Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials

Abstract

Chinese herbal medicine is commonly used as a treatment for benign prostatic hyperplasia (BPH), but its efficacy and safety remain to be examined. To compare the efficacy and adverse events of Chinese herbal medicine alone or used adjuvantly with Western medications for BPH. 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 o3 were selected for meta-analysis. 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.

Immunomodulatory Effect of Red Onion (Allium cepaLinn) Scale Extract on Experimentally Induced Atypical Prostatic Hyperplasia in Wistar Rats

“…Fruits and vegetables have health benefits and are good sources of antioxidants; therefore a lot of recent literature has focused on nutritional and herbal medicine for prostatic hyperplasia [38–40]. In the present study, administration of ROS extract induced significant and dose-related reduction in both the absolute and relative weight of prostate in the APH-induced rats, an effect that was greater than that induced by saw palmetto.…”

The prevalence of benign prostatic hyperplasia in mainland China: evidence from epidemiological surveys

“…A combination of alpha1-blockers and 5-alpha-reductase inhibitors is recommended, and Chinese herbal medicine is also used. While new surgical therapies are constantly emerging and being developed, transurethral resection of the prostate (TURP) rightly remains the dominant mode of treatment in mainland China 45 46 .…”

Feasibility of an Alternative Option for the Management of Male Lower Urinary Tract Symptoms

“…22 Although prevalent in some countries, 10,23 the efficacy of these herbal medications are not proven, with most studies suggesting similar efficacy as placebo. 11,12,24 Given that alpha-1 blockers have proven efficacy and safety for BPH treatment, 16 these medications may be considered as potential OTC alternatives. The current study supports further exploration of an OTC alpha-1 blocker for the self-management of male LUTS.…”