中医药临床优势病种——良性前列腺增生  

Advantages of Chinese Medicine in Treating Dominant Disease:Benign Prostatic Hyperplasia

作　　者：沈建武[1] 王彬[2] 林生 莫美 张志杰[4] 韩亮[5] 柯明辉[6] 宋竖旗[7] 王海[8] 唐渊[9] 韩虎[10] 刘红明 赵勇[12] 赵琦 朱勇 李海松[2] 张霄潇[14] 杨勇 SHEN Jian-wu;WANG Bin;LIN Sheng;MO Mei;ZHANG Zhi-jie;HAN Liang;KE Ming-hui;SONG Shu-qi;WANG Hai;TANG Yuan;HAN Hu;LIU Hong-ming;ZHAO Yong;ZHAO Qi;ZHU Yong;LI Hai-song;ZHANG Xiao-xiao;YANG Yong(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;State Key Laboratory of Critical Technology in Innovative Chinese Medicine,Tianjin 300410,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102400,China;China-Japan Friendship Hospital,Beijing 100029,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Peking Union Medical College Hospital,Beijing 100730,China;Peking University First Hospital,Beijing 100034,China;Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;Air Force Medical Center,PLA,Beijing 100142,China;The Sixth Medical Center of PLA General Hospital,Beijing 100037,China;Institute of Andrology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;China Association of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学东直门医院,北京100700 [3]创新中药关键技术国家重点实验室,天津300410 [4]北京中医药大学东方医院,北京100078 [5]北京中医药大学房山医院,北京102400 [6]中日友好医院,北京100029 [7]中国中医科学院广安门医院,北京100053 [8]北京协和医院,北京100730 [9]北京大学第一医院,北京100034 [10]首都医科大学附属北京朝阳医院,北京100020 [11]中国人民解放军空军特色医学中心,北京100142 [12]解放军总医院,第六医学中心,北京100037 [13]北京中医药大学东直门医院,男科研究所,北京100700 [14]中华中医药学会,北京100029

出　　处：《中国实验方剂学杂志》2022年第2期220-226,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医科学院科技创新工程重大攻关项目(CI2021A02206);中华中医药学会青年人才托举工程项目(CACM-2018-QNRC2-C05);北京中医药大学青年名医培育计划项目。

摘　　要：中华中医药学会组织中西医男科专家进行探讨,探索对良性前列腺增生以中医药为主导疗法的应用人群和治疗阶段。针对良性前列腺增生中医药具有很大的治疗优势,但必须要明确中医药在该病的什么阶段可以做为主导治疗方式,什么阶段最好采用现代医学治疗方式进行治疗,又在什么状况下可采用中西医结合治疗而获取临床的最佳治疗效果。经与会专家讨论认为,年老体弱,基础疾病多不能耐受麻醉和手术的具有临床症状的良性前列腺增生患者;不能耐受西药治疗药物的不良反应,或不能接受西药可能出现的不良反应的具有临床症状的患者;症状处于轻度下尿路症状[国际前列腺症状评分(IPSS)≤7分]和中度以上症状(IPSS≥8分)但生活质量尚未受到明显影响阶段的患者;膀胱逼尿肌功能减退,膀胱功能低下不能手术治疗,或经手术治疗后功能仍然不能使膀胱排空,仍存在较多残余尿的前列腺增生患者;前列腺增生合并前列腺炎,并且以前列腺炎为主要临床表现的前列腺增生患者;术后出现的非急性并发症等,是中医药治疗前列腺增生的优势阶段,可以采用中医药为主导的治疗。前列腺增生做为中医泌尿男科治疗的优势病种之一,在临床治疗中需充分考虑前列腺增生患者的症状程度及并发症状况、疾病的可能转归来确定具体的治疗方案。在以中医药为主导治疗时需定期复查患者的血清前列腺癌特异性抗原水平,排除前列腺恶性肿瘤的可能,足疗程、足周期的应用中医疗法进行治疗,同时亦可中西并用,使患者得到最有效的、最方便的、最经济的、最满意的治疗,将中医治疗该病的优势发扬光大。China Association of Chinese Medicine organized specialists in andrology of Chinese and western medicine to explore the population and treatment stage of benign prostatic hyperplasia(BPH)with Chinese medicine as the leading therapy.Chinese medicine has great advantages in the treatment of benign prostatic hyperplasia.However,it is necessary to make clear the stage when Chinese medicine or modern medical treatment can be used as the leading therapy,and the conditions under which Chinese and western medicine can be combined to achieve the best treatment efficacy.The specialists agreed Chinese medicine as the leading therapy for the treatment of BPH in the following populations or conditions:the elderly and weak patients with basic diseases,BPH symptoms,and cannot tolerate anesthesia and surgery,the patients with BPH symptoms and cannot tolerate the adverse reactions or the possible adverse reactions of western medicine;the patients with mild[international prostatic symptom score(IPSS)≤7]or moderate lower urinary tract symptoms(IPSS≥8)and the quality of life not significantly affected,the patients with bladder detrusor hypofunction,bladder dysfunction and cannot be treated surgically,or with incomplete bladder emptying after surgical treatment;the BPH patients with prostatitis as the main clinical manifestation,the patients with non-acute complications after operation.BPH is one of the dominant diseases in urology and andrology of Chinese medicine,and the symptoms,complications,and prognosis of BPH patients need to be fully considered during the clinical treatment.When Chinese medicine is taken as the leading therapy,it is essential to regularly review the serum level of prostate-specific antigen to exclude the possibility of prostate cancer,and apply Chinese medicine for full treatment course and cycle.At the same time,Chinese and western medicine can be combined to achieve the most effective,convenient,economical,and satisfactory treatment,which can carry forward the advantages of Chinese medicine in treating

关 键 词：前列腺增生 优势病种 中医药主导治疗 

分 类 号：R242[医药卫生—中医临床基础] R2-0[医药卫生—中医学]