锯叶棕的研究进展及中药性能探讨
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摘要
通过梳理近十年国内外研究锯叶棕相关文献,对其最新研究现状进行分类整理和分析,并进一步对其药性进行分析探讨,为外来植物药锯叶棕的深入研究提供研究参考。基于Web of Science(WoS),Pubmed及CNKI数据库,检索相关文献,对162篇临床试验文献,125篇药理作用文献进行重点分析,并结合中医理论对其中药药性进行初步探讨。锯叶棕主要有效成分为脂肪酸及植物甾醇,具有抗菌消炎,改善内分泌,抗癌等活性作用。临床上多用于治疗前列腺增生(BPH)及下尿路症状(LUTS/BPH)、慢性盆腔疼痛综合征(CP/CPPS)、性功能障碍和性激素分泌紊乱等。本文综述了锯叶棕的研究进展,初步推断其中药药性:性味为甘,偏温;归肾,膀胱经。功能主治为温肾助阳,利水消肿。可用于肾阳虚衰,小便余沥,夜尿频多,赋予其中药药性,为其与中药的配伍及临床应用提供理论依据。
Through sorting out the relevant literature on saw palmetto at home and abroad in the past ten years, the latest research status was classified and analyzed, and the medicinal properties of saw palmetto were further analyzed and discussed so as to provide research references for in-depth study of saw palmetto, which is an exotic species. Based on databases of web of science(WOS), PubMed and CNKI, the relevant literatures were retrieved. A total of 162 clinical trial literatures and 125 pharmacological effects literatures were analyzed emphatically, and the medicinal properties of these literatures were preliminarily discussed in combination with the theory of traditional Chinese medicine. The main effective components of saw palmetto are fatty acids and phytosterol, which have antibacterial, anti-inflammatory, endocrine improving and anticancer activities. Clinically, they are often used to treat benign prostatic hyperplasia(BPH) and its lower urinary tract symptoms(LUTS/BPH), chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS), sexual dysfunction and sex hormone secretion disorders and so on. This paper reviews the research progress of saw palmetto and preliminarily concludes that the medicinal properties of it are sweet in flavor and warm in nature. It acts on kidney channel and bladder channel. The main functions are to warm the kidney and assist yang, drain water and relieve swelling. It can be used for treating kidney yang deficiency, excessive urination, and frequent urination at night. The medicinal properties of saw palmetto was figured out to provide theoretical basis for its compatibility with traditional Chinese medicine and clinical application.
Through sorting out the relevant literature on saw palmetto at home and abroad in the past ten years, the latest research status was classified and analyzed, and the medicinal properties of saw palmetto were further analyzed and discussed so as to provide research references for in-depth study of saw palmetto, which is an exotic species. Based on databases of web of science(WOS), PubMed and CNKI, the relevant literatures were retrieved. A total of 162 clinical trial literatures and 125 pharmacological effects literatures were analyzed emphatically, and the medicinal properties of these literatures were preliminarily discussed in combination with the theory of traditional Chinese medicine. The main effective components of saw palmetto are fatty acids and phytosterol, which have antibacterial, anti-inflammatory, endocrine improving and anticancer activities. Clinically, they are often used to treat benign prostatic hyperplasia(BPH) and its lower urinary tract symptoms(LUTS/BPH), chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS), sexual dysfunction and sex hormone secretion disorders and so on. This paper reviews the research progress of saw palmetto and preliminarily concludes that the medicinal properties of it are sweet in flavor and warm in nature. It acts on kidney channel and bladder channel. The main functions are to warm the kidney and assist yang, drain water and relieve swelling. It can be used for treating kidney yang deficiency, excessive urination, and frequent urination at night. The medicinal properties of saw palmetto was figured out to provide theoretical basis for its compatibility with traditional Chinese medicine and clinical application.
引文
[1] 王萍,马子龙,刘立云.锯叶棕的药用价值用市场前景分析[J].中国热带农业,2007,4(3):41-42.
[2] 张建军,王淳,费文婷,等.外来药物“中药化”的研究思路与策略[J].中华中医药杂志,2017,32(4):1425-1430.
[3] 贾敏如.国际传统药物和天然药物[M].北京:中国中医药出版社,2006:193.
