By using traditional Chinese medicine inheritance support system to analyze the dominant experience and recessive principles of the prescriptions for stranguria in the dictionary of traditional Chinese medicine prescription (DCMP), we aim to define the medication pattern and rule and to acquire new prescriptions. In dominant experience analysis, we were able to find 22 drugs used over 50 times, including drugs of clearing heat, diuresis and relieving stranguria which are the most used and drugs of clearing heat, cooling blood, benefiting Qi and nourishing Yin. In addition, drugs of activating Qi and Xue, eliminating phlegm and removing toxic are often used, including 34 herb pairs and 5 combinations of three-taste drugs are used more than 35 times. These results fully reflect the composition principles and compatibility characteristic of prescriptions for treating stranguria in DCMP. Thirteen new prescriptions by way of recessive principle excavating were acquired. These new prescriptions might be suitable to clinical treatments of variable syndromes. This article provides an useful clue to research and produce new drugs.
Cluster Analysis ; Dictionaries as Topic ; Drug Prescriptions ; Humans ; Medicine, Chinese Traditional ; methods ; Urination Disorders ; drug therapy

BACKGROUNDBoth lower urinary tract dysfunction and urinary symptoms are prevalent in patients with multiple sclerosis (MS). Although the significance of identifying and treating urinary symptoms in MS is currently well-known, there is no information about the real prevalence and therapeutic effect of urinary symptoms in patients with MS. The purpose of this study was to analyze the major symptoms and urodynamic abnormalities, and observe the therapeutic effect in different MS characteristics.

METHODSWe enrolled 126 patients with urological dysfunction who were recruited between July 2008 and January 2015 in Beijing Tian Tan Hospital, Capital Medical University and conducted overactive bladder system score (OABSS), urodynamic investigation, and expanded disability status scale (EDSS). Changes of urinary symptoms and urodynamic parameters were investigated.

RESULTSUrgency was the predominant urinary symptom, and detrusor overactivity was the major bladder dysfunction. There was a positive correlation between EDSS and OABSS. Clinically isolated syndrome (CIS) had lowest EDSS and OABSS. CIS exhibited significant improvements in OABSS, maximum urinary flow rate (Qmax), and bladder volume at the first desire to voiding and maximum bladder volume after the treatment (P < 0.05). Relapsing-remitting MS showed significant improvements in the OABSS, Qmax, and bladder volume at the first desire to voiding, maximum bladder volume and bladder compliance after the treatment (P < 0.05). Progressive MS exhibited significant increase in the bladder volume at the first desire to voiding, the detrusor pressure at maximum flow rate (PdetQmax), and bladder compliance after the treatment (P < 0.05).

CONCLUSIONSUrodynamic parameters examined are important in providing an accurate diagnosis, guiding management decisions of MS. Early and effective treatment may improve the bladder function and the quality of life at the early stages of MS.

Adult ; Female ; Humans ; Male ; Middle Aged ; Multiple Sclerosis ; complications ; drug therapy ; Urinary Bladder ; physiopathology ; Urination Disorders ; physiopathology ; Urodynamics ; physiology

AIMTo evaluate the safety and efficacy of an extract of Ganoderma lucidum that shows the strongest 5alpha-reductase inhibitory activity among the extracts of 19 edible and medicinal mushrooms by a double-blind, placebo-controlled, randomized and dose-ranging study in men with lower urinary tract symptoms (LUTS).

METHODSIn this trial, we randomly assigned 88 men over the age of 49 years who had slight-to-moderate LUTS to 12 weeks of treatment with G. lucidum extract (6 mg once a day) or placebo. The primary outcome measures were changes in the International Prostate Symptom Score (IPSS) and variables of uroflowmetry. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, laboratory values and the reported adverse effects.

RESULTSG. lucidum was effective and significantly superior to placebo for improving total IPSS with 2.1 points decreasing at the end of treatment (mean difference, -1.18 points; 95% confidence interval, -1.74 to -0.62; P < 0.0001). No changes were observed with respect to quality of life scores, peak urinary flow, mean urinary flow, residual urine, prostate volume, serum prostate-specific antigen or testosterone levels. Overall treatment was well tolerated with no severe adverse effects.

CONCLUSIONThe extract of G. lucidum was well tolerated and improved IPSS scores. These results encouraged a further, large-scale evaluation of phytotherapy for a long duration using the extract of G. lucidum on men with LUTS.

