| Background Benign Prostate Hyperplasia (BPH) is a very common degenerative disease among the older men in Hong Kong. About half of all male population over age 50 start to develop BPH with almost 90% of men over 80 get BPH. In addition, around half of them have the symptom of urinary obstruction, which may lead to severe urinary problems. The aging of population significantly increases the number of BPH patients and lead to a burden in Hong Kong. Although BPH is not a life-threatening disease, it seriously affects quality of life. A report to summarize the best available evidence in this area would provide invaluable information for Chinese Medicine practitioners as well as the public. Study Objectives a) To review evidence of efficacy and safety of CM in BPH and early prostate cancer in: 1. improving the urination; 2. enhancing quality of life; 3. reducing the size of prostate gland;
b) To classify the study results according to the CM “syndromes (證型)”.
Methods Two independent reviewers searched the major electronic databases for randomized controlled trials comparing Chinese herbal medicine, either in single or adjuvant use with Western medication, with placebo or Western medication. Relevant journals and grey literature were also hand-searched. The outcome measures included changes in urological symptoms, urodynamic measures, prostate volume and adverse events. The frequency of commonly used herbs was also identified. Out of 13 922 identified citations of publications, 31 studies were included. Eleven studies with a Jadad score ≥3 were selected for meta-analysis.
Conclusions Chinese herbal medicine was superior to Western medication in improving quality of life and reducing prostate volume. The frequency of adverse events in Chinese herbal medicine was similar to that of placebo and less than that of Western medication. The evidence is too weak to support the efficacy of Chinese herbal medicine for BPH due to the poor methodological quality and small number of trials included. The commonly used herbs identified here should provide insights for future clinical practice and research. Larger randomized controlled trials of better quality are needed to truly evaluate the efficacy of Chinese herbal medicine |