[4] TAOFIKAT B A,MAX H P,BARBARA W,et al.Serenoa repens (saw palmetto):a systematic review of adverse events[J].Drug Safety,2009,32(8):637-647.
[5] SUZUKI M,ITO Y,FUJINO T,et al.Pharmacological effects of S.repens extract in the lower urinary tract[J].Acta Pharmacol Sin,2009,30:227-281.
[6] DE MONTE C,CARRADORI S,GRANESE A,et al.Modern extraction techniques and their impact on the pharmacological profile of Serenoa repens extracts for the treatment of lower urinary tract symptoms[J].BMC Urol,2014,14(1):63.
[7] OLTA A,ANNABELLA V.What do we know about phytotherapy of benign prostatic hyperplasia?[J].Life Sciences,2015,126:42-56.
[8] BORST SE,YARROW JF,CONOVER CF,et al.Musculoskeletal and prostate effects of combined testosterone and finasteride administration in older hypogonadal men:a randomized,controlled trial[J].American journal of physiology.Endocrinology and metabolism,2013,306(4):433-442.
[9] SOPHIE B,NATASCHA P,PHILIPPE C,et al.Anti-inflammatory properties of Lipidosterolic extract of Serenoa repens (Permixon?) in a mouse model of prostate hyperplasia[J].The Prostate,2015,75(7):706-722.
[10] 沈京莲,张红岩,车玉琴,朱杰,彭沈君.锯叶棕提取物对胶质瘤大鼠免疫的调节[J].中国免疫学杂志,2016,32(9):1299-1302.
[11] YANG Y,IKEZOE T,ZHENG Z,et al.Saw Palmetto induces growth arrest and apoptosis of androgen-dependent prostate cancer LNCaP cells via inactivation of STAT 3 and androgen receptor signaling[J].Int J Oncol,2007,31(3):593-600.
[12] 车玉琴,张立德.锯叶棕提取物通过阻断STAT3通路抑制U266细胞增殖及促凋亡[J].中医药通报,2010,9(2):61-63.
[13] RODERICK M D,JAMES W T,INDULIS R,et al.Serenoa repens monotherapy for benign prostatic hyperplasia (BPH):an updated Cochrane systematic review[J].BJU International,2012,109(12):1756-1761.
[14] ALAIN L,MARIE‐THèRèSE P,JèRòME R,et al.Effects of hexanic extract of serenoa repens (permixon? 160 mg) on inflammation biomarkers in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia[J].The Prostate,2015,75(16):1857-1867.
[15] WILT TJ,ISHANI A,STARK G,et al.Srepens extracts for treatment of benign prostatic hyperplasia[J].JAMA,1998,280:1604-1609.
[16] BOYLE P,ROBERTSON C,LOWEF,et al.Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia[J].BJU International,2004,93(6):751-756.
[17] GIULIANELLI R,PECORARO S,SEPE G,et al.Multicentre study on the efficacy and tolerability of an extract of Serenoa repens in patients with chronic benign prostate conditions associated with inflammation[J].Arch Ital Urol Androl,2012,84(2):94-98.
[18] 韶云鹏,薛浩良,沈百欣,等.锯叶棕果实提取物对以LUTS为主要症状的ⅢA型前列腺炎治疗的疗效观察[J].中华男科学杂志,2017,23(5):417-421.
[19] 居小兵,顾小箭,张征宇,等.锯叶棕果实提取物软胶囊治疗良性前列腺增生的有效性和安全性分析[J].中华男科学杂志,2015,21(12):1098-1101.
[20] MORGIA G,CIMINO S,FAVILLAV,et al.Effects of Serenoa repens,selenium and lycopene (Profluss?) on chronic inflammation associated with benign prostatic hyperplasia:results of “FLOG” (Flogosis and Profluss in Prostatic and Genital Disease),a multicentre Italian study[J].International braz j urol,2013,39(2):214-221.
[21] RUSSO A,CAPOGROSSO P,LA CROCEG,et al.Serenoa repens,selenium and lycopene to manage lower urinary tract symptoms suggestive for benign prostatic hyperplasia[J].Expert Opinion on Drug Safety,2016,15(12):1661-1670.
