| Benign prostatic hyperplasia(BPH) is a common disease & frequently occurring illness in older men. It is reported that BPH occurs in more than 50% of men over 60 years, 15%-30% of patients causing lower urinary tract symptoms(LUTS).Recently, with the population aging, the global average expectation of life is increasingly extending. Meanwhile, with the progress on etiopathogenisis and development of BPH and the improvement in the diagnosis and treatment, the immense medical problems involving BPH are increasingly worldwide at an alarming rate.My doctor advisor, Prof Jia Jin- Ming, combines pathogenesis of TCM with pathology of western medicine, advocating paying equal attention to deficiency of Qi and blood stasis. Based on the pathogenesis feature above, the Long-Bi-Xiao capsule (LBX) was prepared on the therapeutic principle of invigorating Qi and promoting blood flow.Clinical observations have been proved that LBX can reduce the volume of prostate, inhibit excessive hyperplasia of prostate, develop the quality of life and improve the dysuria symptoms. At the same time, the experimental study suggests that LBX can block the αl-adrenergic receptor of cerebral cortex in canines, inhibit the 5-α-reductase activity of prostate, increase the NOS content of prostate, reduce the b-FGF expression, restrain endothelial cell division of prostate and DNA synthesis, and promote the apoptosis of prostatic epithelial cell.On the basis of clinical observation and the research of TCM on Stromal cell culture in vitro of BPH patients, the study explores cytological and molecular mechanism ofLBX on BPH.Chapter 1 Experimental studyIn this experiment, stromal cell cultured in vitro of BPH patients, serum pharmacology of TCM, real-time RT-polymerase chain reaction (RT-PCR), TUNEL(Terminal-Dexynucletidy 1 Transferse Mediated Nick End Labeling), ELISA(En-zyme Linked Immunosorbent Assay),immuocytochemistry were used to explore the mechanism of LBX on Stromal cell of prostate. At the cytological and molecular level of gene expression and signal transduction, this research investigated the molecular mechanism of principle of invigorating Qi and promoting blood flow on cytoki-netics equilibrium cells in Hyperplasia of Prostate. The results were as follows:1. LBX can down-regulate the level of proliferation in cells of BPH by inhibiting the stromal cell's proliferation, but it has unclear effect on stromal cell's apoptosis of BPH.2. LBX can reduce the expression of TGF-P 1 of stromal cell, meanwhile , the expression of smooth muscle specific protein "Smoothelin" is on the decrease correspondingly. The results indicate that the serum of drugs for nourishing Qi and activating blood can depress the proliferation of stromal cell in prostate by inhibiting the expression of TGF-P1;LBX can have stable efficacy in treating BPH by means of inhibiting the proliferation of smooth muscle cell in prostate or impairing the effect of cellular differentiation from fibroblast to smooth muscle cell.3. LBX has a certain inhibitory action on the expression and secretion of extracellular matrix of stromal cell Collagen IV, thus affecting the process of matrix hyperplasia of prostate. But LBX has irregular rule on gene expression of stromal cell Fibronectin in prostate.4. LBX can cut down the expression of gene Smad7. It has no influence on the expression of TGF-pl.The possible reason is that the depression of gene Smad7 expression amount may not affect TGF-P 1 signal pathway or TGF-P 1 may be regulated by other signal pathways. In addition, because we have only examined the expression level of gene Smad7, this can not completely represent its protein expression level, which must be proved through much experiment.Chapter 2 Clinical researchThe study is involved 64 cases BPH patients lasting for 3 months, which is proved the positive effect of LBX in the treatment of BPH. It is showed that LBX can improve the prostatic symptoms, decrease I-PSS(Interaational Prostate Symptom Score) and BS(Bother of Score), reduce the volume of prostate, enhance Qmax (Maximum Flow Rate)& Qave(Average Flow Rate),and debase residual urine volume(RUV).But it has little influence on PSA(Prostatic Specific Antigen) and IIEF-5(International Index Erectile Dysfunction).It is superior to the control group in decreasing I-PSS & BS and raising CW & Qave- This research confirms that LBX can achieve good action in the therapy of BPH by improving clinical symptoms, diminishing the volume of prostate and relieving obstruction of urinary tract, which provide us much beneficial enlightenment.Chapter 3 Academic thought of advisorThis part systematically sums up the theory of Prof. Jia Jin- Ming in the diagnosis and treatment of BPH on the basis of combination of TCM with western medicine.1. From practice, Prof. Jia considers that the name "BPH" should be in common use both TCM and modern medicine, which will be not only helpful for applying the latest theory of modern medicine to clinical practice, but also beneficial to the development of BPH theory based on integrated traditional and western medicine and good for understanding the essence of BPH at higher level.2. BPH should be handled with differential diagnosis of diseases first and then treated with syndrome differentiation in the order of combination of diseases with syndrome. To gain better effect, first of all, modern scientific methods must be used to diagnose diseases differentially according to finding various pathophysiologic changes. Next, the treatment must be based on syndrome differentiation of TCM.3. Paying equal attention to deficiency of Qi and blood stasis and linking patho-genesis of TCM to pathology of western medicine, on the Basis of pathogenesis feature above, the principle of invigorating Qi and promoting blood flow was selected. Not only thinking highly of local ad-justment, but also laying stress on whole regulation, expressing the concept of wholism.4. Attaching importance to mechanism of Chinese herbal medicine treating BPHand emphasize the promotion of scientific research to clinical study.
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