Contrary to popular belief, the incidence of prostatitis confirmed by laboratory testing is only about 9%.However, prostate inflammation often recurs or becomes chronic.
The prevalence of chronic prostatitis is difficult to assess and is characterized by an inactive inflammatory process and mild clinical symptoms that reduce quality of life.
In addition to acute and chronic bacterial prostatitis, we also distinguish between chronic inflammatory pelvic pain syndrome in which white blood cells are detected in the third part of urine or semen, and chronic pelvic pain syndrome without inflammatory changes.
Urinary dysfunction (manifested by high micturition pressure, turbulent urine flow due to intraprostatic reflux, pathogenic influence of microorganisms, immune responses and altered status of the pelvic floor muscles) is very important in the development and maintenance of the characteristic symptoms of chronic prostatitis.
The cyclic occurrence and exacerbation of lower urinary tract (LUTS) pain and symptoms, sleep disturbances, and erectile function can significantly affect a man's physical and psychological state.
Most often, lower urinary tract symptoms in young and middle-aged men are caused by prostatic inflammatory processes, however, given the age of the patient, it is always necessary to make a differential diagnosis of adenoma and prostate cancer.
There are different views on the pathogenesis of chronic prostatitis, and various treatments have been proposed accordingly.Treatment of acute prostatitis depends on the pathogen identified and consists primarily of antimicrobials with maximum penetration into prostate tissue.
Acute bacterial prostatitis requires parenteral administration of bactericidal antibiotics, such as aminoglycosides or third-generation cephalosporins.Treatment is continued until fever disappears and blood counts normalize.In less severe cases, fluoroquinolones may be prescribed.The duration of treatment with fluoroquinolones for acute prostatitis is 2-4 weeks.
Chronic bacterial prostatitis and inflammatory syndromes of chronic pelvic pain can be treated with fluoroquinolones or trimethoprim.The patient is then rechecked and antibiotics are continued only if the microorganism causing the disease is known or if the patient notices a positive effect of the treatment.
The recommended treatment time for chronic prostatitis is 4-6 weeks or longer.Urodynamic studies show increased urethral pressure.In this regard, it has been stated that combined treatment with α-blockers and antibiotics is more effective than antibiotic monotherapy in inflammatory syndromes of chronic pelvic pain.When prescribing treatment, doctors should discuss with patients the duration of treatment, the potential for side effects, and the need to monitor treatment effectiveness and safety.
Herbal remedies for chronic prostatitis
The use of herbal preparations to treat prostate disease has a long history.Evidence for the effectiveness and safety of herbal medicines has been gained empirically.
Currently, the possibility of using herbal medicine should be determined according to modern ideas about the pathogenesis and development of pathological processes, especially of the prostate.
Functional obstruction, the occurrence of urethral prostatic turbulence, the pathological influence of commensal microorganisms, immune changes and other processes can disrupt normal metabolism.Some violations inevitably lead to other violations.For example, chronic inflammation can lead to cell destruction and damage.
In general, the body constantly produces products of incomplete oxidation, so-called free radicals, the number of which increases under various pathological conditions, especially during inflammation.Interruption of oxygen supply to tissues and the accumulation of reactive free radical compounds (oxygen, nitrogen, and chlorine radicals) faster than they can be neutralized is called oxidative stress.As a result, over time, oxidative stress can lead to tissue damage, including the prostate.
Biochemists have long known about natural antioxidants: vitamins E, C and carotenoids, but they do not significantly affect oxidative stress.In recent years, bioflavonoids have attracted more and more attention, and their antioxidant activity is dozens of times stronger than vitamin E, vitamin C and β-carotene.There are more than 6,000 known bioflavonoids in total, including more than 3,000 flavonoids and more than 700 isoflavones.About 2% of the total organic carbon produced by photosynthesis is synthesized by plants into flavonoids or other polyphenols.
Flavonoids protect plants from radiation, UV exposure, oxidation, disease, infection, bacteria.One of the representatives of medicinal plants containing bioflavonoids is Huangyanyan, a perennial herbaceous plant of the Leguminosae family.This small plant is 25-50 cm tall and blooms from June to August with small purple flowers.