[22] NIKOLAI L,ANDREY S,SANDRAS,et al.Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms—long-term follow-up of a placebo-controlled,double-blind,multicenter trial[J].International Urology and Nephrology,2007,39(4):1137-1146.
[23] PAVONE C,ABBADESSA D,TARANTINO M L,et al.Associating Serenoa repens,Urtica dioica and Pinus pinaster.Safety and efficacy in the treatment of lower urinary tract symptoms.Prospective study on 320 patients].[J].Urologia,2010,77(1):43-51.
[24] WILLIAM K O,DANIEL J G,KRISTIN H,et al.Activity of the herbal combination,PC-SPES,in the treatment of patients with androgen-independent prostate cancer[J].Urology,2001,57(1):122-126.
[25] 金锐,张冰.中药药性理论复杂性特征分析[J].中国中药杂志,2012,37(21):3340-3343.
[26] 马健雄,马凰富,王继升,等.李海松教授治疗良性前列腺增生症药对浅析[J].环球中医药,2016,9(09):1091-1093.
[27] ANDREAS S,REINHARD S,EUGEN R,et al.Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation?Results from a pilot trial[J].Phytotherapy Research,2013,27(2):218-226.
[28] SHI R,XIE Q,GANGX,et al.Effect of Saw Palmetto Soft Gel Capsule on Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia:A Randomized Trial in Shanghai,China[J].The Journal of Urology,2007,179(2):610-615.
[29] BOERI L,CAPOGROSSO P,VENTIMIGLIAE,et al.Clinically Meaningful Improvements in LUTS/BPH Severity in Men Treated with Silodosin Plus Hexanic Extract of Serenoa Repens or Silodosin Alone[J].Scientific reports,2017,7(1):15179.
[30] OOI SL ,PAK S C .Serenoa repens for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia:Current Evidence and Its Clinical Implications in Naturopathic Medicine[J].Journal of Altenative And Complementary Medicine,2017,23(8):599-606.
[2] 张建军,王淳,费文婷,等.外来药物“中药化”的研究思路与策略[J].中华中医药杂志,2017,32(4):1425-1430.
[3] 贾敏如.国际传统药物和天然药物[M].北京:中国中医药出版社,2006:193.
[4] TAOFIKAT B A,MAX H P,BARBARA W,et al.Serenoa repens (saw palmetto):a systematic review of adverse events[J].Drug Safety,2009,32(8):637-647.
[5] SUZUKI M,ITO Y,FUJINO T,et al.Pharmacological effects of S.repens extract in the lower urinary tract[J].Acta Pharmacol Sin,2009,30:227-281.
[6] DE MONTE C,CARRADORI S,GRANESE A,et al.Modern extraction techniques and their impact on the pharmacological profile of Serenoa repens extracts for the treatment of lower urinary tract symptoms[J].BMC Urol,2014,14(1):63.
[7] OLTA A,ANNABELLA V.What do we know about phytotherapy of benign prostatic hyperplasia?[J].Life Sciences,2015,126:42-56.
[8] BORST SE,YARROW JF,CONOVER CF,et al.Musculoskeletal and prostate effects of combined testosterone and finasteride administration in older hypogonadal men:a randomized,controlled trial[J].American journal of physiology.Endocrinology and metabolism,2013,306(4):433-442.
[9] SOPHIE B,NATASCHA P,PHILIPPE C,et al.Anti-inflammatory properties of Lipidosterolic extract of Serenoa repens (Permixon?) in a mouse model of prostate hyperplasia[J].The Prostate,2015,75(7):706-722.
[10] 沈京莲,张红岩,车玉琴,朱杰,彭沈君.锯叶棕提取物对胶质瘤大鼠免疫的调节[J].中国免疫学杂志,2016,32(9):1299-1302.
[11] YANG Y,IKEZOE T,ZHENG Z,et al.Saw Palmetto induces growth arrest and apoptosis of androgen-dependent prostate cancer LNCaP cells via inactivation of STAT 3 and androgen receptor signaling[J].Int J Oncol,2007,31(3):593-600.
[12] 车玉琴,张立德.锯叶棕提取物通过阻断STAT3通路抑制U266细胞增殖及促凋亡[J].中医药通报,2010,9(2):61-63.
[13] RODERICK M D,JAMES W T,INDULIS R,et al.Serenoa repens monotherapy for benign prostatic hyperplasia (BPH):an updated Cochrane systematic review[J].BJU International,2012,109(12):1756-1761.
