DOCSLIB.ORG

Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia a Systematic Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia a Systematic Review Review Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia A Systematic Review Timothy J. Wilt, MD, MPH; Areef Ishani, MD; Gerold Stark, MD; Roderick MacDonald, MS; Joseph Lau, MD; Cynthia Mulrow, MD, MS Objective.—To conduct a systematic review and, where possible, quantitative SYMPTOMATIC BENIGN prostatic meta-analysis of the existing evidence regarding the therapeutic efficacy and safety hyperplasia (BPH) is one of the most of the saw palmetto plant extract, Serenoa repens, in men with symptomatic benign commonmedicalconditionsinoldermen. prostatic hyperplasia (BPH). As many as 40% of men aged 70 years or Data Sources.—Studies were identified through the search of MEDLINE (1966- older have lower urinary tract symp- toms consistent with BPH.1 Treatment 1997), EMBASE, Phytodok, the Cochrane Library, bibliographies of identified trials goals in the vast majority of men are to and review articles, and contact with relevant authors and drug companies. relieve irritative (urgency, frequency, Study Selection.—Randomized trials were included if participants had symp- and nocturia) and obstructive (weak tomatic BPH, the intervention was a preparation of S repens alone or in combina- stream,hesitancy,intermittency,andin- tion with other phytotherapeutic agents, a control group received placebo or other complete emptying) symptoms. In the pharmacological therapies for BPH, and the treatment duration was at least 30 United States, treatment of BPH ex- days. ceeds $2 billion in costs, accounts for 1.7 Data Extraction.—Two investigators for each article (T.J.W., A.I., G.S., and million physician office visits,2 and re- R.M.) independently extracted key data on design features, subject characteristics, sults in more than 300 000 prostatecto- 3 therapy allocation, and outcomes of the studies. mies annually. Treatment options in- clude lifestyle modification, device and Data Synthesis.—A total of 18 randomized controlled trials involving 2939 men surgical therapies, and pharmaceutical met inclusion criteria and were analyzed. Many studies did not report results in a and phytotherapeutic preparations.4,5 method that permitted meta-analysis. Treatment allocation concealment was ad- Phytotherapy or the use of plant ex- equate in 9 studies; 16 were double-blinded. The mean study duration was 9 weeks tracts for treating BPH symptoms was (range, 4-48 weeks). As compared with men receiving placebo, men treated with first described in Egypt in the 15th cen- S repens had decreased urinary tract symptom scores (weighted mean difference tury BC. Currently, phytotherapy is com- [WMD], −1.41 points [scale range, 0-19] [95% confidence interval (CI), −2.52 to mon in Europe and is increasing in the −0.30] [n = 1 study]), nocturia (WMD, −0.76 times per evening [95% CI, −1.22 to western hemisphere. The sale of all bo- −0.32] [n = 10 studies]), and improvement in self-rating of urinary tract symptoms; tanical medications in the United States risk ratio for improvement (1.72 [95% CI, 1.21-2.44] [n = 6 studies]), and peak urine is $1.5 billion per year and the use of phy- totherapies increased nearly 70% among flow (WMD, 1.93 mL/s [95% CI, 0.72-3.14] [n = 8 studies]). Compared with men re- US adults in the past year.6,7 Phytothera- ceiving finasteride, men treated with S repens had similar improvements in urinary peutic agents represent nearly half the tract symptom scores (WMD, 0.37 International Prostate Symptom Score points medications dispensed for treatment of [scale range, 0-35] [95% CI, −0.45 to 1.19] [n = 2 studies]) and peak urine flow BPH in Italy, compared with 5% for a- (WMD, −0.74 mL/s [95% CI, −1.66 to 0.18] [n = 2 studies]). Adverse effects due to S repens were mild and infrequent; erectile dysfunction was more frequent with fi- From the Department of Veterans Affairs Coordinat- , ing Center of the Cochrane Collaborative Review Group nasteride (4.9%) than with S repens (1.1%; P .001). Withdrawal rates in men as- in Prostatic Diseases and Urologic Malignancies and signed to placebo, S repens, or finasteride were 7%, 9%, and 11%, respectively. Minneapolis/Veterans Integrated Service Network 13 Conclusions.