Contrary to generally accepted conception, the frequency 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 spread of chronic forms of prostatitis, characterized by an inactive inflammatory process and minor clinical symptoms that reduce quality of life, are difficult to evaluate.
In addition to acute and chronic bacterial prostatitis, chronic inflammatory pelvic pain is distinguished separately, in which leukocytes are detected in the third part of the urine or semen, as well as the chronic pelvic pain syndrome without inflammatory changes.
When the symptoms characteristic of chronic prostatitis, functional disorders of urination, expressed at high pressure of urination, intraprostatic reflux, which forms a turbulent flow of urine, the pathogenic effects of the microorganisms, the immunological reactions and the altered state of the pelvish muscles, are of high pressure.
Periodic onset and intensification of the pain and symptoms of the lower urinary tract (Luts), sleep disorders and often erectile function significantly affects the physical and psychological state of the person.
Most often, the symptoms of the lower urinary tract in young and middle-aged men are caused by an inflammatory process in the prostate gland, but given the age of the patient, it is always necessary to make a differential diagnosis between adenoma and prostate cancer.
There are different opinions about the pathogenesis of chronic prostatitis, on the basis of which different treatments are offered.The treatment of acute prostatitis depends on the identified pathogen and includes mainly antibacterial drugs that have the most penetrating capacity 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 the blood picture normalizes.In less severe cases, fluoroquinolones may be prescribed.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 the antibiotics continue only when the microorganism that caused the disease is known or if the patient has noted a positive effect of therapy.
The recommended treatment period for chronic prostatitis is 4-6 weeks or more.Urodynamic studies have shown increased urethral pressure.In this regard, it was noted that combined treatment with α-blockers and antibiotics is more effective than antibiotic monotherapy in inflammatory syndrome of chronic pelvic pain.When prescribing a course of therapy, the doctor should discuss with the patient the duration, the likelihood of side effects, and the need to monitor the effectiveness and safety of treatment.
Herbal remedies in the treatment of chronic prostatitis
The use of herbal preparations in the treatment of prostate diseases has a long history.Proof of the effectiveness and safety of herbal medicine has been empirically obtained.
At present, the possibility of using herbal remedies should be determined by modern ideas for pathogenesis and the development of pathological processes, more special in the prostate gland.
Processes such as functional obstruction, the appearance of turbulence in the prostatic urethra, the pathological effects of commensal microorganisms, immune changes, disrupt normal metabolism.Some violations inevitably lead to others.For example, chronic inflammation leads to cellular destruction and damage.
Usually the body constantly produces products with incomplete oxidation, the so-called free radicals, the number of which increases in various pathological conditions, in particular during inflammation.The interruption of oxygen supply to the tissues, whereby the rate of accumulation of active radical compounds (oxygen, nitrogen and chlorine radicals) exceeds the rate of their neutralization is called oxidative stress.As a result, oxidative 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 cannot seriously affect oxidative stress.In recent years, more and more attention has been paid to bioflavonoids, which are dozens of times stronger in antioxidant activity than vitamin E, vitamin C and beta-carotene.More than 6,000 bioflavonoids are known in total, of which more than 3000 are flavons and more than 700 isoflavones.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 irradiation, oxidation, diseases, infections, bacteria.One of the representatives of medicinal plants containing bioflavonoids is a hedysarum disdainful, perennial herbaceous plant of the legume family.This small plant, 25-50 cm high, blooms from June to August with small purple-violet flowers.
The roots of the forgotten penny contain flavonoid quercetin, saponins and other biologically active substances.Quercetin derivatives have antioxidant activity and are effective in patients with chronic prostatitis, which is confirmed by the results of clinical trials.
In addition to these properties, the catechins contained at the roots of the forgotten bastard have high P-vitamin activity, strengthen the capillary walls and optimize microcirculation.The roots of the forgotten penny have adaptogenic properties, which also determines the value of the plant's inclusion in the complex therapy of patients with chronic prostatitis.
