臺灣博碩士論文加值系統

落髮問題同時發生在男性與女性身上。在落髮問題中，因為雄性激素造成的雄性禿占大多數。雄性禿的區域多從顳部開始，一直延伸到前額還有頭頂區域。然而後枕部的頭髮則是因為毛囊缺乏雄性激素接受器而不受雄性激素所影響。影響雄性禿中一個很重要的脢即是 5 alpha-reductase(還原脢)，5 alpha-reductase( 還 原 脢 ) 可 以 將 細 胞 內 的 testosterone( 睪 固 酮 ) 轉 換 為dihydrotestosterone(DHT)(二氫睪固酮)。某些植物的萃取物中的植化素有抑制5 alpha-reductase(還原脢)的功效。鋸棕櫚則是其中一種，而且在歐洲已經被廣泛使用在治療攝護腺肥大。在本篇，我們根據”鋸棕櫚的抑制 5 alpha-reductase(還原脢)效果，是否有促進人類頭髮生長的功效”作系統回顧。我們以 PubMed， Cochrane，以及 WOS 作為搜尋。關鍵字為: 5 alpha-reductase，serenoa repens 以及 human hair growth。總共有四篇論文為主要系統回顧內容。鋸棕櫚的萃取物不論是外用或是口服，皆能減少雄性禿惡化。外用的製劑能增加永久毛(terminal hair)的數量，而口服製劑則能穩定落髮狀況不再惡化，或是增加生長期毛囊的數量。但效果仍不如使用藥物(Finasteride)在前額及頂部都有作用。使用鋸棕櫚治療雄性禿是安全的，而且不會造成性功能障礙的副作用。

Background
Hair loss problem affect both men and women. Androgenic alopecia (AGA) is the most common type of male pattern hair loss. The hair loss pattern usually begins with bitemporal recession, followed by the frontal and vertex areas. But the occipital area is not affected by androgen activity due to lack of androgen receptor.
The enzyme 5 alpha-reductase plays on important role in AGA. The conversion of
testosterone to dihydrotestosterone (DHT) is catalyzed by the enzyme 5 alpha-reductase.
Several plants were noted as having 5 alpha-reductase inhibition potential due to its phytochemicals. Serenoa repens is one of these plants which have been common used in Europe for benign prostate hyperplasia. Systemic review was used to investigate the improving human hair growth effect of Serena Repens.
Objectives
This systematic review aimed to assess the effects and harms of Serenoa
repens in the treatment of men with androgenic alopecia.
Search method
We use PubMed as our primary research database. The Cochrane and WOS were also searched.
Selection Criteria
The following keywords were used for searching: 5 alpha-reductase, serenoa
repens and human hair growth.
Result
There are four literatures meet the criteria of our study. It seems effective to treat AGA through topical use and oral treatment. In the topical use study, the terminal hair counts continue increasing at end of trial. Although different formulation of serenoa repens extract, the stabilization of hair loss condition and improving the hair bulb phase proportion are the relative noteworthy effect. In the serenoa repens and finasteride comparison study, serenoa repens lead an improvement only in vertex. Finasteride improved hair growth in all area.
Conclusion
The products of serenoa repens extract, in topical use or oral intake form, are safe and no sexual dysfunction side effect which was one of concerned reason by patients.

Contents i
Table content ii
Figure content iii
1. Introduction 1
1.1. Research Background 1
1.2. Research Motive 1
2. Literature review 3
2.1. Metabolic pathway of Sexual Steroid 3
2.2. Androgenic Alopecia 3
2.3. Phytochemicals 3
3. Materials and Methods 5
3.1. Research Strategy 5
3.2. Meta-analysis limitation 5
4. Results 6
4.1. Review of Studies 6
4.2 Risk of Study Bias 8
5. Discussion and Conclusion 9
5.1. Discussion 9
5.2. Limitation 10
6. Conclusion 11
References 12
Table content
Table 1. System review table 16
Table 2. Multiple compound formulation of topical lotion and concentrated serum 20
Table 3. Side effects of topical used Serenoa repens extract 21
Table 4. Component of softgel formulation 22
Table 5. Multi-component capsule formulation 23
Figure content
Figure 1. Steroidogenesis 24
Figure 2. Fig 2. Norwood's classification of patterned hair loss 25
Figure 3. Flow chart of data base research 26
Figure 4. Risk of bias graph 27
Figure 5. Risk of bias summary 28

Aggarwal, S., Verma, A., Shukla, R., Batra, S., R Bhardwaj, T., & Kumar, M. (2014). An overview of phytotherapeutic approaches for the treatment of benign prostatic hyperplasia. Mini reviews in medicinal chemistry, 14(3), 257-270.