—The existing literature on S repens for treatment of BPH is lim- Center for Chronic Diseases Outcomes Research, Min- neapolis Veterans Affairs Medical Center, Minneapolis, ited in terms of the short duration of studies and variability in study design, use of Minn (Drs Wilt, Ishani, and Stark and Mr MacDonald); phytotherapeutic preparations, and reports of outcomes. However, the evidence New England Medical Center, Boston, Mass (Dr Lau); and the Department of Veterans Affairs San Antonio suggests that S repens improves urologic symptoms and flow measures. Com- Cochrane Center, San Antonio, Tex (Dr Mulrow). pared with finasteride, S repens produces similar improvement in urinary tract The authors have no commercial, proprietary, or financial interest in the products or companies in this symptoms and urinary flow and was associated with fewer adverse treatment article. events. Further research is needed using standardized preparations of S repens to Reprints: Timothy J. Wilt, MD, MPH, Minneapolis Vet- erans Affairs Medical Center (111-0), 1 Veterans Dr, Min- determine its long-term effectiveness and ability to prevent BPH complications. neapolis, MN 55417 (e-mail: wilt.timothy@minneapolis JAMA. 1998;280:1604-1609 .va.gov). 1604 JAMA, November 11, 1998—Vol 280, No. 18 Palmetto Extracts for Benign Prostatic Hyperplasia—Wilt et al ©1998 American Medical Association. All rights reserved. Downloaded From: by a University of Kansas HQ User on 01/04/2019 blockers and 5% for 5 a-reductase inhibi- mally sensitive search strategy for trials ences and their 95% confidence intervals tors.8 In Germany and Austria, phyto- from the Cochrane Collaboration with (CIs) were calculated using RevMan 3.0 therapy is the first-line treatment for the medical subject headings prostatic software.18 For categorical variables mild-to-moderate lower urinary tract hyperplasia, phytosterols, plant ex- weighted risk ratios (RRs) and 95% CIs symptomsandrepresentsmorethan90% tracts,sitosterols,Serenoarepens,orSa- were calculated.19 For continuous mea- of all drugs prescribed for the treatment bal serrulata, including all subhead- surements, a difference between treat- of BPH.9 In the United States, phyto- ings.16 EMBASE, (1974-July 1997), ment means and its correlated SE of the therapies for BPH are readily available Phytodok (Munich, Germany), and the difference were calculated using the as nonprescription dietary supplements. Cochrane Library, including the data- methods of Lau19 and Laird and Mo- Most of these compounds are unlicensed base of the Cochrane Prostatic Diseases steller.20 Because studies did not report and often promoted to “maintain a and Urologic Malignancies Group and the SE of the difference between the healthy prostate” and as a natural and the Cochrane Field for Complementary means (S repens and control), analyses harmless treatment of BPH symptoms. Medicine, were searched in a similar were carried out for 3 different assumed There are about 30 phytotherapeutic fashion. Reference lists of all identified values of correlation (0.25, 0.50, 0.75). compounds used for the treatment of trials and previous reviews were This approach was taken to test the sen- BPH.10 The most widely used is the ex- searched for additional trials. Expert sitivity of the results to this unknown tract of the dried ripe fruit from the relevant trialists and pharmaceutical parameter. Because there were no sta- American dwarf saw palmetto plant Sere- companies were asked to identify addi- tistically significant differences in the noa repens (also known by its botanical tional published or unpublished trials. outcomes, according to the different cor- name Sabal serrulata). Berries from saw There were no language restrictions. relation coefficients, we used SEMs cal- palmetto were first used by the Ameri- culated with a correlation coefficient of can Indians in Florida in the early 1700s Data Extraction and Study Appraisal 0.50. x2 Tests were used for analysis of to treat testicular atrophy, erectile dys- Study characteristics, demographic in- bivariate comparisons. To assess the function, and prostate gland swelling or formation,enrollmentcriteria,therapyal- percentage of patients having improve- inflammation.10 The medicinal value of location, adverse effects, outcomes and ment in urologic symptoms, a modified S repens for relief of prostate gland swell- numbers, and reasons for dropouts were intention-to-treat analysis was per- ing has been reported in medical litera- extracted independently by 2 reviewers. formed(ie,menwhodroppedoutorwere ture since the 1800s. The mechanism of Missing information was sought from au- losttofollow-upwereconsideredtohave action of S repens is not known but may thors and/or sponsors. Extracted data had worsening symptoms).21 The de- include alteration of cholesterol metabo- were reviewed by the principal reviewer nominator for the modified intention-to- lism,11 antiestrogenic, antiandrogenic, and discrepancies resolved by discussion. treat analysis included the number ran- and anti-inflammatory effects,12-14 and The main outcome was the efficacy of domized to treatment at baseline, and a decrease in available sex hormone– S repens vs placebo or active control in the numerator included the number binding globulin.15 Although S repens has improving urologic symptom scale completing the trial and showing im- been evaluated in several randomized tri-
Load more

Recommended publications
  • (12) Patent Application Publication (10) Pub. No.: US 2004/0224012 A1 Suvanprakorn Et Al
    US 2004O224012A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2004/0224012 A1 Suvanprakorn et al. (43) Pub. Date: Nov. 11, 2004 (54) TOPICAL APPLICATION AND METHODS Related U.S. Application Data FOR ADMINISTRATION OF ACTIVE AGENTS USING LIPOSOME MACRO-BEADS (63) Continuation-in-part of application No. 10/264,205, filed on Oct. 3, 2002. (76) Inventors: Pichit Suvanprakorn, Bangkok (TH); (60) Provisional application No. 60/327,643, filed on Oct. Tanusin Ploysangam, Bangkok (TH); 5, 2001. Lerson Tanasugarn, Bangkok (TH); Suwalee Chandrkrachang, Bangkok Publication Classification (TH); Nardo Zaias, Miami Beach, FL (US) (51) Int. CI.7. A61K 9/127; A61K 9/14 (52) U.S. Cl. ............................................ 424/450; 424/489 Correspondence Address: (57) ABSTRACT Eric G. Masamori 6520 Ridgewood Drive A topical application and methods for administration of Castro Valley, CA 94.552 (US) active agents encapsulated within non-permeable macro beads to enable a wider range of delivery vehicles, to provide longer product shelf-life, to allow multiple active (21) Appl. No.: 10/864,149 agents within the composition, to allow the controlled use of the active agents, to provide protected and designable release features and to provide visual inspection for damage (22) Filed: Jun. 9, 2004 and inconsistency. US 2004/0224012 A1 Nov. 11, 2004 TOPCAL APPLICATION AND METHODS FOR 0006 Various limitations on the shelf-life and use of ADMINISTRATION OF ACTIVE AGENTS USING liposome compounds exist due to the relatively fragile LPOSOME MACRO-BEADS nature of liposomes. Major problems encountered during liposome drug Storage in vesicular Suspension are the chemi CROSS REFERENCE TO OTHER cal alterations of the lipoSome compounds, Such as phos APPLICATIONS pholipids, cholesterols, ceramides, leading to potentially toxic degradation of the products, leakage of the drug from 0001) This application claims the benefit of U.S.
