(2):40.
    57 王劲松.前列腺增生症论治五法.四川中医,2000,12(18):11-12.
    58 郭明福.“开利散结汤”治疗前列腺增生110例[J].江苏中医药,2003,24(3):34.
    59 冯彩云.前列腺增生宜从症论治.中医研究,1999,3(12):44-46.
    60 焦安钦.前列腺增生症病机特点与治疗思路.贵阳中医学院学报,1996;18(4):4.
    61 谢昌仁.中医精华文摘.名老中医治疗良性前列腺增生经验荟萃.中国临床医生,2006,4(34)57-59.
    62 国家中医药管理局.中医病症诊断疗效标准[M].南京,南京大学出版社,1994,49.
    63 戴金,阮善明,陆宁.董襄国教授验方前列相治疗前列腺增生.现代中西医结合杂志,2006,15(20):2743.
    64 曹志明.马鞭草治疗前列腺增生症[J].中医杂志,2001,42(7):393.
    65 林祖贤.三七粉治疗前列腺肥大.中医杂志,1994;35(4):199.
    66 吴国欣,林跃鑫,欧敏锐,等.白芥子提取物抑制前列腺增生的实验研究[J].中国中药杂志,2002,27(10):766-768.
    67 谭毓治,伍爱婵,叶勇,等.榆白皮抗前列腺增生和抗炎作用研究[J].中药药理与临床,2003,19(1):21-22.
    68 董能本,詹炳炎,夏炎森,等.补骨脂素抗良性前列腺增生的研究[J].中华实验外科杂志,2003,20(2):109-110.
    69 李明志,任国峰,黄忆明,等.大豆异黄酮对前列腺增生大鼠血清PAP的影响[J].实用预防医学,2003,10(5):650-651.
    70 潘恩山,徐发彬.秦兆江.崔学教教授运用通法经验介绍.新中医,2005,37(2):13-14.
    71 刘亮.补气化瘀法治疗前列腺增生继发尿潴留.中国中医急症,2005,4(14):378.
    72 谈宇文,谈宇武,谈宇梁.补肾为主治疗老年前列腺增生症44例.吉林中医药,2005,1(25):29-30.
    73 蔡俊亮,吕璞琦.补肾益气软坚通络法治疗良性前列腺增生78例.浙江中西医结合杂志,2006,4(16):244-245.
    74 陈超存.八正散化裁治疗前列腺增生证验案举隅.中国全科医学,2005,12(8):1025.
    75 唐礴,蔡美珠,杜位良.前淋通栓合特拉唑嗪治疗前列腺增生症疗效观察.四川中医.
    76 康武宏.中西药结合治疗高龄晚期前列腺肥大16例.中国社区医师,2004,1(6):42-43.
    77 郝秀项,巴音德力格尔,姜乐鹤.蒙药结合针灸治疗前列腺增生症24例体会.中国民族药杂志,2005,1.
    78 周勇.隔姜灸治疗良性前列腺增生症的临床研究.山东中医药大学学报,2007(31):47-48,67.
    79 焦晓民,李继荣.中医辨证治疗急性心梗30例.辽宁中医杂志,2005 6(32):565-566.
    80 郑冬杏,黄春燕,苏海丹等.开塞露灌肠治疗前列腺增生尿潴留的临床观察.护理研究,2005,7(19):1250-1251.
    81 高杰.推拿治疗前列腺增生96例疗效观察.云南中医中药杂志,2005,4(26):26.
    82 张宏.中药溻渍联合场效应微波治疗前列腺增生症56例.国医论坛,2006,2(21):25.
    83 中华人民共和国卫生部制定.中药新药临床研究指导原则第三辑.1997:54
    84 国家中医药管理局.中华人民共和国中医药行业标准.中医病证诊断疗效标准.第1版.南京:南京大学出版社,1994:19
    85 中华人民共和国卫生部药政局.新药(西药)临床前研究指导原则汇编[s].北京:人民卫生出版社,1993:101-103
    86 贾金铭.马春涛.王勒渝等中药消癃通闭对大鼠前列腺平滑肌一氧化氮合酶及上皮细胞凋亡的影响[J].中国中西医结合杂志 2002,22(3):196-199
    87 李琦.温进坤.韩梅 黄芪利当归对血管平滑肌细胞表型标志基因表达和细胞增殖的影响[J].中国动脉硬化杂志,2004,12(2):147-150
    88 王若光.尤昭玲.李春梅等 黄芪丹参复方成分对一氧化氮合成阻滞孕鼠胎盘细胞凋亡调控基因(bcl-2/Bcl-2基因)蛋白影响研究[J].中国实验方剂学杂志,2005,5:44-46
    89 李东涛.孙桂芝.裴迎霞等 益气活血软坚解毒方含药血清诱导人肝癌细胞系Bel-7402细胞凋亡过程中部分凋亡调控基因变化[J].世界华人消化杂志,2006,14(36):3443-3449.
    90 李海刚.苏巧珠 中药诱导肿瘤细胞凋亡的研究进展[J],中药材, 2000,23(8):500-503
    91 蔡文清.黎玮.张勇等 中药对小鼠前列腺细胞增殖及凋亡的影响[J].中华泌尿外科杂志,2004,5:40-42
    92 李铁民.王润田.韩志鹏等 抑瘤饮影响S180移植瘤组织中Bcl2和Bcl-2基因表边的动态研究[J]河北医科大学学报,2008,3:324-327
    93 Ji HB,Zhai QW,Liu XY,Zheng ZC.Transcription regulation of bcl-2gene.Acta Biochim Biophys Sin,2000,32(2):95-99.

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