[14] ALAIN L,MARIE‐THèRèSE P,JèRòME R,et al.Effects of hexanic extract of serenoa repens (permixon? 160 mg) on inflammation biomarkers in the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia[J].The Prostate,2015,75(16):1857-1867.
[15] WILT TJ,ISHANI A,STARK G,et al.Srepens extracts for treatment of benign prostatic hyperplasia[J].JAMA,1998,280:1604-1609.
[16] BOYLE P,ROBERTSON C,LOWEF,et al.Updated meta-analysis of clinical trials of Serenoa repens extract in the treatment of symptomatic benign prostatic hyperplasia[J].BJU International,2004,93(6):751-756.
[17] GIULIANELLI R,PECORARO S,SEPE G,et al.Multicentre study on the efficacy and tolerability of an extract of Serenoa repens in patients with chronic benign prostate conditions associated with inflammation[J].Arch Ital Urol Androl,2012,84(2):94-98.
[18] 韶云鹏,薛浩良,沈百欣,等.锯叶棕果实提取物对以LUTS为主要症状的ⅢA型前列腺炎治疗的疗效观察[J].中华男科学杂志,2017,23(5):417-421.
[19] 居小兵,顾小箭,张征宇,等.锯叶棕果实提取物软胶囊治疗良性前列腺增生的有效性和安全性分析[J].中华男科学杂志,2015,21(12):1098-1101.
[20] MORGIA G,CIMINO S,FAVILLAV,et al.Effects of Serenoa repens,selenium and lycopene (Profluss?) on chronic inflammation associated with benign prostatic hyperplasia:results of “FLOG” (Flogosis and Profluss in Prostatic and Genital Disease),a multicentre Italian study[J].International braz j urol,2013,39(2):214-221.
[21] RUSSO A,CAPOGROSSO P,LA CROCEG,et al.Serenoa repens,selenium and lycopene to manage lower urinary tract symptoms suggestive for benign prostatic hyperplasia[J].Expert Opinion on Drug Safety,2016,15(12):1661-1670.
[22] NIKOLAI L,ANDREY S,SANDRAS,et al.Efficacy and safety of a combination of Sabal and Urtica extract in lower urinary tract symptoms—long-term follow-up of a placebo-controlled,double-blind,multicenter trial[J].International Urology and Nephrology,2007,39(4):1137-1146.
[23] PAVONE C,ABBADESSA D,TARANTINO M L,et al.Associating Serenoa repens,Urtica dioica and Pinus pinaster.Safety and efficacy in the treatment of lower urinary tract symptoms.Prospective study on 320 patients].[J].Urologia,2010,77(1):43-51.
[24] WILLIAM K O,DANIEL J G,KRISTIN H,et al.Activity of the herbal combination,PC-SPES,in the treatment of patients with androgen-independent prostate cancer[J].Urology,2001,57(1):122-126.
[25] 金锐,张冰.中药药性理论复杂性特征分析[J].中国中药杂志,2012,37(21):3340-3343.
[26] 马健雄,马凰富,王继升,等.李海松教授治疗良性前列腺增生症药对浅析[J].环球中医药,2016,9(09):1091-1093.
[27] ANDREAS S,REINHARD S,EUGEN R,et al.Improving BPH symptoms and sexual dysfunctions with a saw palmetto preparation?Results from a pilot trial[J].Phytotherapy Research,2013,27(2):218-226.
[28] SHI R,XIE Q,GANGX,et al.Effect of Saw Palmetto Soft Gel Capsule on Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia:A Randomized Trial in Shanghai,China[J].The Journal of Urology,2007,179(2):610-615.
[29] BOERI L,CAPOGROSSO P,VENTIMIGLIAE,et al.Clinically Meaningful Improvements in LUTS/BPH Severity in Men Treated with Silodosin Plus Hexanic Extract of Serenoa Repens or Silodosin Alone[J].Scientific reports,2017,7(1):15179.
[30] OOI SL ,PAK S C .Serenoa repens for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia:Current Evidence and Its Clinical Implications in Naturopathic Medicine[J].Journal of Altenative And Complementary Medicine,2017,23(8):599-606.