    [Show full text]
  • Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
    MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01
    [Show full text]
  • Pharmaceutical Appendix to the Tariff Schedule 2
    Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. ABACAVIR 136470-78-5 ACIDUM LIDADRONICUM 63132-38-7 ABAFUNGIN 129639-79-8 ACIDUM SALCAPROZICUM 183990-46-7 ABAMECTIN 65195-55-3 ACIDUM SALCLOBUZICUM 387825-03-8 ABANOQUIL 90402-40-7 ACIFRAN 72420-38-3 ABAPERIDONUM 183849-43-6 ACIPIMOX 51037-30-0 ABARELIX 183552-38-7 ACITAZANOLAST 114607-46-4 ABATACEPTUM 332348-12-6 ACITEMATE 101197-99-3 ABCIXIMAB 143653-53-6 ACITRETIN 55079-83-9 ABECARNIL 111841-85-1 ACIVICIN 42228-92-2 ABETIMUSUM 167362-48-3 ACLANTATE 39633-62-0 ABIRATERONE 154229-19-3 ACLARUBICIN 57576-44-0 ABITESARTAN 137882-98-5 ACLATONIUM NAPADISILATE 55077-30-0 ABLUKAST 96566-25-5 ACODAZOLE 79152-85-5 ABRINEURINUM 178535-93-8 ACOLBIFENUM 182167-02-8 ABUNIDAZOLE 91017-58-2 ACONIAZIDE 13410-86-1 ACADESINE 2627-69-2 ACOTIAMIDUM 185106-16-5 ACAMPROSATE 77337-76-9
    [Show full text]
  • The Effects of Lovastatin on Conventional Medical Treatment of Lower Urinary Tract Symptoms with Finasteride
    ��������������linical Urolo�� Lovastatin and Treatment of LUTS with Finasteride International Braz J Urol Vol. 34 (5): 555-562, September - October, 2008 The Effects of Lovastatin on Conventional Medical Treatment of Lower Urinary Tract Symptoms with Finasteride Konstantinos N. Stamatiou, Paraskevi Zaglavira, Andrew Skolarikos, Frank Sofras Department of Urology (KS, PZ), General Hospital of Thebes, Greece, Department of Urology (AS), University of Athens, Greece and Department of Urology (FS), University of Crete, Greece ABSTRACT Objective: To explore whether or not statins have any impact on the progression of components of benign prostatic hyper- plasia (lower urinary tract symptoms severity, prostate volume and serum prostate specific antigen (PSA) when combined with other agents inhibiting growth of prostate cells. Materials and Methods: This was a preliminary, clinical study. Eligible patients were aged > 50 yrs, with International Prostate Symptom Score (IPSS) between 9 and 19, total prostate volume (TPV) > 40 mL, and serum PSA > 1.5 ng/mL. Patients were divided in two groups: those with and those without lipidemia. After selection, eligible BPH patients with lipidemia (n = 18) were prescribed lovastatin 80 mg daily and finasteride 5 mg daily, while eligible patients without lipidemia (n = 15) were prescribed only finasteride 5 mg daily. IPSS, TPV and serum PSA were evaluated at end point (4 months). Results: There was no difference between the two groups on the primary end point of mean change from baseline in IPSS (p = 0.69), TPV (p = 0.90) and PSA (p = 0.16) after 4 months of treatment. Conclusions: Short-term lovastatin treatment does not seem to have any effect on IPSS, TPV and PSA in men with prostatic enlargement due to presumed BPH.
