Clinical Observation On Treatment Of Benign Prostatic Hyperplasia With Qianlong Tong Capsule And Experimental Study Of The Influence Of It On Expression Of IGF-â… mRNA/IGF-â… RmRNA And Fas/Fas1 Of Prostate In Rats Model

Backgroud:Benign prostatic hyperplasia(BPH) is a common and frequently occurring disease of senile male. With the growing number of aged population,the incidence of BPH is also rising. BPH has become a major disease with serious influence on senile male's physical and mental health and quality of life.Objective:To investigate the clinical effect and mechanism of Qianlong Tong Capsule(QLTC) on BPH, to probe into the traditional chinese medical pathogenesis of BPH and support the capsule with scientific basis, so as to be better popularized and applied. Methods:1. Clinical study:74 cases of BPH were randomly divided into treatment group and control group. The cases were treated respectively by Qianlong Tong Capsule (QLTC) and Qianlie Shule Capsule (QLSLC) for 3 months. Changes of international prostate symptom scores (Ⅰ-PSS), quality of life(QOL) seores, TCM symtomatic scores, maximun flow rate(Qmax), average flow rate (Qave), bladder residual urine (RUV), and total prostate volume (PV) in patients with BPH were observed before and after treatment.2. Animal experiment:72 SD male rats were randomly divided into six groups:normal group, model group, QLSLC group, QLTC low-dosage group, QLTC medium-dosage group, QLTC large-dosage group. Except for normal group, rats of the rest groups were established by subcutaneously injecting testosterone propionate after being castrated. The rats were killed and prostate glands were removed after intragastric achainistration respectively for 30 days. The weight, volume and index of the prostate were measured.By means of RT-PCR, the expressions of IGF-ⅠmRNA,IGF-ⅠRmRNA were examined in the prostates of rats. By means of immunohistochemisty the expressions of Fas, Fasl were examined in the prostates of rats. Results:1. Clinical study:After 3 months'treatment,①the levels ofⅠ-PSS and QOL seores in patients with BPH were reduced significantly in the treated group by QLTC and the control group by QLSLC(P<0.01). In respect of reducing the levels ofⅠ-PSS and QOL seores, QLTC superior to QLSLC (P<0.05).②QLTC and QLSLC improved significantly the levels of Qmax and Qave(P<0.01), QLTC superior to QLSLC(P<0.05).③QLTC and QLSLC reduced significantly the levels of RUV and PV (P<0.01), QLTC superior to QLSL (P<0.05).④QLTC and QLSLC reduced the longitudinal diameter of prostate significantly(P<0.05), but QLTC and QLSLC had no significantly difference (P>0.05).⑤QLTC and QLSLC reduced significantly the levels of dysuria, nocturia number, urine line, languid, the lower abdomen symptoms seores (P<0.01). QLTC reduced the levels of dysuria, urine line and nocturia number seores superior to QLSLC (P<0.05). But QLTC reduced the levels of languid, the lower abdomen symptoms seores had no significantly difference to QLSLC (P>0.05).⑥The markedly effective rate, total effective rate in the treated group was 61.8%,88.2% respectively, the markedly effective rate, total effective rate in the control group was 32.3%,74.2% respecti-vely. The curative effects of QLTC superior to QLSLC(P<0.05). ⑦QLTC and QLSLC both have little influence on tPSA and IIEF-5(P>0.05).2. Animal experiment:①Copared with model group, prostatic weights, volumes and indexs decreased significantly in all of QLTC group and QLSLC group(P<0.01). Prostatic weights, volumes and indexs in QLTC large-dosage groups were less than QLSLC group (P<0.05).②Compared with model group, the expressions of IGF-ⅠmRNA and IGF-ⅠRmRNA decreased signifieantly in all QLTC and QLSLC groups(p<0.01). Compared with QLSLC, the expressions of IGF-ⅠmRNA and IGF-ⅠRmRNA in QLTC large-dosage groups groups decreased significantly (p<0.05).③The expressions of Fas and Fasl in QLTC varied dose group and QLSLC group were significantly more than model group (p<0.01), the expressions of Fas and Fasl in QLTC were significantly more than QLSLC group (p<0.05).Conclusions:1. Deficiency of Qi and blood stasis is the basic pathogenesis of BPH. The treatment of invigorating Qi and promoting blood flow and Lishui Xiaozheng were selected.2.QLTC can effectively reduce the levels ofⅠ-PSS and ameliorated quality of life, improve the levels of Qmax and Qave, redue the levels of RUV, ameliorat the symptom of TCM, lessen PV.3. QLTC shows multiway and multitarget treatment effects on BPH in experimental rats. QLTC can effectively decrease prostatic weights, volumes and indexs, decrease the expressions of IGF-ⅠmRNA and IGF-ⅠRmRNA, increase the expressions of Fas and Fasl in experimental rats. Experimental results indicated that the treatment of QLTC on benign prostatic hyperplasia is many links and targets, influence of the expression of IGF-ⅠmRNA,IGF-ⅠRmRNA,Fas and Fasl in prostate tissue might be one of the mechanisms.