At present, patients with
lower urinary tract symptoms, including storage symptoms, caused by
prostatic disease are predominantly treated with alpha1-adrenoceptor antagonist and
anticholinergic agents. However, some patients are not improved by this treatment. We investigated the efficacy of
Goshajinkigan in 25 patients with
prostatic disease in whom pollakisuria was not improved by treatment with drugs for
lower urinary tract symptoms. The urinary frequency was significantly improved both in the daytime and at night. The parameters of uroflowmetry, the residual urine volume, the international prostate symptom score and QOL score were also improved after
therapy. It was considered that the pollakisuria was improved by
Goshajinkigan induced activation of spinal
kappa-opioid receptors, which inhibited the micturition reflex via blunting of bladder sensation. The inhibition of C-fiber and the down regulation of Fos
protein in the pontine micturition center were also suggested to be related with improvement ofpollakisuria. Chinese herbal medicine
therapy is different in various aspects from Western medicine. Clarification of the mechanisms of Chinese herbal medicine and Sho (patient status in Chinese herbal medicine) is awaited.