    [Show full text]
  • Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness Comparative Effectiveness Review Number 41
    Comparative Effectiveness Review Number 41 Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness Comparative Effectiveness Review Number 41 Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. 290-2007-10065-I Prepared by: Vanderbilt Evidence-based Practice Center Nashville, Tennessee Investigators: Jeff Andrews, M.D. Amanda Yunker, D.O., M.S.C.R. W. Stuart Reynolds, M.D. Frances E. Likis, Dr.P.H., N.P., C.N.M. Nila A. Sathe, M.A., M.L.I.S. Rebecca N. Jerome, M.L.I.S., M.P.H. AHRQ Publication No. 11(12)-EHC088-EF January 2012 This report is based on research conducted by the Vanderbilt Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA 290-2007-10065-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2003/0068365A1 Suvanprakorn Et Al
    US 2003.0068365A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2003/0068365A1 Suvanprakorn et al. (43) Pub. Date: Apr. 10, 2003 (54) COMPOSITIONS AND METHODS FOR Related U.S. Application Data ADMINISTRATION OF ACTIVE AGENTS USING LIPOSOME BEADS (60) Provisional application No. 60/327,643, filed on Oct. 5, 2001. (76) Inventors: Pichit Suvanprakorn, Bangkok (TH); Tanusin Ploysangam, Bangkok (TH); Publication Classification Lerson Tanasugarn, Bangkok (TH); Suwalee Chandrkrachang, Bangkok (51) Int. Cl." .......................... A61K 9/127; A61K 35/78 (TH); Nardo Zaias, Miami Beach, FL (52) U.S. Cl. ............................................ 424/450; 424/725 (US) (57) ABSTRACT Correspondence Address: Law Office of Eric G. Masamori Compositions and methods for administration of active 6520 Ridgewood Drive agents encapsulated within liposome beads to enable a wider Castro Valley, CA 94.552 (US) range of delivery vehicles, to provide longer product shelf life, to allow multiple active agents within the composition, (21) Appl. No.: 10/264,205 to allow the controlled use of the active agents, to provide protected and designable release features and to provide (22) Filed: Oct. 3, 2002 Visual inspection for damage and inconsistency. US 2003/0068365A1 Apr. 10, 2003 COMPOSITIONS AND METHODS FOR toxic degradation of the products, leakage of the drug from ADMINISTRATION OF ACTIVE AGENTS USING the liposome and the modifications of the Size and morphol LPOSOME BEADS ogy of the phospholipid liposome vesicles through aggre gation and fusion. Liposome vesicles are known to be CROSS REFERENCE TO OTHER thermodynamically relatively unstable at room temperature APPLICATIONS and can Spontaneously fuse into larger, leSS Stable altered liposome forms.
    [Show full text]
  • Stembook 2018.Pdf
    The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 WHO/EMP/RHT/TSN/2018.1 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances. Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data.
    [Show full text]
  • Customs Tariff - Schedule
    CUSTOMS TARIFF - SCHEDULE 99 - i Chapter 99 SPECIAL CLASSIFICATION PROVISIONS - COMMERCIAL Notes. 1. The provisions of this Chapter are not subject to the rule of specificity in General Interpretative Rule 3 (a). 2. Goods which may be classified under the provisions of Chapter 99, if also eligible for classification under the provisions of Chapter 98, shall be classified in Chapter 98. 3. Goods may be classified under a tariff item in this Chapter and be entitled to the Most-Favoured-Nation Tariff or a preferential tariff rate of customs duty under this Chapter that applies to those goods according to the tariff treatment applicable to their country of origin only after classification under a tariff item in Chapters 1 to 97 has been determined and the conditions of any Chapter 99 provision and any applicable regulations or orders in relation thereto have been met. 4. The words and expressions used in this Chapter have the same meaning as in Chapters 1 to 97. Issued January 1, 2020 99 - 1 CUSTOMS TARIFF - SCHEDULE Tariff Unit of MFN Applicable SS Description of Goods Item Meas. Tariff Preferential Tariffs 9901.00.00 Articles and materials for use in the manufacture or repair of the Free CCCT, LDCT, GPT, following to be employed in commercial fishing or the commercial UST, MXT, CIAT, CT, harvesting of marine plants: CRT, IT, NT, SLT, PT, COLT, JT, PAT, HNT, Artificial bait; KRT, CEUT, UAT, CPTPT: Free Carapace measures; Cordage, fishing lines (including marlines), rope and twine, of a circumference not exceeding 38 mm; Devices for keeping nets open; Fish hooks; Fishing nets and netting; Jiggers; Line floats; Lobster traps; Lures; Marker buoys of any material excluding wood; Net floats; Scallop drag nets; Spat collectors and collector holders; Swivels.