Aged ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Ethanol ; Humans ; Male ; Middle Aged ; Phytotherapy ; Placebos ; Reishi ; Solvents ; Treatment Outcome ; Urination Disorders ; drug therapy ; Urodynamics ; drug effects

By literature survey searching references and parsing prescriptions, the auther has analyze the clinical advantage of Miao medicine in the treatment of symptom heat stranguria. Guizhou Miao medicine Polygonum capitatum has many advantages such as resources and clinical. After companying with Phellodendri Cortex, the compound prescription plays the pharmacological activity of antipyretic and diuretic, especially for the symptom heat stranguria, damp and hot junction based in the bladder. Miao medicine Kelintong capsule showed clinical advantage in the treatment of symptom heat stranguria, having a clinical advantage in improving the overall effectiveness and improve the overall aspects of the patient's symptoms.
Animals ; Capsules ; chemistry ; therapeutic use ; Drug Prescriptions ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Polygonum ; chemistry ; Urination Disorders ; drug therapy

OBJECTIVE: To evaluate the therapeutic effect of harnal and proscar in treating benign prostatic hyperplasia (BPH). METHODS: Two hundreds and twenty-two patients with BPH were randomly assigned into 2 groups:harnal (0.2 mg/d) group (n = 112) and proscar (5 mg/d) group (n = 108). American Urologic Association Symptom Index (AUA-SI) scores, the maximal urinary flow rate (Qmax) and prostatic volume were analyzed in the 2 groups. RESULTS: After 12 weeks of treatment, 54.5% of the harnal group improved in AUA-SI score; 54.6% of the proscar group improved in AUA-SI score; and there was no significant difference between the 2 groups (P > 0.05). After 24 weeks of treatment, the proscar group (79.6%) had a greater improvement in AUA-SI score than the harnal group (64.3%) (P < 0.05); Qmax in the 2 groups was significantly increased than that before the treatment, and it is proportional to the therapeutic time. The prostatic volume in 2 groups had no significant change. CONCLUSION Harnal and proscar can significantly improve BPH symptoms and the urinary flow rate. The therapeutic effect of harnal and proscar has their own characteristics.
5-alpha Reductase Inhibitors ; Adrenergic alpha-Antagonists ; therapeutic use ; Aged ; Finasteride ; therapeutic use ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; drug therapy ; Urination Disorders ; etiology ; physiopathology ; Urodynamics

OBJECTIVETo explore the possible relationship between erectile dysfunction (ED) and benign prostate hyperplasia (BPH) in men, and to assess the positive effect of Sildenafil on the lower urinary tract symptoms (LUTS) from BPH while treating ED.

METHODSThirty-two patients with ED and BPH were offered oral Sildenafil and reviewed before and six months after the administration of Sildenafil by the International Index of Erectile Function-5 (IIEF-5) and the International Prostate Symptom Score (IPSS) questionnaires. Scores were tested by chi-square.

RESULTSIIEF-5 scores were increased by 42.36% and IPSS scores declined by 20.14%, with statistical significance (P < 0.01).

CONCLUSIONTreatment of ED with Sildenafil appears to improve urinary symptom scores. A lower IPSS at baseline seems to predict a better response to Sildenafil therapy for ED.

Aged ; Erectile Dysfunction ; drug therapy ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Prostatic Hyperplasia ; complications ; Purines ; therapeutic use ; Sildenafil Citrate ; Sulfones ; therapeutic use ; Surveys and Questionnaires ; Urination Disorders ; drug therapy ; etiology

OBJECTIVE: To investigate the timing of reaching maximum improvement of the lower urinary tract symptoms (LUTS) in patients with advanced prostate cancer treated with maximal androgen blockade(MAB), and to provide guidelines for the treatment program. METHODS: We collected the data of 45 advanced prostate cancer patients complicated with lower urinary tract symptoms who were treated by MAB. The international prostate symptom score (IPSS) and maximum urinary flow rate (Qmax) were selected as indicators reflecting the degree of lower urinary tract symptoms and were observed before the MAB, 3, 6, and 9 months after the patients received MAB. We also observed the changes of prostate volume and analyzed the role of MAB in improving LUTS in patients with prostate cancer. RESULTS: The IPSS and Qmax had significant difference between the 3rd month after the patients received MAB and before the MAB (P<0.05). No significant difference was found between the 3rd month and the 6th month after the patients received MAB (P>0.05). The prostate volume had significant difference in the 3rd month and the 6th month (P<0.05), but no significant difference in the 6th month and the 9th month (P>0.05). CONCLUSION MAB for patients with advanced prostate cancer can improve their lower urinary tract symptoms, whose main effect is presented in the 3rd months after the androgen deprivation therapy.
Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Anilides ; therapeutic use ; Flutamide ; therapeutic use ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Nitriles ; therapeutic use ; Prostatic Neoplasms ; complications ; drug therapy ; Tosyl Compounds ; therapeutic use ; Urination Disorders ; drug therapy ; etiology

