A Classic Herbal Formula Danggui Beimu Kushen Wan for Chronic Prostatitis: From Traditional Knowledge to Scientific Exploration

Abstract

Chronic prostatitis (CP) is a chronic inflammation in the prostate with unsatisfactory management. Danggui Beimu Kushen Wan (DBKW) is a classic formula developed 1800 years ago for patients with difficult urination and it has been widely utilized for CP in modern days. However, scientific understanding of DBKW on CP has not been systematically reviewed. First, we searched the Encyclopedia of Traditional Chinese Medicine for the etiologies and pathogeneses of CP-like symptoms and DBKW and compared their similarities and differences from traditional Chinese medicine and conventional medicine perspectives. Then, we searched 21 electronic databases to identify potential clinical and experimental studies. Characteristics of included studies, ingredients, herb frequency, and possible mechanisms of actions were descriptively summarized. Risk of bias of randomized controlled trials (RCTs) was evaluated using the Cochrane risk of bias assessment tool. A total of 290 studies were identified. Six clinical studies, including four RCTs and two case series, and eight experimental studies were included. Clinical studies indicated that DBKW used alone or as an adjunct therapy significantly reduced the CP symptom scores and decreased the expressed prostatic secretions-pH when compared to antibiotics or α-blocker. Most RCTs have high or unclear risk of bias. Experimental studies revealed that DBKW may have effects on anti-inflammation, antibacteria, antioxidation, sex hormone regulation, and immunoregulation. DBKW demonstrated a great potential in the treatment of CP. High-quality RCTs and network pharmacological studies should be considered for future research.

Fritillariae Thunbergii Bulbus: Traditional Uses, Phytochemistry, Pharmacodynamics, Pharmacokinetics and Toxicity

“…FTB is a significant traditional Chinese herb with bitter and cold properties, entering the Lung and Heart channels [2]. It is generally prescribed as one of the ingredients of herbal formula, such as Danggui Beimu Kushen Wan (Chinese Angelica, Fritillaria and Flavescent Sophora Pill; DBKW) in traditional and contemporary clinical practice [3,4]. Recently, investigating potential treatments from ancient records has been employed as a strategy to direct novel drug discovery [5].…”

Herbal formula (Danggui Beimu Kushen Wan) for prostate disorders: a systematic review of classical literature

“…A recently published review on clinical and experimental studies of DBKW has revealed that DBKW could be a promising formula with great potential for the management of chronic prostatitis 25 . Specifically, four randomized controlled trials (RCTs) applied modified or basic DBKW to treat patients with chronic prostatitis 18, 26, 27, 28.…”

“…Compared to antibiotic drugs, two RCT involving 170 and 156 patients respectively revealed that the modified DBKW significantly relieved difficult urination, perineal pain and tenderness of prostate after a four-week treatment 26, 27. However, the review did not synthesize the corresponding data since insufficient details provided in the original studies 25 . Another RCT enrolling 100 patients reported that the pH level in the expressed prostatic secretions test was significantly reduced by the modified DBKW decoction after four weeks, compared to ofloxacin (mean difference (MD) −0.17, 95% confidence interval (CI) −0.33 to −0.01) 28 .…”

“…A recent review and some experimental studies of DBKW pointed out that DBKW may have multiple actions that could have effects on more than one pathway of prostate disorders at the same time 25, 32, 33, 34, 35, 36, 37, 38, 39. A number of animal studies investigated the mechanisms of actions of DBKW on rats or mice in the treatment of chronic bacterial prostatitis.…”

“…Recent laboratory studies reported that all Angelicae Sinensis Radix, Fritillariae Thunbergii Bulbus and Sophorae Flavescentis Radix have anti-inflammatory and immunoregulatory activities evidenced by decreasing the expression of TNF-α,43, 44, 45, 46, 47 IL-1β, 48 IL-6,45, 46 IL-8, 45 nuclear factor kappa light chain enhancer of activated B cells, 49 as well as enhancing the expression of Interferon-γ 50 . The therapeutic effects of DBKW on prostate disorders may be due to the multiple active compounds in DBKW, such as ferulic acid, oxymatrine, oxysophocarpine, matrine, sophocarpine, verticine and verticinone 25, 40, 41, 42, 51. However, the actual mechanisms of actions of DBKW for prostate disorders are unknown that should be comprehensively detected in the future.…”