    [Show full text]
  • Saw Palmetto ทำงเลือกในกำรรักษำภำวะต่อมลูกหมำกโต
    Saw palmetto ทำงเลือกในกำรรักษำภำวะต่อมลูกหมำกโต จ ำนวนหน่วยกิตกำรศึกษำต่อเนื่อง ผู้เขียนบทควำม 3.00 หน่วยกิต เภสัชกร ภูมิรพี นันทวงศ์ และ รองศำสตรำจำรย์ เภสัชกร ดร.บุญชู ศรีตุลำรักษ์ ภาควิชาเภสัชเวทและเภสัชพฤกษศาสตร์ คณะเภสัชศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย บทคัดย่อ Saw palmetto เป็นสมุนไพรที่มีสรรพคุณช่วยรักษาภาวะต่อมลูกหมากโต สารสกัดจาก saw palmetto ที่ นิยมน ามาใช้คือ liposterolic extract ซึ่งสารสกัดนี้มีฤทธิ์ในการรักษาภาวะต่อมลูกหมากโตผ่านหลายกลไก เช่น การยับยั้งเอนไซม์ 5-alpha reductase ยับยั้งการหดเกร็งของกล้ามเนื้อ ต้านฮอร์โมนเพศชาย ต้านการอักเสบ การศึกษาในมนุษย์นั้นยังไม่สามารถสรุปแน่ชัดได้ว่าสามารถน ามาใช้บรรเทาอาการต่อมลูกหมากโตได้หรือไม่ บาง งานวิจัยพบว่ามีผลในบรรเทาอาการต่าง ๆ ที่เกิดจากภาวะต่อมลูกหมากโตได้ในขณะที่บางงานวิจัยพบว่าไม่มีผลต่าง จากยาหลอก Saw palmetto เป็นสมุนไพรที่ปลอดภัยส าหรับผู้ป่วยที่ไม่ได้เป็นมะเร็งต่อมลูกหมาก แต่มีผลข้างเคียง ที่พบได้บ่อยคืออาการผิดปกติในทางเดินอาหาร ค ำส ำคัญ Saw palmetto, การรักษา, ภาวะต่อมลูกหมากโต, สมุนไพร, ผลข้างเคียง Saw palmetto ทางเลือกในการรักษาภาวะต่อมลูกหมากโต หน้า 1 จาก 19 บทน ำ ภาวะต่อมลูกหมากโต (Benign prostatic hyperplasia; BPH) เป็นอาการผิดปกติของระบบทางเดินปัสสาวะที่มัก พบได้ในผู้ชายสูงอายุ โดยมีโอกาสพบประมาณ 50% ในผู้ชายที่มีอายุมากกว่า 80 ปี ต่อมลูกหมากมีต าแหน่งอยู่ใต้กระเพาะ ปัสสาวะและท าหน้าที่สร้างสารที่เป็นของเหลวหล่อเลี้ยงน้ าอสุจิ เมื่อขนาดของต่อมลูกหมากใหญ่ขึ้น จะเบียดกับท่อปัสสาวะ ท าให้ท่อปัสสาวะตีบแคบลง ส่งผลให้เกิดความผิดปกติมากมาย เช่น ความแรงของปัสสาวะลดลง ไม่สามารถขับปัสสาวะได้ หมด ปัสสาวะกะปริบกะปรอยตอนกลางคืน และปัสสาวะขัด ซึ่งอาการเหล่านี้จะเรียกรวม ๆ ว่า
    [Show full text]
  • Council of Europe Committee of Ministers (Partial
    COUNCIL OF EUROPE COMMITTEE OF MINISTERS (PARTIAL AGREEMENT IN THE SOCIAL AND PUBLIC HEALTH FIELD) RESOLUTION AP (82) 2 ON THE CLASSIFICATION OF MEDICINES WHICH ARE OBTAINABLE ONLY ON MEDICAL PRESCRIPTION (Adopted by the Committee of Ministers on 2 June 1982 at the 348th meeting of the Ministers' Deputies and superseding Resolution AP (77) 1) AND APPENDIX containing the list of medicines adopted by the Public Health Committee (Partial Agreement) updated to 31 October 1982 RESOLUTION AP (82) 2 ON THE CLASSIFICATION OF MEDICINES WHICH ARE OBTAINABLE ONLY ON MEDICAL PRESCRIPTION 1 (Adopted by the Committee of Ministers on 2 June 1982 at the 348th meeting of the Ministers' Deputies) The Representatives on the Committee of Ministers of Belgium, France, the Federal Republic of Germany, Italy, Luxembourg, the Netherlands, the United Kingdom of Great Britain and Northern Ireland, these states being parties to the Partial Agreement in the social and public health field, and the Representatives of Austria, Denmark, Ireland and Switzerland, states which have participated in the public health activities carried out within the above-mentioned Partial Agreement since 1 October 1974, 2 April 1968, 23 September 1969 and 5 May 1964, respectively, Considering that, under the terms of its Statute, the aim of the Council of Europe is to achieve a greater unity between its Members for the purpose of safeguarding and realising the ideals and principles which are their common heritage and facilitating their economic and social progress; Having regard to the