Also, containing flavonoids is outraged (Polygonum Aviculare), annual herbaceous weed with small, elliptical leaves.A single stem that extends from the base of the root branches extensively and produces a mass of green shoots.This low-growing plant carries numerous imperceptible green and white flowers in May.Knotweed also contains a large amount of ascorbic acid, vitamin K and provitamin A.
Herbal braid based products have long been known in urological practice as they have a diuretic, anti-gave and adaptogenic effect.The combined use of common and knitting allows us to expect a clinically significant effect.
The herbal remedies available in the clinical practice produced by the municipality (root and rhizome), as well as the herb of the knit, is a tincture of the root of the forgotten common part.
The biologically active substances included in the tincture contain natural antioxidants and substances that improve the microcirculation, which determines the ability of these herbal medicines to reduce the severity of the inflammatory process in the prostate syndrome and pain (feeling of pain and heaviness in the perinea, prostatic).
Increased blood circulation in the prostate reduces the severity of the symptoms of the lower urinary tract (including frequent, difficult urination, discomfort when emptying the bladder, weakened urine flow and the feeling of incomplete bladder emptying), and also improves the functional state of the cavernous arteries.
Clinical effectiveness of tincture from the roots of the forgotten bastard
The effectiveness of tincture has been studied in an openly randomized study.The purpose of the study was to study the effect of herbal preparations on the dynamics of pain syndrome, objective data and laboratory parameters in patients with chronic prostatitis.
In addition to the study of complaints and medical history, the diagnosis was confirmed by laboratory tests of prostate secretions in pure form or in urine.In parallel groups with active control, the effectiveness, safety and tolerance of the drug in patients with chronic prostatitis is evaluated.
To objectify the description of the symptoms, the National Institute for Health Chronic Prostatitis Symptom (NiH-CPSI), an analysis of urine diaries and the comparison of laboratory data is used.In patients, urological diseases that could be accompanied by similar symptoms (benign hyperplasia, prostate cancer), pathological changes in the nervous system and the gastrointestinal tract are excluded.
The long course of prostatitis with periodic exacerbations adversely affects the emotional and sexual sphere.Monitoring and changes in erectile function against the background of chronic prostatitis in patients who have received the drug are also performed with the help of standard questionnaires.In parallel, the safety of the drug is evaluated compared to other herbal remedies.
In order to clarify the effective dose of tincture of the roots of the forgotten penny, the patients were divided into two groups.The first group, which consisted of 30 people, received 1 teaspoon tincture 3 times a day.Patients in the second group, which also consisted of 30 people, took 2 teaspoons 3 times a day.
The distribution of patients in groups is carried out using a simple randomization method, which has made it possible to examine the effects of the drug in homogeneous groups.Red Root Plus was prescribed on an empty stomach at least 30 minutes before meals.Before use, the bottle of the drug is shaken and one dose is dissolved in 1/3 cup of water.The duration of treatment was 30 days.
A control group of 20 patients diagnosed with chronic prostatitis has received treatment with another herbal preparation for the same period.The effectiveness criteria in the groups that used the tincture of 1 teaspoon 3 times a day, 2 teaspoons 3 times a day or have taken a comparison medicine are changes in clinical symptoms based on a patient examination, questionnaire and urination diaries.All patients included have completed the study.
The average age of patients in the first group who received a tincture from the roots of the forgotten bastard, 1 teaspoon 3 times a day was 45.5 (37-56) years (below the average, as well as the 25th and 75th percentiles).The average age of patients in the second group, which took the tincture of 2 teaspoons 3 times a day, was 45.5 (33-55) years.The average age of patients in the control group was 48 (36-59) years.
There are no statistically significant differences in the age between groups (p = 0.63) (used below analysis of the dispersion).It should be noted that chronic prostatitis is identified in people of the most active and labor age, for which preservation of erectile and reproductive function is particularly important.All patients included in the study, 26 (32.5%) had a history of sexually transmitted diseases.The distribution of such patients in the groups was the same.
Prior to prescribing the tincture plus, 57 (71.3%) patients have received treatment of chronic prostatitis.Most often it is antibacterial therapy and/or α-blockers.The distribution of patients who have previously received treatment, as well as the type of treatment, does not differ significantly between groups, which confirms modern ideas for pathogenesis and, accordingly, methods of treating chronic prostatitis.
