Phytocomplex in the treatment of prostate diseases
Chronic prostatitis (CP) and benign prostatic hyperplasia (BPH) represents the most common diseases of the prostate gland (the pancreas) which are usually interrelated . HP in Russia, according to rough estimates, in 35% of cases is the reason to the urologist men of working age . Progressive nature of BPH is confirmed by numerous studies, marking disorders of urination in 40-90% of cases in the age group from 50 to 80 years and older .
In the presence of moderate or severe symptoms of disorders of the lower urinary tract (Luts) caused by BPH, drug therapy is the standard treatment for patients not eligible for surgical intervention . However, in different European countries there are differences concerning the assignments of drugs for the treatment of BPH . The guide 2013 for the treatment of Luts in men, including benign obstruction of the pancreas), published by the European Association of urology (EAU) recommend the use of several different variants of pharmacotherapy for the treatment of Luts, depending on the clinical situation . Herbal medicine is up to 40% on all appointments and is specific to certain countries . EAU 2013 recommends that in conjunction with the standard therapy of BPH and CP to use herbal remedies .
In this regard, researchers are actively engaged in the study and creation of medicines based on natural compounds: plant components, minerals and vitamins . Drug Likoprofit contains 10 components that together provide anti-inflammatory, antioxidant, immunomodulatory effects and inhibition of 2 subtypes of 5α-reductase, which corresponds to the pathogenetic approach to the treatment of HPS, and adenomas of the pancreas. The composition of the plant complex Likoprofit include the carotenoid lycopene, vitamins C, E, D3, palm fruit extract (Serenoa repens), Pygeum (Pygeum africanum), nettle root extract (Urtica dioica), chromium picolinate, asparaginat zinc, yeast enriched with selenium (tab. 1) .
Lycopene – a carotenoid with antioxidant properties. Selectively accumulates in the tissues of the prostate and protects cells from damage by free radicals. Reduces the activity of inflammatory and autoimmune processes in tissues of the prostate, prevents the conversion of testosterone to dihydrotestosterone and controls excessive multiplication of cells of the pancreas. Improves sperm quality by increasing the number of normal forms of sperm. One of the most important properties of lycopene – proven to reduce the risk of prostate cancer the systematic usedrug. Vitamin E has potent antioxidant activity and significantly enhances anti-cancer effect of the carotenoid lycopene. The fruit extract saw Palmetto blocks the main mechanisms of development of BPH by inhibiting the activity of enzymes involved in the activation of testosterone and has a pronounced anti-inflammatory effect in prostatitis, which leads to a decrease in frequency of nighttime urination, reduced residual urine volume. The nettle root extract reduces the growth of pancreatic tissues, eliminates voiding. The Pygeum bark, reduces proliferation of cells in the pancreas protects the vascular wall, reducing swelling and inflammation, helps normalize skin tone and eliminate spasms of the muscles of the bladder and urethra. Vitamin C increases the body's resistance to infections, reduces the severity of inflammatory reactions, supports the enzyme system of antioxidant protection . Additional amounts of zinc can reduce the severity of inflammatory reaction. It is the zinc provides the antimicrobial activity of the prostate secretion. Selenium is an antioxidant essential for the normal functioning of the prostate, together with vitamin E contributes to the death of atypical glandular cells of the prostate .
An example of successful clinical application of the drug Likoprofit patients with BPH is a placebo-controlled study A. V. Maximov et al. . The study included 41 patients over 50 years with BPH. All patients were divided into 2 equal groups: primary (n=20) patients were treated with Likoprofit 1 capsule (500 mg) 1 p/day during meals for 6 months. in the control (n=21) – placebo. The result was a marked improvement in all studied parameters in the study group compared with those in the control. The total score on the IPSS scale in the main group decreased by 15.8%, whereas in the control – only 4.7%. The authors believe that a more substantial decrease in prostate volume in the main group, most likely due to the effect part of the preparation of extracts of Serenoa repens and Pygeum africanum, having the properties of inhibitors of 5α-reductase and providing anti-edema effect. Also this paper shows a positive effect on the maximum rate of urine flow (Qmax) in patients of the main group. To similar conclusions came V. N. Pavlov et al. studying the clinical efficacy and safety of Likoprofit in the treatment of patients with BPH with mild to moderate symptoms of the disease . In the treatment process improved both the subjective data (IPSS and quality of life index in average is 17.1 and 31.5%, respectively), and objective indicators. According to uroflowmetry notedthe increase in Qmax and average flow rate of urine in an average of 21.1 and 31.7%, respectively. The pancreas volume according to transrectal ultrasound were reduced on average by 7.4%.
Drug exposure to the components of the complex Likoprofit associated with the improvement of microcirculation, manifested in the reduction of dysuria and improving uroflowmetric parameters (increase the maximum volumetric rate of flow of urine), which, according to A. A. Semeniuk, due to increased threshold of excitability and elasticity of the detrusor .