    [Show full text]
  • (CP/CPPS): a Systematic Review and Meta-Analysis
    Therapeutic Intervention for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Systematic Review and Meta-Analysis The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Cohen, Jeffrey M., Adam P. Fagin, Eduardo Hariton, Joshua R. Niska, Michael W. Pierce, Akira Kuriyama, Julia S. Whelan, Jeffrey L. Jackson, and Jordan D. Dimitrakoff. 2012. Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): a systematic review and meta-analysis. PLoS ONE 7(8). Published Version doi:10.1371/journal.pone.0041941 Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:10436278 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA Therapeutic Intervention for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS): A Systematic Review and Meta-Analysis Jeffrey M. Cohen1., Adam P. Fagin3., Eduardo Hariton1., Joshua R. Niska1., Michael W. Pierce1., Akira Kuriyama5, Julia S. Whelan1, Jeffrey L. Jackson4, Jordan D. Dimitrakoff1,2* 1 Harvard Medical School, Boston, Massachusetts, United States of America, 2 Massachusetts General Hospital, Boston, Massachusetts, United States of America, 3 Harvard School of Dental Medicine, Boston, Massachusetts, United States of America, 4 Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America, 5 Kurashiki Central Hospital, Okayama, Japan Abstract Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has been treated with several different interventions with limited success.
    [Show full text]
  • Harmonized Tariff Schedule of the United States (2004) -- Supplement 1 Annotated for Statistical Reporting Purposes
    Harmonized Tariff Schedule of the United States (2004) -- Supplement 1 Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2004) -- Supplement 1 Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABACAVIR 136470-78-5 ACEXAMIC ACID 57-08-9 ABAFUNGIN 129639-79-8 ACICLOVIR 59277-89-3 ABAMECTIN 65195-55-3 ACIFRAN 72420-38-3 ABANOQUIL 90402-40-7 ACIPIMOX 51037-30-0 ABARELIX 183552-38-7 ACITAZANOLAST 114607-46-4 ABCIXIMAB 143653-53-6 ACITEMATE 101197-99-3 ABECARNIL 111841-85-1 ACITRETIN 55079-83-9 ABIRATERONE 154229-19-3 ACIVICIN 42228-92-2 ABITESARTAN 137882-98-5 ACLANTATE 39633-62-0 ABLUKAST 96566-25-5 ACLARUBICIN 57576-44-0 ABUNIDAZOLE 91017-58-2 ACLATONIUM NAPADISILATE 55077-30-0 ACADESINE 2627-69-2 ACODAZOLE 79152-85-5 ACAMPROSATE 77337-76-9 ACONIAZIDE 13410-86-1 ACAPRAZINE 55485-20-6 ACOXATRINE 748-44-7 ACARBOSE 56180-94-0 ACREOZAST 123548-56-1 ACEBROCHOL 514-50-1 ACRIDOREX 47487-22-9 ACEBURIC ACID 26976-72-7
    [Show full text]