In contrast to popular belief, the incidence of prostatitis identified and confirmed by laboratory tests is only about 9%.However, inflammation of the prostate gland is often repeated or becomes chronic.
The prevalence of chronic forms of prostatitis, characterized by an inactive inflammatory process and minor clinical symptoms that reduce the quality of life, is difficult to evaluate.
In addition to acute and chronic bacterial prostate, chronic pelvic pain syndrome is distinguished, in which leukocytes are detected in the third part of the urine or seminal fluid, as well as chronic pelvic syndrome without inflammatory changes.
In the emergence and maintenance of characteristic symptoms of chronic prostatitis, functional disorders of urination, expressed in high urination pressure, intrapostatic reflux that form a turbulent flow of urine, the pathogenic influence of microorganisms, immune reactions and a changed condition of pelvic muscles.
Periodic occurrence and intensification of pain and symptoms of the lower urinary tract (Luts), sleep disturbances and, often, erectile function significantly affects a person's physical and psychological state.
Most often, symptoms of the low urinary tract in young and middle -aged men are caused by an inflammatory process in the prostate gland, however, given the patient's age, it is always necessary to make a differential diagnosis between adenoma and prostate cancer.
There are different opinions about the pathogenesis of chronic prostate, based on which different methods of treatment are proposed.The treatment of acute prostatitis depends on the pathogen identified and mainly includes antibacterial medicines that have the greatest penetrating ability in the prostate tissue.
Acute bacterial prostatitis requires parenteral administration of bactericidal antibiotics, such as aminoglycosides or third generation cephalosporins.Treatment continues until the fever disappears and blood normalizes.In less severe cases, fluoroquinolones can be described.The duration of treatment with fluoroquinolones for acute prostatitis is 2-4 weeks.
For chronic bacterial prostatitis and inflammatory syndrome of chronic pelvic pain, treatment is performed with fluoroquinolones or trimethoprim.The patient is then examined again and antibiotics continue only in cases where the microorganism that caused the disease, or if the patient has noticed a positive effect of therapy.
The recommended period of treatment for chronic prostatitis is 4-6 weeks or more.Urodynamic studies have shown increased urethra pressure.In this regard, it was observed that treatment combined with α-blocking and antibiotics is more effective than antibiotics monotherapy in chronic pelvic pain syndrome.When describing a course of therapy, the doctor should discuss with the patient his duration, the possibility of side effects, and the need to monitor the effectiveness and safety of treatment.
Herbal medicines in the treatment of chronic prostatitis
The use of herbal preparations in the treatment of prostate diseases has a long history.The evidence of the effectiveness and safety of the herbal medicine is obtained empirically.
Currently, the possibility of using plant remedies should be determined by modern ideas about the pathogenesis and development of pathological processes, especially in the prostate gland.
Processes such as functional barriers, the emergence of riots in the prostate urethra, the pathological impact of commercial microorganisms, immune changes, disrupt normal metabolism.Some violations inevitably lead to others.For example, chronic inflammation leads to disruption and cellular damage.
Normally, the body constantly produces incomplete oxidation products, so -called free radicals, the number of which grows under various pathological conditions, especially during inflammation.An interruption in the supply of oxygen to the tissue, in which the rate of accumulation of active radical compounds (oxygen, nitrogen and chlorine radicals) exceeds the degree of their neutralization, is called oxidizing stress.As a result, oxidizing stress leads to tissue damage over time, including in the prostate gland.
Biochemists have long known about natural antioxidants: vitamins E, C and carotenoids, but they may not seriously affect oxidative stress.In recent years, more and more attention has been paid to bioflavonoids, which are tens of times stronger in antioxidant activity than vitamin E, vitamin C and beta-carotene.In total, more than 6,000 bioflavonoids are known, of which more than 3,000 are flavone and more than 700 isoflavone.About 2% of the total organic carbon produced by photosynthesis is synthesized by plants in flavonoids or other polyphenols.
Flavonoids protect plants from radiation, ultraviolet radiation, oxidation, diseases, infections, bacteria.One of the representatives of medicinal plants containing bioflavonoids is hedysarum legnalctum, a perennial herb from the legume family.This small plant, 25-50 cm long, blooms from June to August with small purple-purple flowers.
The roots of forgotten pennyweed contain flavonoid quercetin, saponins and other biologically active substances.It is the derivatives of the quercetin that have antioxidant activity and are effective in patients with chronic prostate, which is confirmed by the results of clinical studies.