Likoprofit proven itself in the rehabilitation of patients after transurethral resection (TUR) of the prostate . The disruption of the microcirculation significantly affects the processes of biological oxidation. For BPH lowest indicators of microcirculation detected in the region of the bladder neck and triangle Leto. This is due to the compression of the adenomatous tissue of the bladder wall in this area and redistribution of blood flow through the main type. On the basis of dynamic observation of patients, who underwent TUR RV, VN. Pavlov et al. it was concluded about the role of Likoprofit in the restoration of capillary blood flow of the bladder wall .
In the analysis of results of treatment of HP with the use of Likoprofit draw attention to work that in different periods of time was carried out V. V. Borisov, V. N. Tkachuk, V. N. Zhuravlev, A. I. Neimark, V. N. Krupin, M. E. Sitdykova etc. .
The use of drugs containing vitamins and minerals, is justified in the treatment of CP patients. In addition, the antibacterial protection of the pancreas is closely associated with the presence of this body free of zinc, while bacterial prostatitis zinc levels are reduced. In the study on the efficacy and safety of the use of Likoprofit patients with chronic pancreatitis V. V. Borisov noted that the total subjective improvement occurred in the majority (56,6%) patients. As a result of application of the drug complex of Likoprofit for 3 months. 1 capsule (500 mg) 2 p/day during meals mentioned objective changes during the course of treatment, such as improvement of flow rate, decreasing residual urine volume, changes in the secretion of the pancreas, reduction in prostate volume .
In the 48 patients suffering from abacterial HP, VN. Tkachuk noted symptomatic improvement in 47 (97.9%) of patients; Qmax increased from 10.7±2.4 to 18,9±1.3 ml/s (p<0,05); was the improvement of the microcirculation in the pancreas. One of the results of the study was improvement of immunity. Patients with CP categories IIIA and IIIB received only Likoprofit 1 capsule (500 mg) 2 p/day during meals for 60 days. We investigated the effect on disease symptoms and quality of life of patients, evaluated by NIH-CPSI and the international scale IPSS; the influence on the microcirculation in the pancreas, the pancreas echostructure (according to ultrasound), indicatorsthe sperm and the immune system. For example, increased the number of CD3+, CD4+, T lymphocytes, significantly decreased the concentration of immunoglobulin A. Before taking complex Likoprofit violation of sperm motility in the ejaculate were detected in 18 (37.5%) of 48 patients, after completion of the course – only in 9 (18.7 per cent). In addition, the increased volume of ejaculate. It should be emphasized that patients with abacterial HP after taking Likoprofit increased level of citric acid in the ejaculate, which in turn indicates an improvement of the function of the pancreas. None of the 48 patients during admission Likoprofit not been reported side effects .
Of particular interest are studies of the influence of a medical complex on a status of seminal plasma and semen quality [14, 15]. V. N. Zhuravlev et al. presented data of clinical observations, in which for 6 months. in the complex treatment of CP in 58 patients was used Likoprofit 1 capsule (500 mg) 2 p/day during meals. Group comparisons were made by 42 of the patient in therapy which Likoprofit not included. In the process of treatment in most patients of both groups were in positive overall health and the data of objective research methods. After 6 months. 50 (86.2% of) patients of the 1st group, the clinical manifestations of the disease were absent, while in the 2nd group, 21.4% of patients had increased numbers of leukocytes in the prostate secretion. According to uroflowmetry in both groups showed an increase in the average flow rate of 1.9 to 2.6 ml/s and reducing the time of urination of 1.5 to 2.6 s. the Researchers noted the high level of security of Likoprofit and its effectiveness in the treatment of CP .
A similar conclusion came the employees of the Altai state medical University (A. I. Neimark and A. V. Davydov, who used Likoprofit in the treatment of patients with CP . It is shown that after treatment pain relieved 70% of patients, and dysuria – 100%. The average score on a scale SOS-CP has decreased on average to 2.17, the number of leukocytes in the prostate secretion to 8.3±2,34 (R<0,001). According to uroflowmetry was an increase in Qmax to 28.7±6,8 ml/s, average speed of urination – to 11.32±4,12 ml/s. According to transrectal ultrasound of the prostate was observed a decrease of its volume of 16.72 cm3. According to monitoring survey of this group of patients, 30 days after the end of therapy achieved effect is completely preserved.
Similar in design and objectives the study was conducted at the Department of urology of the Kazan state medical University, Professor M. E. Sitdykova, the Tomsk research Institute of balneology and physiotherapy – I. A. Colacem , the Ural state medical Academyfurther education – N.And. Tarasov, Chelyabinsk state medical Academy and A. V. Sokolov , in the Medical center diagnosis and prevention of Yaroslavl – I. A. Tuzikova . Their clinical studies, all authors proved the effectiveness and safety of Likoprofit when using sick HP. So, for example, I. A. Kalmatsuy stressed that Likoprofit most appropriate to prescribe in the stage of incomplete remission and a latent inflammation at the stage of rehabilitation therapy and for the prevention of exacerbations of inflammatory process. Under the influence of therapy with Likoprofit reduces the severity of pain and dysuria was stopped, the inflammatory process, improved the functional state of the pancreas and indicators of the ejaculate (decrease agglutination and increase the motility of the sperm, reducing the concentration of white blood cells). The author also noted that the drug not only has no negative influence on erectile function, but in some cases it improves that, no doubt due to its anti-inflammatory action (table. 2) .
