苦参通关丸通过调控miRNA21/NF-κB/COX2信号通路介导铁死亡治疗良性前列腺增生的作用机制研究OA

Objective To investigate the clinical efficacy of Kushen Tongguan Pills in patients with benign prostatic hyperplasia(BPH)and to explore its potential mechanisms of action,with emphasis on whether it is related to regulation of the miRNA21/NF-κB/COX-2 signaling pathway mediated ferroptosis.Methods A total of 64 BPH patients treated in the Male Outpatient Department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from June 2025 to October 2025 were enrolled.Patients were randomly assigned to an observation group and a control group using a random number table,with 32 cases in each group.During the study,2 cases in each group were lost to follow-up,and 30 cases in each group completed the trial.The observation group received Kushen Tongguan Pill granules,while the control group received a placebo at 10%of the dosage of the observation group.The treatment course was 4 weeks.Before and after treatment,International Prostate Symptom Score(IPSS)and traditional Chinese medicine(TCM)syndrome scores were evaluated.Enzyme-linked immunosorbent assay(ELISA)was used to detect levels of glutathione peroxidase 4(GPx4),cyclooxygenase-2(COX-2),superoxide dismutase(SOD),malondialdehyde(MDA),nuclear factor-κB p65(NF-κB p65),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in expressed prostatic secretion(EPS).Polymerase chain reaction(PCR)was used to determine miRNA21 expression in EPS.Results After treatment,IPSS and TCM syndrome scores in the observation group were significantly lower than those before treatment and those in the control group(P<0.05).Compared with the control group,the observation group showed significantly increased levels of GPx4 and SOD in EPS(P<0.05),while levels of COX-2,MDA,NF-κB p65,IL-6,TNF-α,and miRNA21 expression were significantly decreased(P<0.05).No serious adverse events occurred in either group.Conclusion Kushen Tongguan Pills can effectively improve clinical symptoms in patients with BPH.Its mechanism may be related to downregulation of miRNA21 expression,inhibition of NF-κB/COX-2 signaling pathway activity,regulation of ferroptosis-related indicators(GPx4,MDA),and alleviation of inflammatory response(IL-6,TNF-α)and oxidative stress injury(SOD).