Benign prostatic hyperplasia (BPH) is a common senile disease, and its main clinical manifestation is lower urinary tract symptom (LUTS), which has long been afflicting old male patients. Previous study showed that alpha1-receptor in the prostate was involved in the development of LUTS. At present, alpha1-receptor blocker is generally accepted as a choice drug for treating BPH and relieving LUTS. The article reviews the tissue distribution of alpha1-receptor and clinical application of alpha1-receptor blocker.
Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-Antagonists ; adverse effects ; pharmacokinetics ; therapeutic use ; Humans ; Male ; Prostatic Hyperplasia ; drug therapy ; Receptors, Adrenergic, alpha-1 ; analysis

OBJECTIVESTo evaluate the efficacy of selective alpha 1A-adrenergic receptor antagonists for the treatment chronic abacterial prostatitis/chronic pelvic pain syndrome (CPPS).

METHODSFrom October 2000 to September 2001, a selective alpha 1A-adrenergic receptor antagonists, tamsulosin, had been used in 43 patients with CPPS for four weeks. 0.2 mg dosage was given daily, and uroflowmetry was followed. Symptom scores were evaluated by the NIH-chronic prostatitis symptom index (NIH-CPSI) before and after the treatment.

RESULTSThese patients had a clinically significant response to the treatment of tamsulosin. Of these, thirty two patients (74.5%) responded to one month therapy and had a decrease in NIH-CPSI scores, while maximal urinary flow rate (MFR) and average urinary flow rate (AFR) in patients with poor MFR improved 30.4% and 65.4%, respectively. No severe side effects were observed.

CONCLUSIONSIt is suggested that Tamsulosin, a selective alpha 1A-adrenergic receptor antagonist, is effective in the treatment of CPPS.

Adolescent ; Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-Antagonists ; therapeutic use ; Adult ; Chronic Disease ; Humans ; Male ; Middle Aged ; Pelvic Pain ; drug therapy ; etiology ; Prostatitis ; complications ; drug therapy ; Receptors, Adrenergic, alpha-1 ; Sulfonamides ; therapeutic use ; Treatment Outcome

Drugs for the treatment of premature ejaculation (PE) are divided to two categories: oral drugs and local drugs. Oral drugs include antidepressive drugs, alpha-adrenoceptor blocking drugs, phosphodiesterase type V blocking drugs and Chinese herbal medicine. Local drugs include local surface drugs, intracavernosal injective drugs and local urethra drugs. Antidepressive drugs are extensively used, which have moderate efficacy, relatively more side effects and high recurrence rate; alpha-adrenoceptor blocking drugs are seldom used and are less effective than antidepressive drugs; phosphodiesterase type V blocking drugs like sildenafil have good efficacy and few side-effects and are worthy to be studied further. Local surface drugs like SS-Cream have good efficacy and few side-effects and are worthy to be applied and promoted; local urethral drugs like MUSE and Befar may become a new method to treat PE after being further studied. Medication for premature ejaculation shall be made specific and suitable as much as for each individual patient.
Adrenergic alpha-Antagonists ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; drug effects ; Humans ; Male ; Phosphodiesterase Inhibitors ; therapeutic use

OBJECTIVEPostural tachycardia syndrome (POTS) is one of the major causes of orthostatic intolerance in children. We systematically reviewed the pathogenesis and the progress of individualized treatment for POTS in children.

DATA SOURCESThe data analyzed in this review are mainly from articles included in PubMed and EMBASE.

STUDY SELECTIONThe original articles and critical reviews about POTS were selected for this review.

RESULTSStudies have shown that POTS might be related to several factors including hypovolemia, high catecholamine status, abnormal local vascular tension, and decreased skeletal muscle pump activity. In addition to exercise training, the first-line treatments mainly include oral rehydration salts, beta-adrenoreceptor blockers, and alpha-adrenoreceptor agonists. However, reports about the effectiveness of various treatments are diverse. By analyzing the patient's physiological indexes and biomarkers before the treatment, the efficacy of medication could be well predicted.

CONCLUSIONSThe pathogenesis of POTS is multifactorial, including hypovolemia, abnormal catecholamine state, and vascular dysfunction. Biomarker-directed individualized treatment is an important strategy for the management of POTS children.

Adrenergic alpha-Agonists ; therapeutic use ; Adrenergic beta-Antagonists ; therapeutic use ; Catecholamines ; metabolism ; Humans ; Postural Orthostatic Tachycardia Syndrome ; drug therapy ; metabolism ; pathology ; therapy

OBJECTIVESTo evaluate the clinical efficacy and safety of Naftopidil tablet in treating benign prostatic hyperplasia.