In addition to these properties, the catechins included in the roots of the forgotten kopeck have high P-vitamin activity, strengthen capillary walls and optimize microcirculation.The roots of forgotten pennyweed have adaptogenic properties, which also determines the value of the plant's involvement in the complex therapy of patients with chronic prostate.
Also containing flavonoids is knotweed (avicular polygonum), an annual weeds with small elliptical leaves.A single stem extending from the base of experienced root branches and produces a mass of green shoots.This low -growing plant holds numerous blurry green flowers in May.Knotweed also contains a large amount of ascorbic acid, vitamin K and provitamin A.
Products based on knotweed herb have long been known in urological practice because they have a diuretic, anti-gouut and adaptogenic effect.Combined use of Commonweed and Knotweed allows us to expect a clinically significant effect.
Plant medicines available in clinical practice, which are produced by Commonweed (root and rhizome), as well as Knotweed herb, is a root solution of the forgotten communa.
Biologically active substances included in the solution contain natural antioxidants and substances that improve microcirculation, which determines the ability of these herbal remedies to reduce the severity of the inflammatory process in the prostate gland and pain syndrome (feelings of pain and severe prostitutes).
Increased blood circulation in the prostate reduces the severity of the symptoms of the lower urinary tract (including frequent, difficult urination, embarrassment when emptying the bladder, flow of urine flow and the feeling of incomplete bladder emptying), and also improves the functional state of the arteries in the kavernous.
Clinical effectiveness of the solution from the roots of the forgotten kopeck
The effectiveness of the solution was studied in an open comparative study of the case.The purpose of the study was to study the effect of herbal preparations on the dynamics of pain syndrome, objective data and laboratories in patients with chronic prostate.
In addition to studying complaints and medical history, the diagnosis was confirmed by laboratory tests of prostate secretions in pure form or urine.In parallel groups with active control, the effectiveness, safety and tolerance of the drug in patients with chronic prostate were evaluated.
To objectify the symptoms description, the chronic symptoms of chronic health prostatitis (NIH-CPSI), urinary diaries and comparison of laboratory data were used.In patients, urological diseases that may be associated with similar symptoms (benign hyperplasia, prostate cancer), pathological changes in the nervous system and the gastrointestinal tract were excluded.
A long course of prostate with periodic irritation adversely affects the emotional and sexual sphere.Observation and changes in the function erectile against the background of chronic prostate in patients who took the medicine were also performed using standard questionnaires.In parallel, drug safety was evaluated compared to other herbal medicines.
To clarify the effective dose of the forgotten pennyweed root solution, patients were divided into two groups.The first group, which consisted of 30 people, received 1 teaspoon of knocking 3 times a day.Patients in the second group, who also consisted of 30 people, received the solution 2 tablespoons 3 times a day.
Distribution of patients in groups was performed using a simple case method, which made it possible to study the effects of the drug in homogeneous groups.The red root of the drug plus was described on an empty stomach, at least 30 minutes before meals.Before use, the bottle was shaken, and a single dose was dissolved in 1/3 cup of water.The duration of treatment was 30 days.
A control group of 20 patients diagnosed with chronic prostate received treatment with another plant preparation for the same period.Criteria for effectiveness in groups that used tincture 1 teaspoon 3 times a day, 2 teaspoons 3 times a day or received a comparison drug were changes in clinical symptoms based on a study of patients, questionnaire data and urination diaries.All patients involved completed the study.
The average age of patients in the first group, who received solution of forgotten Kopeck roots, 1 teaspoon 3 times a day, was 45.5 (37-56) years (in further text average, as well as 25 and 75 percentage).The average age of patients in the second group, who received the solution 2 tablespoons 3 times daily, was 45.5 (33-55) years.The average age of patients in the control group was 48 (36-59) years.
There was no statistically significant difference between groups (p = 0.63) (further variance analysis was used).It should be noted that chronic prostatitis has been identified in people of the most active and working age, for whom the maintenance of erectile and reproductive function is particularly important.Of all the patients involved in the study, 26 (32.5%) had a history of sexually transmitted diseases.The distribution of such patients in groups was the same.
Before describing Tincture Plus, 57 (71.3%) patients received treatment for chronic prostatitis.Most often this was antibacterial and/or α-blocker therapy.The distribution of patients who had previously received treatment, as well as the type of treatment, do not differ significantly between groups, which confirms modern ideas for pathogenesis and, accordingly, methods of treatment of chronic prostate.