Arendt, E. K., & Zannini, E. (2013). Cereal grains for the food and beverage industries: Elsevier.
Barber, B., Kaufman, K., Kozloff, R., Girman, C., & Guess, H. (1998). A hair growth questionnaire for use in the evaluation of therapeutic effects in men. Journal of Dermatological Treatment, 9(3), 181-186.
Bauman, D. R., Steckelbroeck, S., Williams, M. V., Peehl, D. M., & Penning, T. M.(2006). Identification of the major oxidative 3α-hydroxysteroid dehydrogenase in human prostate that converts 5α-androstane-3α, 17β-diol to 5α-dihydrotestosterone: a potential therapeutic target for androgen dependent disease. Molecular endocrinology, 20(2), 444-458.
Cheema, P., El‐Mefty, O., & Jazieh, A. (2001). Intraoperative haemorrhage associated with the use of extract of Saw Palmetto herb: a case report and review of literature. Journal of Internal Medicine, 250(2), 167-169.
Chin, A. C., & Baskin, L. B. (2012). Effect of Herbal Supplement–Drug Interactions on Therapeutic Drug Monitoring Therapeutic Drug Monitoring (pp. 417-445): Elsevier.
Debruyne, F., Koch, G., Boyle, P., Da Silva, F. C., Gillenwater, J. G., Hamdy, F.C., . . . Raynaud, J.-P. (2002). Comparison of a phytotherapeutic agent (Permixon) with an α-blocker (tamsulosin) in the treatment of benign prostatic hyperplasia: a 1-year randomized international study. Eur Urol, 41(5), 497-507.
Griffin, J., & Wilson, J. (1989). The resistance syndromes: 5α-reductase deficiency, testicular feminisation and related disorders. The metabolic basis of inherited disease. Mc-Graw-Hill, New York, 1919-1944.
Gupta, M., & Mysore, V. (2016). Classifications of patterned hair loss: A review. J Cutan Aesthet Surg, 9(1), 3.
Hanukoglu, I. (1992). Steroidogenic enzymes: structure, function, and role in regulation of steroid hormone biosynthesis. J Steroid Biochem Mol Biol, 43(8), 779-804.
Harikrishnan, R., Balasundaram, C., & Heo, M.-S. (2011). Impact of plant products on innate and adaptive immune system of cultured finfish and shellfish. Aquaculture, 317(1-4), 1-15.
Imperato-McGinley, J., Guerrero, L., Gautier, T., & Peterson, R. E. (1974). Steroid 5α-reductase deficiency in man: an inherited form of male pseudohermaphroditism. Science, 186(4170), 1213-1215.
Irwig, M. S., & Kolukula, S. (2011). Persistent sexual side effects of finasteride for male pattern hair loss. The journal of sexual medicine, 8(6), 1747-1753.
Jibrin, I., Erinle, A., Saidi, A., & Aliyu, Z. Y. (2006). Saw palmetto-induced pancreatitis. South Med J, 99(6), 611-613.
Kaufman, K. D. (2002). Androgens and alopecia. Molecular and Cellular Endocrinology, 198(1-2), 89-95.
Kaufman, K. D., Olsen, E. A., Whiting, D., Savin, R., DeVillez, R., Bergfeld, W., . . . Hordinsky, M. (1998). Finasteride in the treatment of men with androgenetic alopecia. Journal of the American Academy of Dermatology, 39(4), 578-589.
Lourith, N., & Kanlayavattanakul, M. (2013). Hair loss and herbs for treatment. J Cosmet Dermatol, 12(3), 210-222.
