Objective To explore the correlation between metabolic syndrome (MS)and benign prostatic hyperplasia (BPH) and the drug treatment of BPH.Methods 300 cases of BPH patients treated between May 2011 to June 2012 in our hospital and Tong-Hai County hospitals of traditional Chinese medicine were included.The patients were divided into observing group (n=100) and control group (n=200).The observing group was treated with 5-alpha reductase inhibitors (finasteride).100 patients in control group-1 were treated with alpha-1 receptor blockers (terazosin).100 patients in control group-2 were treated with finasteride and terazosin.The changes of symptom scores,maximum urinary flow rate and prostate volume at month 3,month 6 and at end of a year after the treatment were compared among all groups.Results In 300 cases of BPH patients,there are 256 cases (85.3％) of MS+BPH,and 44 cases (14.7％) of simple BPH,with no statistically significant difference between the two groups in age and total cholesterol level (both P＞0.05).Among 256 cases of MS+ BPH,127 cases (49.6％) had diabetes,174cases (68.0％) had hypertension,85 cases (33.2 ％) had hypercholesterolemia or high triglyceride.The body mass index,blood pressure,fasting plasma glucose,IPSS gland volume were significantly higher (P＜0.05),and the maximum urinary flow rate was significantly lower in MS+BPH group than in the pure BPH group (P＜0.05).Prostate volume was positively correlated with age,body mass index,systolic blood pressure,fasting plasma glucose.IPSS score were positively correlated with age,body mass index,fasting blood glucose,total cholesterol.Maximum urinary flow rate were negatively correlated with age,fasting glucose,total cholesterol.At month 3 after treatment,the symptom score,maximum urinary flow rate were better in both of control group 1 and 2 than in the observation group (both P＜0.05).At 6 months after treatment,there was no statistically significant difference between the two groups in the symptom score,maximum urinary flow rate (both P＞0.05),while prostate volume was smaller in the observation group than in controls group 1 (P＜0.05).After a year of treatment,there were statistically significant differences in above indicators between the observe group and control group-1 (all P＜0.05),and had no statistically significant difference between the observe group and control group 2(all P＞0.05).Conclusions Most patients with BPH are suffering from MS at the same time.Body mass index,blood pressure,blood sugar,prostate volume,IPSS are higher in MS+BPH patients than in patients only with BPH.MS may affect the incidence and prognosis of BPH.Finasteride combined with terazosin can be used within 6 months,and finasteride can be used alone after 6 months of the drug therapy.%目的 分析良性前列腺增生(BPH)患者代谢综合征(MS)发病情况,探讨MS与BPH发病风险的相关性及药物治疗BPH的合理方案. 方法 分析2011年5月至2012年6月在上海市中医药大学附属岳阳医院、云南省玉溪市通海县中医医院收治的BPH患者临床资料300例,将患者分为观察组和对照组,观察组100例给予5α-还原酶抑制剂(非那雄胺);对照Ⅰ组100例,给予α1受体阻滞剂(盐酸特拉唑嗪);对照Ⅱ组100例,给予非那雄胺+盐酸特拉唑嗪.对比分析观察组与对照组患者用药3个月、6个月及12个月后国际前列腺症状评分(IPSS)、最大尿流率、前列腺体积变化情况. 结果 300例BPH患者中,并存MS者(MS+ BPH组)256例(85.3％),其中糖尿病127例(49.6％),高血压174例(68.0％),高胆固醇或高三酰甘油血症85例(33.2％);非并存MS患者(单纯BPH组)44例(14.7％),两组患者在年龄、总胆固醇比较,差异无统计学意义(P＞0.05).MS+BPH组患者体质指数、血压、空腹血糖均、列腺体积、IPSS均显著高于单纯BPH组(P＜0.05),而最大尿流率则明显低于单纯BPH组(P＜0.05).前列腺体积与年龄、体质指数、收缩压、空腹血糖呈正相关,IPSS评分与年龄、体质指数、空腹血糖、总胆固醇呈正相关.最大尿流率与年龄、空腹血糖、总胆固醇呈负相关.治疗3个月后,对照Ⅰ组和对照Ⅱ组在症状评分、最大尿流率方面优于观察组(P＜0.05);6个月后,对照Ⅰ组和对照Ⅱ组与观察组比较,症状评分、最大尿流率方面差异无统计学意义(P＞0.05),观察组在前列腺体积缩小方面优于对照Ⅰ组(P＜0.05);12个月后,观察组与对照Ⅰ组在以上观察项目组间比较差异有统计学意义(P＜0.05),与对照Ⅱ组比较差异无统计学意义(P＞0.05). 结论 多数BPH患者同时罹患MS,MS+ BPH患者较单纯BPH患者的体质指数、血压、血糖、前列腺体积、IPSS均升高,MS可能影响BPH的发病率及预后.药物治疗6个月内,可联合应用非那雄胺与特拉唑嗪,6个月后可单独应用非那雄胺.
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