To objectively assess their symptoms and severity, as well as the quality of life of patients, NIH-CPSI scale, which is recommended for both the basic assessment and the monitoring of the patient's condition.Initially, the level of pain according to the nih-cpsi scale before treatment in the group that received Pennywort roots solution, 1 teaspoon 3 times a day, was 13 (10-15) points;In the group that received the tincture solution 2 3 times daily - 12 (10-15) points.In the control group, this indicator was 13 (10-15) points.The severity of the pain between the groups had no statistically significant differences (p = 0.846).
Patient groups were homogeneous in both localization and severity of pain, which is especially important given the variety of clinical manifestations of this disease.
SINCE URINARY DISORDERS, Namely Bladder Outlet Obstruction, Detrusor-Ssphincter Dyssynergia, Increas Pressure in the Lumen of Prostatic urethra and Intraprostatic Reflux, Play an Important Role the Supposed Causes of the Onset and Recurrence of Prostate,Attention was paid to the distribution of patients according to the presence and severitity of Luts Against the background of Pain and Discomfort.Initially, in the first group this indicator was, according to the NIH-CPSI scale, 2 (1–3) points, in the second group-2 (1–3) points and in control-also 2 (1–3) points.
The severity of the urinary disorders does not statistically change statistically between groups (P = 0.937).The study groups were homogeneous about Luts.There were no differences between groups in the results of the urination journal analysis.It can be said with reasonable confidence that Luts was associated with prostate disease, not with functional bladder disorders or water balance.
The maximum urinary flow rate, according to Uroflowmetry, in the first group was 13.3 (11.8–14.2) ml/s, in the second group - 13.2 (12.1–14.0) ml/s, and in the control group - 13.0 (11.8-14.6) ml/s.There is no statistically significant difference in this indicator between groups (p = 0.996).The volume of the remaining urine in the first, second and control groups was 23.0 (20-26), 23 (18-25) and 20 (16.5–24) ml respectively.Patient groups also did not change in this indicator (P = 0.175).
It can be said that no pronounced concern of the reservoir and bladder evacuation functions were detected in patients with chronic prostate in the study groups, however, existing Lut allows us to doubt the source of pathological symptoms precisely at the level of prostatic urethra.
The subjective perception of patients for the symptoms of chronic prostatitis is also of great importance.A variety of unpleasant sensations of the varying severity, which are prone to repetition, often unpredictable, significantly disrupt the usual way of people's lives.This affects not only their mood but also their social activity.This is why the study of the quality of life, which depends on the severity of the disease, its relapses and its consequences, also serves as a criterion for the effectiveness of treatment.
Before describing the treatment, in the group that received the red root solution plus 1 teaspoon 3 times a day, the quality of life, according to the questionnaire, was rated at 6 (5-9) points, in the group that received the Tincture points 2 3 times daily - at 8 (6–9) points, and in the control group - at 6 (3–9).There is no statistically significant difference between groups for this indicator (p = 0.22).
The overall scope in the first group in the first group was 22 (19-25), in the second group-23 (19-25), and in control-22 (18-25) (p = 0.801).Thus, the groups were homogeneous not only in terms of the amount of results in the degree of chronic prostate symptoms, but also in terms of its individual ingredients.All patients answered questions in the degree of male copulative function (MCF).In the first group the indicator was 31 (23-41) points, in the second points - 34 (27–39), in the third points - 34 (26–37).The effect of chronic prostatitis on erectile function also remains the subject of study.
In all three groups, the range of values is quite wide.This indicates the individual degree of one's response to his symptoms and disorders.However, the distribution of patients with chronic prostate with different states of raised function in pre -treatment groups did not change (P = 0.967).Thus, at the beginning of the study, it was possible to form three groups of patients with chronic prostate, which were homogeneous in age, type and severity of clinical symptoms, which affected the quality of life.At the same time, tank disorders and bladder evacuation functions were excluded.
After 30 days of treatment, the symptoms were evaluated in the formed groups.In the group of patients who received solution of forgotten pennyweed roots, 1 teaspoon 3 times a day, according to a control questionnaire, a decrease in the frequency and severity of pain and discomfort was observed by 51%.When taking the solution 2 teaspoons 3 times a day, a decrease in the severity of the symptoms by 55%was observed.
