Can saw palmetto treat an enlarged prostate?
Marketed as a natural remedy for an enlarged prostate, saw palmetto is a top-selling dietary supplement.
锯棕榈作为治疗前列腺肥大的天然药物而上市，是最畅销的膳食补充剂。
It's extracted from berries that grow on saw palmetto palm trees, which are native to the southeastern United States.
它是从锯棕榈树上生长的浆果中提取的，锯棕榈树原产于美国东南部。
By one estimate, more than a third of all US adults who take supplements use saw palmetto specifically.
据估计，超过三分之一服用补充剂的美国成年人专门使用锯棕榈。
Some evidence suggests that saw palmetto has anti-inflammatory properties, and its use as folk medicine dates back over a century.
一些证据表明，锯棕榈具有抗炎特性，其作为民间药物的使用可以追溯到一个多世纪前。
But experts at Harvard say men should view its supposed benefits for prostate health skeptically.
但哈佛大学的专家表示，男性应该对它所谓的前列腺健康益处持怀疑态度。
"Saw palmetto is unlikely to harm you, but it probably won't provide any major benefits either," says Dr. Heidi Rayala, a urologic surgeion at Harvard-affiliated Beth Israel Deaconess Medical Center and an assistant professor of urology at Harvard Medical School.
“锯棕榈不太可能对你造成伤害，但它也可能不会带来任何重大好处，”哈佛附属贝斯以色列女执事医疗中心的泌尿外科医生、哈佛医学院泌尿科助理教授海蒂·拉亚拉博士说。
It's common for men to develop an enlarged prostate, or benign prostatic hyperplasia (BPH), when they get older.
当男性变老时，前列腺肥大或良性前列腺增生 (BPH) 是很常见的。
BPH impedes urinary flow through the urethra, causing obstructive symptoms that can worsen with time.
良性前列腺增生会阻碍尿液流经尿道，导致阻塞症状，并随着时间的推移而恶化。
Just how saw palmetto might act on the prostate to improve symptoms isn't entirely clear, however.
然而，锯棕榈如何作用于前列腺以改善症状尚不完全清楚。
Some evidence suggest it mimics the effects of certain drugs used for treating BPH, including 5-alpha reductase inhibitors such as finasteride (Proscar), which shrink the prostate gland.
一些证据表明，它模仿了某些用于治疗 BPH 的药物的作用，包括 5-α 还原酶抑制剂，例如非那雄胺（保列治），它可以缩小前列腺。
In the US, no herbal supplement is approved as BPH treatment.
在美国，没有草药补充剂被批准用于治疗 BPH。
The American Urological Association cautions that studies backing saw palmetto for treating enlarged prostates have numerous flaws, including short durations and a lack of placebo controls.
美国泌尿外科协会警告说，支持锯棕榈治疗前列腺肥大的研究存在许多缺陷，包括持续时间短和缺乏安慰剂对照。
Most of the supporting evidence comes from small studies paid for by companies that sell dietary supplements.
大多数支持证据来自销售膳食补充剂的公司资助的小型研究。
The best-conducted research shows no benefits from saw palmetto for BPH.
最全面的研究表明，锯棕榈对良性前列腺增生症没有任何益处。
During one study , 225 men with moderate to severe BPH were treated with either a placebo or 160 milligrams (mg) of saw palmetto, taken twice daily for a year.
在一项研究中，225 名患有中度至重度 BPH 的男性接受了安慰剂或 160 毫克 (mg) 锯棕榈的治疗，每天服用两次，持续一年。
The investigators detected no difference in outcomes, but they also acknowledged that doses tested in the study may have been too low to produce measurable effects.
研究人员发现结果没有差异，但他们也承认，研究中测试的剂量可能太低，无法产生可测量的效果。
So, during a larger subsequent study , researchers tested higher doses of saw palmetto ranging up to 320 mg given three times a day.
因此，在随后的一项更大规模的研究中，研究人员测试了更高剂量的锯棕榈，每天服用 3 次，最高剂量为 320 毫克。
Nearly 370 men ages 45 and older were randomized to treatment or placebo groups.