In order to objectively evaluate the symptoms and their severity, as well as the quality of life of patients, the NIH-CPSI scale is used, which is recommended for both basic assessment and monitoring of patients' condition.Initially, the level of pain according to the NiH-CPSI scale before treatment in the group that received a tincture from the roots of Pennywort, 1 teaspoon 3 times a day, is 13 (10-15) points;In the group, which received the tincture of 2 teaspoons 3 times a day - 12 (10-15) points.In the control group, this indicator is 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 the severity of pain, which is especially important, given the variety of clinical manifestations of the disease.
As urinary disorders, namely, obstruction of the bladder output, dissyner of the detrusor-spincter, increased pressure in the lumen of the prostatic urethra and intraprostatic reflux, plays an important role in the alleged causes and repetition of chronic prostatitis.Initially, in the first group, this indicator is according to the scale of NIH-CPSI, 2 (1-3) points, in the second group-2 (1-3) points and in control-also 2 (1-3) points.
The severity of urine disorders does not differ statistically significantly between groups (p = 0.937).The groups studied are homogeneous in terms of Luts.There are no differences between the groups in the results of the urination diary analysis.It can be said with reasonable confidence that Luts were related to prostate disease rather than functional disorders of bladder or water balance.
The maximum urinary flow rate, according to the urofl, in the first group is 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 are no statistically significant differences in this indicator between groups (p = 0.996).The volume of residual urine in the first, second and control groups is 23.0 (20–26), 23 (18–25) and 20 (16.5–24) ml, respectively.Patient groups also do not differ in this indicator (p = 0.175).
It may be noted that no pronounced tank disorders and evacuation functions of the bladder have been detected in patients with chronic prostatitis in the studied groups, but existing Lut allow us to suspect the source of pathological symptoms exactly at the level of prostatic urethra.
Subjective perception of patients for the symptoms of chronic prostatitis is also of great importance.A variety of uncomfortable sensations of varying weight that are prone to repetition, often unpredictable, significantly disturb the usual lifestyle of men.This affects not only their mood, but also their social activity.Therefore, a quality of life, which depends on the severity of the disease, its relapses and consequences, also serves as a criterion for the effectiveness of treatment.
Before the treatment is prescribed, in the group that received the red root tincture plus 1 teaspoon 3 times a day, the quality of life, according to the questionnaire, was estimated at 6 (5-9) points, in the group that received the tincture of 2 teaspoons 3 times a day - at 8 (6-9) points and in the control group.There are no statistically significant differences between the groups for this indicator (p = 0.22).
The total result on the NIH-CPSI scale in the first group is 22 (19–25), in the second group-23 (19–25), and in control-22 (18-25) (p = 0.801).In this way, the groups are homogeneous not only in terms of the sum of assessments on the scale of the symptoms of chronic prostatitis, but also in its individual components.All patients answered questions on the scale of the male copulative function (MCF).In the first group the indicator is 31 (23-41) points, in the second - 34 (27-39) points, in the third - 34 (26-37) points.The effect of chronic prostatitis on erectile function also remains subject to examination.
In all three groups, the range of values is quite wide.This shows the individual degree of human response to his or her symptoms and disorders.The distribution of patients with chronic prostatitis with different conditions of erectile function in groups before treatment does not differ (p = 0.967).Thus, at the beginning of the study, it was possible to form three groups of patients with chronic prostatitis who are homogeneous in the age, type and severity of the clinical symptoms that affected the quality of life.At the same time, tank violations and bladder evacuation functions were excluded.
After 30 days of treatment, the symptoms are evaluated in the formed groups.In the group of patients who received a tincture from the roots of the forgotten penny, 1 teaspoon 3 times a day, according to a control questionnaire, reducing the frequency and severity of pain and discomfort was noted by 51%.When taking the tincture, 2 teaspoons 3 times a day notice a reduction in the severity of symptoms by 55%.