In the control group, the pathological symptoms decreased by 37%.The differences between the three groups of patients were statistically significant (p = 0.029).However, no statistically significant differences were found between the first and second groups.Thus, it is possible to achieve a clinically significant effect with minimal doses of the drug.Moreover, statistically significant changes remained to reduce pathological symptoms when evaluating each of the groups that received solution of forgotten Kopeck roots compared to control.
According to the questionnaire, there has been an improvement in urinary performance in patients with chronic prostate during treatment, but the changes were not statistically significant even among groups that received penny roots solution in different doses, and compared to the control group.
When analyzing the urination diary data obtained after the treatment course, there were also no statistically significant differences listed in all three groups.According to the results of the control uroflowmetry, there was an increase in the maximum urinary flow rate in all groups, which ranged from 5 to 12%.The volume of remaining urine in patients taking the medicine in various doses, and in patients receiving treatment with a herbal reference drug decreased by 4-6%.The differences between the groups were not statistically significant.
This fact can be explained by the relatively short period of use, as well as the lack of ingredients in the red root plus the solution that would have a effect similar to α-adrenergic blockers and 5α-reductase inhibitors.The main active ingredient of the drug is compounds from the group of bioflavonoids, which have a variety of effects, mainly antioxidant and anti-inflammatory effects.
According to the examination of the audit, based on repeated interrogation, an improvement in the quality of life indicator was observed after the course of treatment for 30 days.In the first group, this figure changed by 55%, in the second - with 59%, and in the control group - with 39%.Differences in the dynamics of changes in the quality of life while using the solution of the forgotten kopeck roots and in the control group were statistically significant (p = 0.008).
It should be noted that the groups that received the solution in different doses do not vary significantly in the dynamics of the quality of life.Analysis of changes in quality of life confirms the adaptogenic effect of the components of plant preparation containing kopek and forgotten knotweed.The overall result of NIH-CPSI decreased in all three groups after 30 days of treatment.In the first group there was a 50%decrease, in the second - with 52%, and in the third - with 29%.At the same time, the same trend was observed as in the analysis of other indicators.
The difference was statistically significant among patients who received the solution of forgotten Kopeck roots and patients in the control group, and no differences were found between the groups that took the medicine in different doses.
All three groups of patients showed the same increase in the overall result in the ICF questionnaire (P = 0.455).The change in indicators in all groups was no more than 10%.There were no statistically significant differences between groups.
Improving copulatory function can be mainly associated with a decrease in pathological symptoms of the prostate gland, a decrease in prayer, adaptogenic properties and improved microcirculation.The condition of the prostate gland when using plant preparations is of interest.This is demonstrated by the analysis of the results of a repeated study of prostate secretion.
If first groups of patients do not vary in the presence and number of leukocytes in prostate secretion (P = 0.528), then after 30 days treatment in all groups had a decrease in the severity of the inflammatory process.In the groups that received the solution of the forgotten pennyweed roots, a statistically significant decrease (P = 0.028) in the number of leukocytes was observed compared to the control group.Changing the dose of the medicine had no effect on the dynamics of leukocyte lowering.
According to a study of prostate secretions, a significant decrease in the severity of the inflammatory process and an improvement in the functional state of the prostate gland was created.
Different herbal medicines contain an individual group of bioflavonoids that have different activities.Apparently, the combination of commonweed and knotweed rhizomes and roots contains bioflavonoids that are active against the effects of oxidative stress on prostate tissue.This can be assumed based on the results of the effectiveness of the drug and the lack of dose -dependent changes.However, this assumption must be confirmed by further research.
cONcluSiON
Among the methods of treatment of prostate, the use of herbal preparations occupies an important place.The effectiveness of this group of medicines has been confirmed by clinical experience.However, performing the clinical trials of the case aimed at evaluating the effectiveness of herbal preparations based on modern ideas regarding the active principle allows us to take a new approach to herbal medicine.
The effectiveness of plant bioflavonoids is justified by the theory of oxidative stress, according to which the products of free uncontrolled radical oxidation have a harmful effect on the cell and cause multiple organs and systems dysfunction.
Considering the above, it seems that it is possible to conclude that the herbal medicine using the root roots of the forgotten kopeck roots, a medicinal product with pronounced anti-inflammatory and antioxidant effects, is the most effective both in the complex treatment of patients with chronic prostate and in monotherapy for the prevention of this disease.