METHODSEighty BPH patients were divided into two groups randomly by double-blind, double-simulated and active control parallel study trials. Forty patients in treatment group were given Naftopidil tablet 25 mg, p.o., qn for 42 days, while 40 patients in control group were given Tamsulosin 0.2 mg, p.o., qn for 42 days. Statistical analysis was given from 77 cases in the groups. Estimation of the efficacy was done by the change of major indexes include international prostate symptom score (IPSS), maximum flowrate (Qmax) and secondary indexes such as quality of life (QOL), residual urine (Ru) and volume of prostate (V).

RESULTSThe changes of IPSS, Qmax, QOL had significant difference between two groups before and after treatment(P < 0.05). The change of Ru had no significant difference between two groups before and after treatment (P > 0.05) while there was significant difference between two groups after six-week treatment(P < 0.05). The change of V had no significant difference (P > 0.05). The adverse reactions in both groups were mild, and there was no significant difference between two groups(P > 0.05).

CONCLUSIONSNaftopidil tablet was safe and effective in treating benign prostatic hyperplasia.

Adrenergic alpha-1 Receptor Antagonists ; Adrenergic alpha-Antagonists ; therapeutic use ; Aged ; Double-Blind Method ; Humans ; Male ; Middle Aged ; Naphthalenes ; adverse effects ; therapeutic use ; Piperazines ; adverse effects ; therapeutic use ; Prostatic Hyperplasia ; drug therapy ; psychology ; Quality of Life ; Tablets

OBJECTIVETo evaluate and compare the clinical efficacy and safety of the highly selective alpha receptor antagonist tamsulosin and its combination with the M receptor antagonist tolterodine in the treatment of refractory lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).

METHODSWe included in this study 184 BPH patients with refractory LUTS with the disease course of 4 weeks to 2 years, whose LUTS were not alleviated after a week's treatment with tamsulosin. The patients were randomly divided into Groups A and B, the former (n=89) treated with tamsulosin at 0.2 mg qd and the latter (n=95) given tolterodine at 2 mg bid in addition to tamsulosin medication, both for 4 weeks. Scores on IPSS, QOL and Qmax were obtained before and after the treatment, and the improvement of LUTS evaluated after the medication.

RESULTSThe tamsulosin group showed no significant differences before and after the treatment in the scores on IPSS (13.23 +/- 4.39 vs. 12.21 +/- 4.07), QOL (4.23 +/- 1.27 vs 3.53 +/- 0.95) and Qmax ([12.3 +/- 8.39] ml/s vs. [14.1 +/- 8.62] mls) (P > 0.05), while the combination group exhibited significantly higher scores on IPSS and QOL and lower score on Qmax after the medication than before it (IPSS: 14.45 +/- 5.31 vs. 6.56 +/- 2.03, P < 0.05; QOL: 4.45 +/- 0.79 vs. 2.34 +/- 0.73, P < 0.05; Qmax: [11.4 +/- 9.21] ml/s vs. [15.5 +/- 8.35] ml/s, P < 0.01). No severe complications were found in any of the cases.

CONCLUSIONCombination of tamsulosin and tolterodine can significantly alleviate refractory LUTS and improve QOL without causing serious adverse events in BPH patients.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Aged ; Aged, 80 and over ; Benzhydryl Compounds ; therapeutic use ; Cresols ; therapeutic use ; Humans ; Male ; Middle Aged ; Muscarinic Antagonists ; therapeutic use ; Phenylpropanolamine ; therapeutic use ; Prostatic Hyperplasia ; drug therapy ; Sulfonamides ; therapeutic use ; Tolterodine Tartrate ; Treatment Outcome

OBJECTIVETo study the efficacy and safety of alpha1 adrenoceptor antagonist Naftopidil in the treatment of chronic non-bacterial prostatitis.

METHODSAn opened, self-controlled, multicentral clinical trial was conducted. One hundred and six cases of patients who had been diagnosed as chronic non-bacterial prostatitis (NBP) were treated with Naftopidil (25 mg once a day) for 4 weeks. The efficacy was evaluated by the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and the WBC in the examination of prostatic secretion (EPS) after the treatment.

RESULTSAfter 4 weeks therapy, 105 cases were evaluable. After treatment, NIH-CPSI total score were averagely decreased 12.0 points (P <0.001), symptom score 7.9 points (P <0.001) and QOL score 4.1 points (P <0.001). There was a statistically significant difference in WBC count ([(15.2 +/- 15.1)/HP vs (9.5 +/- 12.0)/HP, P < 0.01] and max flow rate(MFR) [(19.2 +/- 4.8) ml/s vs (22.7 +/- 4.9) ml/s, P < 0.01]. The total effective rate were 84.8% in the whole group. The clinical adverse rate was 3.81%, including 3 cases of mild dizziness and 1 case of mild inappetence.

CONCLUSIONalpha1 adrenoceptor antagonist Naftopidil is effective and safe for the treatment of chronic non-bacterial prostatitis.