In the control group, pathological symptoms decrease by 37%.The differences between the three patient groups are statistically significant (p = 0.029).However, no statistically significant differences were found between the first and second groups.In this way, it is possible to achieve a clinically significant effect with minimal doses of the drug.In addition, the statistically significant differences remain when the pathological symptoms are reduced in the assessment of each of the groups that have taken the tincture from the roots of the forgotten bastard compared to control.
According to the questionnaire, there was an improvement in urine effectiveness in patients with chronic prostatitis during treatment, but the differences are not statistically significant between the groups that have received tincture from the roots of the penis at different doses and compared to the control group.
When analyzing the data on the urination diary obtained after the course of treatment, there were also no statistically significant differences noted in all three groups.According to the results of the control uroflowmetry, all groups notice an increase in the maximum flow of urinary flow, which varies from 5 to 12%.The volume of residual urine in patients receiving the drug in different doses and in patients receiving herbal reference treatment decreases by 4-6%.The differences between groups are not statistically significant.
This fact can be explained by the relatively short period of use, as well as the lack of components in the red root plus the tincture, which would have an effect similar to α-adrenergic blockers and 5α-refusal inhibitors.The main active ingredient of the drug is compounds in the group of bioflavonoids, which have different effects, mainly antioxidant and anti -inflammatory effects.
According to a repeated examination, repeated interrogation notes an improvement in the quality of life quality after the course of treatment for 30 days.In the first group, this figure changes by 55%, in the second - by 59%, and in the control group - by 39%.The differences in the dynamics of changes in the quality of life during the use of the tincture of the roots of the forgotten bastard and in the control group were statistically significant (P = 0.008).
It should be noted that the groups that have received the tincture in different doses do not differ significantly in the dynamics of quality of life.The analysis of changes in quality of life confirms the adaptogenic effect of the components of the herbal preparation containing forgotten Kopek and Knotweed.The total result of NIH-CPSI decreases in all three groups after 30 days of treatment.The first group had a decrease of 50%, in the second - by 52%, and in the third - by 29%.At the same time, the same tendency is noted as in the analysis of other indicators.
The difference was statistically significant between patients who received the tincture of the roots of the forgotten bastard and patients in the control group, and no differences were found between the groups that received the medicine in different doses.
All three groups of patients show the same increase in the total result of the ICF questionnaire (p = 0.455).The change in the indicator in all groups was no more than 10%.There are no statistically significant differences between groups.
Improvement of copulatory function can be mainly associated with reducing the pathological symptoms of the prostate gland, reducing Luts, adaptogenic properties and improved microcirculation.The condition of the prostate gland during the use of herbal preparations is of interest.This is demonstrated by analyzing the results of a repeated study of prostate secretion.
If initially patient groups do not differ in the presence and number of leukocytes in prostate secretion (p = 0.528), then after 30 days of treatment in all groups there is a decrease in the severity of the inflammatory process.The groups that have received the tincture of the roots of the forgotten penny is noted statistically significant (p = 0.028) decrease in the number of leukocytes compared to the control group.Changing the dose of the drug does not affect the dynamics of leukocyte reduction.
According to a study of prostate secretions, a significant reduction in the severity of the inflammatory process and improving the functional state of the prostate gland has been found.
Different herbal remedies contain an individual set of bioflavonoids that have different activities.Obviously, the combination of the rhizomes and roots of the municipality and the knit contains bioflavonoids that are active against the effects of oxidative stress in the tissue of the prostate.This can be taken on the basis of the results of the effectiveness of the drug and the lack of dose -dependent differences.However, this assumption must be confirmed through additional studies.
Conclusion
Among the methods for the treatment of prostatitis, the use of herbal preparations occupies a significant place.The effectiveness of this group of medicines has been confirmed by clinical experience.However, conducting randomized clinical trials aimed at evaluating the effectiveness of herbal preparations based on modern ideas on 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 uncontrolled oxidation of free radicals have a detrimental effect on the cell and cause multiple organs and systems.
Considering the above, it seems that it is possible to conclude that herbal medicine using the tincture of the roots of the forgotten bastard, a medicinal product with pronounced anti-inflammatory and antioxidant effects, is most effective, both in the complex treatment of patients with chronic prostatitis and in the prevention of the disease.