The roots of the forgotten pentagram contain the flavonoids quercetin, saponins, and other bioactive substances.It is a quercetin derivative that has antioxidant activity and is effective in patients with chronic prostatitis, as confirmed by clinical research results.
In addition to these properties, the catechins contained in oblivion kopi root have high P-vitamin activity, which strengthens capillary walls and optimizes microcirculation.The root of the forgotten pentagram has adaptogenic properties, which also determines the value of incorporating the plant into the comprehensive treatment of patients with chronic prostatitis.
Flavonoids are also found in knotweed (Polygonum aviculare), an annual herbaceous weed with small, oval leaves.A single stem extends profusely from the base of the root branch and produces numerous green shoots.This low-growing plant produces numerous unprepossessing green-white flowers in May.Knotweed also contains high amounts of ascorbic acid, vitamin K and provitamin A.
Products based on the knotweed herb have long been known in urological practice for their diuretic, antigouty and adaptogenic effects.The combined use of common grass and knotweed allows us to expect clinically significant results.
Herbal medicines available in clinical practice, made from common grass (roots and rhizomes) and knotweed herb, are tinctures of the forgotten common grass roots.
The bioactive substances contained in the tinctures contain natural antioxidants and substances that improve microcirculation, which determines the ability of these herbs to reduce the severity of prostatic inflammatory processes and painful syndromes (perineal pain and heaviness, prostatic leakage).
Increased blood circulation to the prostate reduces the severity of lower urinary tract symptoms (including urinary frequency, difficulty urinating, discomfort when emptying the bladder, weakened urine flow, and the sensation of incomplete bladder emptying) and improves the functional status of the cavernosal arteries.
Clinical efficacy of Forgotten Gobi Root Tincture
The effectiveness of the tincture was studied in an open comparative randomized study.The aim of this study was to investigate the effect of herbal preparations on pain syndrome dynamics, objective data and laboratory parameters in patients with chronic prostatitis.
In addition to studying the chief complaint and medical history, the diagnosis is confirmed by laboratory testing of pure prostatic secretions or prostatic secretions in the urine.The drug's efficacy, safety, and tolerability were evaluated in patients with chronic prostatitis in an active-controlled parallel group.
To objectify symptom descriptions, the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), urine diary analysis, and comparison of laboratory data were used.Among patients, pathological changes of the urinary system (benign hyperplasia, prostate cancer), nervous system and gastrointestinal tract that may be accompanied by similar symptoms were excluded.
The long-term course and periodic exacerbations of prostatitis can have adverse effects on mood and sexual life.Observations and changes in erectile function in the setting of chronic prostatitis were also observed using a standard questionnaire in patients receiving the drug.At the same time, the safety of the drug was evaluated compared with other herbal medicines.
To determine the effective dose of amnesic Penny Root tincture, the patients were divided into two groups.The first group, consisting of 30 people, received 1 teaspoon of tincture three times a day.A second group of 30 patients also took 2 teaspoons of the tincture three times a day.
Patients are divided into groups using a simple randomization method, which makes it possible to study the effect of a drug in a homogeneous group.Red Root Plus medication is to be taken on an empty stomach, at least 30 minutes before meals.Before use, shake bottle containing medication and dissolve single dose in 1/3 cup of water.The duration of treatment is 30 days.
A control group of 20 patients diagnosed with chronic prostatitis were treated with another herbal preparation during the same period.Efficacy criteria for the group that took 1 teaspoon of the tincture three times a day, 2 teaspoons three times a day, or a control drug were based on changes in clinical symptoms from patient surveys, questionnaire data, and voiding diaries.All included patients completed the study.
The average age of the first group of patients who took the Forget Cobig root tincture (1 teaspoon 3 times a day) was 45.5 (37-56) years (median, as well as 25th and 75th percentiles are shown below).Patients in the second group, with an average age of 45.5 (33-55) years, took 2 teaspoons 3 times a day.The mean age of control patients was 48 (36-59) years.
There was no statistically significant difference in age between groups (p = 0.63) (analysis of variance below).It should be noted that chronic prostatitis has been found in the most active and working-age people, for whom maintaining erectile and reproductive function is particularly important.Of all patients included in the study, 26 (32.5%) had a history of sexually transmitted diseases.The distribution of such patients was the same across groups.