We evaluated the therapeutic effects of tamsulosin for women with non-neurogenic voiding dysfunction. Women who had voiding dysfunctions for at least 3 months were included. Inclusion criteria were age > or =18 yr, International Prostate Symptom Score (IPSS) of > or =15, and maximum flow rate (Q(max)) of > or =12 mL/sec and/or postvoid residuals (PVR) of > or =150 mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram as having no or mild obstruction (group A) or moderate or severe obstruction (group B). After 8 weeks of treatment, treatment outcomes and adverse effects were evaluated. One hundred and six patients were evaluable (70 in group A, 36 in group B). After treatments, mean IPSS, bother scores, Q(max), PVR, diurnal and nocturnal micturition frequencies and scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF) were changed significantly. Eighty-nine patients (84%) reported that the treatment was beneficial. The proportion of patients reported that their bladder symptoms caused "moderate to many severe problems" were significantly decreased. No significant difference were observed between the groups in terms of IPSS, bother score, Q(max), PVR, micturition frequency, and BFLUTS-SF changes. Adverse effects related to medication were dizziness (n=3), de novo stress urinary incontinence (SUI) (n=3), aggravation of underlying SUI (n=1), fatigue (n=1). Tamsulosin was found to be effective in female patients with voiding dysfunction regardless of obstruction grade.
Adrenergic alpha-Antagonists/adverse effects/pharmacokinetics/*therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Middle Aged ; Questionnaires ; Severity of Illness Index ; Sulfonamides/adverse effects/pharmacokinetics/*therapeutic use ; Treatment Outcome ; Urination Disorders/*drug therapy

BACKGROUNDThe primary objectives of the treatment for the lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) are to produce rapid, sustained, and safe improvements in the symptoms that affect the quality of life in the majority of men over 50. In this study, we evaluated the efficacy and safety of the combined therapy with terazosin (apha1-adrenergic receptor antagonist) and tolterodine (anticholinergic agent) for LUTS associated with BPH.

METHODSThis combination study included 69 patients diagnosed with LUTS associated with BPH based on the International Prostate Symptom Scores (IPSS), urinary flow rate, prostate volume, urinary residual, and their serum prostate-specific antigen levels. Initially, 191 patients were treated with terazosin 2 mg once daily for one week. Those patients with continued LUTS after the initial treatment were allocated randomly into two groups: terazosin group (n = 36) in which patients were treated with terazosin 2 mg once daily for six weeks, and combination group (n = 33) in which patients were treated with both terazosin 2 mg once daily and tolterodine 2 mg twice daily for 6 weeks.

RESULTSThe IPSS were significantly improved in both groups after treatment, and the reduction of IPSS in the combination group was significantly greater than that in the terazosin group (P < 0.01). A decrease in urgency, frequency and nocturia were the main contributory factors causing the reduction of IPSS in the combination group. The differences about the peak urinary flow rate and the residual urine from the baseline values were noted in both groups after treatment, but were not significant between the two groups. The incidence of adverse effects in the combination group was higher than that in the terazosin group. As expected the most common adverse effect was mouth dryness which was associated with anticholinergic drugs such as tolterodine.

CONCLUSIONSPatients with LUTS associated BPH appear the improved IPSS after combined therapy with terazosin and tolterodine. This study, although short term and limited numbers of patients, provides evidence that the combined therapy with terazosin plus tolterodine is a good approach for meeting the objectives of rapid, sustained, and safe improvements in the LUTS associated with BPH. And the profile of patients in this study might be used as the indication of such combined therapy for LUTS associated with BPH without urodynamic evaluation.

Adrenergic alpha-Antagonists ; administration & dosage ; Aged ; Benzhydryl Compounds ; administration & dosage ; adverse effects ; Cresols ; administration & dosage ; adverse effects ; Drug Therapy, Combination ; Humans ; Male ; Middle Aged ; Muscarinic Antagonists ; administration & dosage ; Phenylpropanolamine ; administration & dosage ; adverse effects ; Prazosin ; administration & dosage ; adverse effects ; analogs & derivatives ; Prospective Studies ; Prostatic Hyperplasia ; complications ; drug therapy ; Tolterodine Tartrate ; Urination Disorders ; drug therapy