Adolescent ; Adrenergic alpha-Antagonists ; therapeutic use ; Adult ; Chronic Disease ; Humans ; Male ; Middle Aged ; Naphthalenes ; therapeutic use ; Piperazines ; therapeutic use ; Prostatitis ; drug therapy

OBJECTIVETo investigate the effect of Longbishu Capsule (, LBS), doxazosin, and combination therapy on benign prostatic hyperplasia (BPH).

METHODSA randomized, double-blind, multi-center parallel trial was conducted involving 360 patients in hospitals in Beijing (108 cases), Heilongjiang (90 cases), Sichuan (90 cases), Shanghai (72 cases), China. They were randomly assigned with central randomization method to group A (LBS placebo plus doxazosin), group B (LBS plus doxazosin) or group C (LBS plus doxazosin placebo), 120 cases for each group. The international prostate symptom score, maximum urinary flow rate, postvoid residual urine volume and prostate volume were measured for evaluating the efficacy of the three treatments.

RESULTSAt baseline, there was no significant difference in the measured variables among the three groups. After 12-month treatment, the three groups showed significant improvements in IPSS and maximum urinary flow rate from baseline (P<0.01). Although postvoid residual urine volume was not significantly different from the baseline in group A (P>0.05), it significantly decreased in group B and C (P<0.05). The incidence of adverse events were similar among the three groups.

CONCLUSIONSThe treatment of LBS alone or LBS plus doxazosin was able to significantly improve IPSS in patients with BPH. The treatments may reduce the increase in prostate volume and postvoid residual urine volume as well.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Double-Blind Method ; Doxazosin ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Placebos ; Prostatic Hyperplasia ; drug therapy

OBJECTIVETo assess the effectiveness and safety of the alphala/d blocker naftopidil in the treatment of benign prostatic hyperplasia (BPH) patients with overactive bladder (OAB) symptoms.

METHODSFifty BPH patients with OAB symptoms were treated with naftopidil at the dose of 25 mg/d for 6 weeks. A self-controlled clinical trial was conducted. The effectiveness and safety of the drug were observed by comparing the International Prostate Symptom Scores (IPSS), quality of life indexes (QOL), maximum urinary flow rates (Qmax) , average urinary flow rates (Qave), voiding volumes (VV), blood pressures (BP) and heart rates (HR) obtained before and after the treatment.

RESULTSAfter 6 weeks' medication, the 46 assessable cases showed an average decrease of 9.75 in IPSS (P < 0.01), 3.97 in voiding symptom score (P < 0.01), 5.78 in urinary storage symptom score (P < 0.01) and 1.95 in QOL (P < 0.01), and a mean increase of 4.29 ml/s in Qmax (P < 0.01), 3.75 ml/s in Qave (P < 0.01) and 55.12 ml/s in VV (P < 0.05). But no significant changes were observed in BP and HR. Only 1 patient (4.35%) experienced the adverse event of dizziness.

CONCLUSIONThe alphalA/D blocker naftopidil is both effective and safe in the treatment of BPH patients with OAB symptoms.

Adrenergic alpha-Antagonists ; therapeutic use ; Aged ; Humans ; Male ; Middle Aged ; Naphthalenes ; therapeutic use ; Piperazines ; therapeutic use ; Prostatic Hyperplasia ; complications ; drug therapy ; Urinary Bladder, Overactive ; complications ; drug therapy

PURPOSE: Tamsulosin 0.2 mg is used widely in Asian people, but the low dose has been studied less than tamsulosin 0.4 mg or other alpha blockers of standard dose. This study investigated the efficacy and safety of tamsulosin 0.2 mg by a meta-analysis and meta-regression. MATERIALS AND METHODS: We conducted a meta-analysis of efficacy of tamsulosin 0.2 mg using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). Safety was analyzed using adverse events. Relevant studies were searched using MEDLINE, EMBASE, and Cochrane library from January 1980 to June 2013. RESULTS: Ten studies were included with a total sample size of 1418 subjects [722 tamsulosin 0.2 mg group and 696 other alpha-blockers (terazosin, doxazosin, naftopidil, silodosin) group]. Study duration ranged from 4 to 24 weeks. The pooled overall standardized mean differences (SMD) in the mean change of IPSS from baseline for the tamsulosin group versus the control group was 0.02 [95% confidence interval (CI); -0.20, 0.25]. The pooled overall SMD in the mean change of QoL from baseline for the tamsulosin group versus the control group was 0.16 (95% CI; -0.16, 0.48). The regression analysis with the continuous variables (number of patients, study duration) revealed no significance in all outcomes as IPSS, QoL, and Qmax. CONCLUSION: This study clarifies that tamsulosin 0.2 mg has similar efficacy and fewer adverse events compared with other alpha-blockers as an initial treatment strategy for men with lower urinary tract symptoms.
Adrenergic alpha-1 Receptor Antagonists/*administration & dosage/therapeutic use ; Adrenergic alpha-Antagonists ; Dose-Response Relationship, Drug ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia/*complications ; *Quality of Life ; Sulfonamides/*administration & dosage/therapeutic use