Fifty-seven patients (71.3%) were treated for chronic prostatitis before prescribing tincture plus.The most common are antimicrobial treatment and/or alpha-blockers.The distribution of previously treated patients as well as the type of treatment did not differ significantly between the groups, confirming modern views on the pathogenesis of chronic prostatitis and corresponding treatments.
In order to objectively assess the patient's symptoms, severity, and quality of life, the NIH-CPSI scale is recommended for basic assessment and monitoring of the patient's condition.Initially, the pain rating on the NIH-CPSI scale before treatment was 13 (10–15) points in the group that received astragalus root tincture (1 teaspoon 3 times a day) and in the group that received 2 teaspoons of tincture 3 times a day – 12 (10–15) points.In the control group, this indicator was 13 (10-15) points.There was no statistically significant difference in pain severity between groups (p = 0.846).
The location and severity of pain were the same in both groups, which is particularly important given the diverse clinical presentation of the disease.
Since urological disorders, namely bladder outlet obstruction, detrusor-sphincter dyssynergia, increased prostatic urethral luminal pressure and intraprostatic reflux, play an important role in the presumed causes of the onset and recurrence of chronic prostatitis, special attention is paid to the distribution of patients according to the presence and severity of LUTS in the context of pain and discomfort.Initially, according to the NIH-CPSI scale, this indicator was 2 (1-3) points in the first group, 2 (1-3) points in the second group, and also 2 (1-3) points in the control group.
There was no significant difference in the severity of urinary tract disease between groups (p = 0.937).The study group was homogeneous with respect to LUTS.Analysis of voiding diaries did not differ between groups.There is reason to believe that LUTS is related to prostate disease rather than bladder dysfunction or water balance.
According to uroflowmetry, the maximum urine flow rate was 13.3 (11.8-14.2) ml/s in the first group, 13.2 (12.1-14.0) ml/s in the second group, and 13.0 (11.8-14.6) ml/s in the control group.There was no statistical difference in this indicator between groups (p = 0.996).The residual urine volumes of the first group, the second group and the control group were 23.0 (20-26), 23 (18-25) and 20 (16.5-24) ml respectively.The patient groups also did not differ on this measure (p = 0.175).
It can be said that no obvious bladder reservoir and emptying dysfunction was detected in the patients with chronic prostatitis in the study group, however, the existing LUTS allowed us to accurately suspect the origin of pathological symptoms at the level of the prostatic urethra.
The patient's subjective perception of chronic prostatitis symptoms is also important.Uncomfortable sensations of varying severity are easily repetitive and often unpredictable, seriously disrupting a man's normal lifestyle.This not only affects their mood but also their social activities.This is why studies on quality of life (depending on the severity, recurrence and consequences of the disease) can also serve as a criterion for the effectiveness of treatment.
Prior to treatment, the quality of life assessment based on the questionnaire was 6 (5-9) points for the group receiving red root tincture plus 1 teaspoon 3 times a day, 8 (6-9) points for the group receiving red root tincture plus 1 teaspoon 3 times a day, and 6 (3-9) points for the control group.There was no statistically significant difference between groups for this indicator (p = 0.22).
The total NIH-CPSI scale score was 22 points (19-25) for the first group, 23 points (19-25) for the second group, and 22 points (18-25) for the control group (p = 0.801).Thus, the groups were homogeneous not only with respect to the sum of scores on the Chronic Prostatitis Symptom Scale, but also with respect to its individual components.All patients answered questions on the Male Communicative Functioning Scale (MCF).The indicator for the first group is 31 (23–41) points, for the second 34 (27–39) points and for the third 34 (26–37) points.The impact of chronic prostatitis on erectile function remains the subject of research.
In all three groups, the range of values is quite wide.This indicates the individual extent of a person's response to their symptoms and illness.However, there was no difference in group distribution before treatment among chronic prostatitis patients with different erectile function status (p = 0.967).Therefore, at the beginning of the study, it was possible to form three groups of patients with chronic prostatitis who were homogeneous in terms of age, type and severity of clinical symptoms, which affected the quality of life.Also rule out bladder reservoir and emptying dysfunction.
Symptoms in each group were assessed after 30 days of treatment.According to a controlled questionnaire, the frequency and severity of pain and discomfort decreased by 51% in the group of patients who received forgotten bamboo grass root tincture (1 teaspoon three times daily).When 2 teaspoons of the tincture was taken three times a day, the severity of symptoms was reduced by 55%.