近 370 名 45 岁及以上的男性被随机分配到治疗组或安慰剂组。
After year and a half, men in both groups reported feeling either no worse or a little better.
一年半后，两组男性都表示感觉没有更差，或者有所好转。
Remarkably, 40% of the placebo-treated men said symptoms had improved, suggesting the simple act of taking a pill could have something to do with the supplement's perceived benefits.
值得注意的是，40% 接受安慰剂治疗的男性表示症状有所改善，这表明服用药物这一简单行为可能与补充剂的感知益处有关。
Dr. Michael Barry, a professor of medicine at Harvard Medical School, led the study.
哈佛医学院医学教授迈克尔·巴里博士领导了这项研究。
He urges men to consult with their doctors before trying saw palmetto, mainly to rule out other potential causes of urinary obstruction, which can include bladder or prostate cancer.
他敦促男性在尝试锯棕榈之前先咨询医生，主要是为了排除尿路梗阻的其他潜在原因，其中可能包括膀胱癌或前列腺癌。
And saw palmetto may interfere with the blood's clotting ability, making it risky for men who take blood thinners.
锯棕榈可能会干扰血液的凝固能力，使服用血液稀释剂的男性面临风险。
The latest evidence on saw palmetto and BPH comes from a Cochrane Review of 27 placebo-controlled studies enrolling a combined 4,656 participants.
关于锯棕榈和 BPH 的最新证据来自 Cochrane 综述，该综述对 27 项安慰剂对照研究进行了评估，共招募了 4,656 名参与者。
Results published in 2024 showed no improvement in urinary symptoms or quality of life from taking saw palmetto (alone or with other herbal supplements) over durations ranging up to 17 months.
2024 年发布的结果显示，服用锯棕榈（单独或与其他草药补充剂一起）长达 17 个月的时间没有改善泌尿系统症状或生活质量。
"If the ingredients in these herbal products worked well for urinary symptoms, drug companies would have already had them approved by the FDA as a medicine that insurance companies would have to cover," Dr. Rayala said.
拉亚拉博士说：“如果这些草药产品中的成分对泌尿系统症状有效，那么制药公司就已经让它们获得 FDA 批准，作为保险公司必须承保的药物。”
"It's okay to take them, but just be cautious about spending too much of your own money on these alternatives."
“服用它们是可以的，但要小心不要在这些替代品上花费太多自己的钱。”
"It is easy to understand why so many find taking a naturally occurring supplement for treating urinary difficulties in middle age appealing," said Dr. Marc Garnick, the Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of the Harvard Medical School Guide to Prostate Diseases .
“很容易理解为什么这么多人认为服用天然补充剂来治疗中年泌尿困难很有吸引力，”哈佛医学院和贝斯以色列女执事医疗中心的戈尔曼兄弟医学教授、哈佛医学院前列腺疾病指南的主编马克·加尼克博士说。
"However, evidence of effectiveness with saw palmetto is lacking, and its use for BPH and other common urinary symptoms without a full evaluation of the potential cause should be discouraged."
“然而，缺乏锯棕榈有效性的证据，在没有对潜在原因进行全面评估的情况下，不应将其用于治疗良性前列腺增生和其他常见泌尿系统症状。”
C.W.
C.W.
Schmidt , Editor, Harvard Medical School Annual Report on Prostate Diseases
施密特，哈佛医学院前列腺疾病年度报告编辑
Marc B.
马克·B.
Garnick, MD , Editor in Chief, Harvard Medical School Annual Report on Prostate Diseases; Editorial Advisory Board Member, Harvard Health Publishing
Garnick，医学博士，哈佛医学院前列腺疾病年度报告主编；哈佛健康出版社编辑顾问委员会成员
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作为为读者提供的一项服务，哈佛健康出版社提供对我们存档内容库的访问。
Please note the date of last review or update on all articles.
请注意所有文章的最后审查或更新日期。
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
本网站上的任何内容，无论日期如何，都不应替代您的医生或其他合格临床医生的直接医疗建议。
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