Madersbacher, S., Ponholzer, A., Berger, I., & Marszalek, M. (2007). Medical management of BPH: role of plant extracts. eau-ebu update series, 5(5),
197-205.
McGinley, K. J., Marples, R. R., & Plewig, G. (1969). A method for visualizing and quantitating the desquamating portion of the human stratum corneum. Journal of Investigative Dermatology, 53(2), 107-111.
Miroddi, M., Carni, A., Mannucci, C., Moleti, M., Navarra, M., & Calapai, G. (2012). Hot flashes in a young girl: a wake-up call concerning Serenoa repens use in children. Pediatrics, 130(5), e1374-1376. doi: 10.1542/peds.2011-2679
Norwood, O. (1975). Male pattern baldness: classification and incidence. South Med J, 68(11), 1359-1365.
O'Hara, M., Kiefer, D., Farrell, K., & Kemper, K. (1998). A review of 12 commonly used medicinal herbs. Archives of Family Medicine, 7(6), 523.
Olsen, E. A., Whiting, D. A., Savin, R., Rodgers, A., Johnson-Levonas, A. O., Round, E., . . . Kaufman, K. D. (2012). Global photographic assessment of men aged 18 to 60 years with male pattern hair loss receiving finasteride 1 mg or placebo. Journal of the American Academy of Dermatology, 67(3), 379-386.
Payne, A. H., & Hales, D. B. (2004). Overview of steroidogenic enzymes in the pathway from cholesterol to active steroid hormones. Endocrine reviews, 25(6), 947-970.
Penugonda, K., & Lindshield, B. L. (2013). Fatty acid and phytosterol content of commercial saw palmetto supplements. Nutrients, 5(9), 3617-3633.
Prager, N., Bickett, K., French, N., & Marcovici, G. (2002). A randomized, doubleblind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med, 8(2), 143-152. doi: 10.1089/acm.2002.8.143
Robbers, J. E., & Tyler, V. E. (1999). Tyler's herbs of choice. The therapeutic use of phytomedicinals: Haworth Press Inc.
Rossi, A., Mari, E., Scarno, M., Garelli, V., Maxia, C., Scali, E., . . . Carlesimo, M. (2012). Comparitive effectiveness of finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol, 25(4), 1167-1173. doi: 10.1177/039463201202500435
Serrano-Falcón, C., Fernández-Pugnaire, M., & Serrano-Ortega, S. (2013). Hair and scalp evaluation: the trichogram. Actas Dermo-Sifiliográficas (English Edition), 104(10), 867-876.
Thigpen, A. E., Silver, R. I., Guileyardo, J. M., Casey, M. L., McConnell, J. D., & Russell, D. W. (1993). Tissue distribution and ontogeny of steroid 5 alpha reductase isozyme expression. The Journal of clinical investigation, 92(2), 903-910.
Togni, S., Maramaldi, G., Meneghin, M., Giacomelli, L., & Eggenhoffner, R. (2016). Effective oral treatment for scalp disorders: results from a double blind, placebo-controlled study. Esperienze dermatologiche, 8(3-4), 187-191. http://cochranelibrary- wiley.com/o/cochrane/clcentral/articles/093/CN01328093/frame.html
Villanueva, S., & Gonzalez, J. (2009). Coagulopathy induced by saw palmetto: a case report. Boletin de la Asociacion Medica de Puerto Rico, 101(3), 48-50.
Wargo, K. A., Allman, E., & Ibrahim, F. (2010). A possible case of saw palmettoinduced pancreatitis. South Med J, 103(7), 683-685. doi: 10.1097/SMJ.0b013e3181e1e3ee
Wessagowit, V., Tangjaturonrusamee, C., kootiratrakarn, T., Bunnag, T., Pimonrat, T., Muangdang, N., & Pichai, P. (2016). Treatment of male androgenetic alopecia with topical products containing Serenoa repens extract. Australas J Dermatol, 57(3), e76-82. doi: 10.1111/ajd.12352
Wilt, T., Mac Donald, R., Ishani, A., Rutks, I., & Stark, G. (1998). Cernilton for benign prostatic hyperplasia. Cochrane Database Syst Rev 2000b, 2.