Pathological symptoms were reduced by 37% in the control group.The difference between the three groups of patients was statistically significant (p = 0.029).However, no statistically significant differences were found between the first and second groups.Therefore, clinically significant effects can be achieved with minimal drug doses.Furthermore, there was still a statistically significant difference in the reduction in pathological symptoms when evaluating the groups taking amnestic cobby root tincture compared to the control group.
The questionnaire showed that the urinary performance of patients with chronic prostatitis improved during treatment, but the differences were not statistically significant between different doses of Huanghua root tincture groups and compared with the control group.
When voiding diary data obtained after the course of treatment was analyzed, no statistically significant differences were found across all three groups.Maximal urinary flow rates were increased in all groups, ranging from 5% to 12%, as measured by control uroflowmetry.Residual urine output was reduced by 4-6% in patients receiving different doses of the drug, as well as in patients treated with the herbal reference drug.There was no statistically significant difference between the groups.
This fact can be explained by the relatively short time of use and the fact that Red Root Plus tincture does not contain ingredients with similar effects to alpha-adrenergic blockers and 5α-reductase inhibitors.The main active ingredients of the drug are bioflavonoid compounds, which have a variety of effects, mainly antioxidant and anti-inflammatory.
According to the control examination and repeated questioning, the quality of life indicators improved after 30 days of treatment.In the first group, this number changed by 55%, in the second group by 59%, and in the control group by 39%.The dynamic difference in the changes in quality of life during the use of amnesia kobigan tincture and the control group was statistically significant (p = 0.008).
It should be noted that there were no significant differences in the dynamics of quality of life between the groups receiving different doses of tincture.Analysis of changes in quality of life confirmed the adaptogenic effect of the components of herbal preparations containing amnesia koppei and knotweed.After 30 days of treatment, the total NIH-CPSI score decreased in all three groups.The first group saw a 50% drop, the second a 52% drop, and the third a 29% drop.At the same time, the same trend was found in the analysis of other indicators.
The difference was statistically significant between the patients who received the amnesia gobi root tincture and the control group, while no differences were found between the groups that received different doses of the drug.
All three groups of patients showed the same increase in total ICF questionnaire score (p = 0.455).The changes in each group of indicators did not exceed 10%.There were no statistically significant differences between the groups.
The improvement in mating function may be mainly related to the reduction of prostate pathological symptoms, reduction of LUTS, adaptive properties and improvement of microcirculation.The condition of the prostate during the use of herbal preparations is of interest.This was demonstrated by an analysis of the results of repeated studies of prostate secretion.
If initially there were no differences in the presence and number of leukocytes in the prostate secretions between the groups (p = 0.528), then after 30 days of treatment the severity of the inflammatory process decreased in all groups.In the group that received forgotten Pennywort root tincture, there was a statistically significant decrease in white blood cell counts compared to the control group (p = 0.028).Changing the drug dose had no effect on the dynamics of leukopenia.
According to studies of prostate secretions, the severity of inflammatory processes is significantly reduced and the functional status of the prostate is improved.
Different herbs contain a separate group of bioflavonoids with different activities.Apparently, a combination of common grass and knotweed rhizomes and roots contain bioflavonoids that are effective in combating the effects of oxidative stress in prostate tissue.This can be assumed based on the results of drug effectiveness and the absence of dose-dependent differences.However, this hypothesis must be confirmed by further studies.
in conclusion
The use of herbal preparations plays an important role in the treatment of prostatitis.The effectiveness of this group of drugs has been confirmed by clinical experience.However, conducting randomized clinical trials aimed at evaluating the effectiveness of herbal preparations based on modern concepts of active ingredients allows us to take a new approach to herbal treatment.
The effectiveness of plant bioflavonoids is demonstrated by the oxidative stress theory, according to which uncontrolled free radical oxidation products have a destructive effect on cells and lead to many dysfunctions of organs and systems.
Taking into account the above, it seems possible to conclude that the herbal use of amnesia root tincture is a medicine with significant anti-inflammatory and antioxidant effects and is most effective both in the combined treatment of patients with chronic prostatitis and as a monotherapy in the prevention of this disease.