Conclusion. In the course of numerous studies conducted in the leading urological clinics in Russia, where Likoprofit used HP and BPH patients, it was shown that the drug improves microcirculation in the tissues of the pancreas, has anti-edema effect, improves urination, indicators of the ejaculate, has a positive effect on sexual function, has a high safety profile.
The use of Likoprofit reliably showed its efficiency and safety, and, according to the given information, it can be recommended as a means of combination therapy of CP patients and BPH.
- Maksimov V. A., Boldyreva L. A.. Dudareva, A. A., Moskalev, N. G., Martov A. G. the Use of herbal drugs in the treatment of diseases of the urinary organs in men. Guidelines No. 31. M., 2010.
- Lopatkin N.. Urology. National leadership. M.: GEOTAR-Media, 2009. 538 p.
- Berry S. L., Coffey D. S., Walsh P. at al. The development of human benign prostatic hyperplasia with age // J. Urol. 1984. Vol. 132. R. 474-479.
- M. Oelke, A. Bachmann, Descazeaud A. et al. M. guidelines on the management of male lower urinary tract symptoms (LUTS), incl. bening prostatic obstruction (BPO). European Association of Urology 2013/ available from http://www.uroweb.org/pdf/13_Male_LUTS - LR.PDF.
- J. N. Cornu, O. Cussenot, F. Haab, Lukacs B. A widespread population study of actual medical management of lower urinary tract sympthomas related to bening prostatic hypeplasia across. Europe and beyond official clinical guidelines // Eur Urol. 2010. Vol. 58. R. 450-456.
- Govorov A.V., Kasyan G. R., Vasil'ev A. O., Pushkar D. Yu. Tadalafil in the treatment of symptoms from the lower urinary tract: review of the literature and existing clinical practice // Consilium medicum. 2014. No. 7. S. 33.
- Tkachuk V. N. The effectiveness of a comprehensive drug Likoprofit patients with chronic abacterial prostatitis: a Handbook for physicians. SPb., 2010.
- Spivak L. G.The efficacy and safety of the use of likoprofit patients with chronic prostatitis and benign prostatic hyperplasia // Urology. 2013. No. 2. P. 118-122.
- Borisov V. V. Antioxidant therapy male sexual and reproductive disorders (clinical lecture) // Consilium medicum. 2014. No. 7. S. 45.
- Maksimov V. A., Danovich, V. M., Davydova E. N. etc. evaluation of the effectiveness of the drug Likoprofit in patients with BPH // Medical class. 2007. No. 5. S. 30-32.
- Pavlov V. N., Safiullin R. I., Kazimirov A. A., etc. Likoprofit in the rehabilitation of patients after transurethral resection for benign prostate hyperplasia stage II // Effective pharmacotherapy in urology. 2007. No. 3. P. 32-36.
- Semeniuk A. A. Use of dietary supplements Likoprofit in the treatment of benign prostatic hyperplasia. http://www.ekomir.ru/research/ muzhskove_zdorove/likoprofit-zheleza-semenuk.
- Tkachuk V. N. The effectiveness of a comprehensive drug Likoprofit patients with chronic abacterial prostatitis. http://www.ekomir.ru/research/muzhskove_ zdorove/likoprofit-tkachuk-abakt-prostatit.
- Krupin V. N., Krupin A.V. Likoprofit in chronic prostatitis. http://www.ekomir.ru/research/muzhskove_zdorove/ lycoprofit-prostatitis-test.
- Zhuravlev V. N. Experience with the use of the drug Likoprofit in the treatment of patients with chronic prostatitis // Effective pharmacotherapy in urology. 2007. No. 4. Pp. 40-42).
- Neimark A. I., Neimark B. A., Miller M. A., Sizov, K. A., Tishchenko G. S. study of the activity of BAD Likoprofit potential in the treatment of patients with erectile dysfunction on the background of arterial hypertension // Bulletin of Siberian medicine. 2012. T. 11. No. 2. Pp. 36-39.
- Kalmatsuy I. A. Likoprofit in complex restorative treatment of patients with chronic prostatitis and benign prostate hyperplasia in combination with chronic prostatitis. http://www.ekomir.ru/research/muzhskove_zdorove/likoprofit-kolmacuy-tomsk.
- Tuzikov I. A. the Results of clinical trials of efficacy and safety of a nutraceutical Likoprofit in patients with chronic prostatitis in routine urological outpatient practice. http://www.ekomir.ru/research/muzhskove_zdorove/likoprofit-tuzikov-yaroslavl.