宫瘤宁胶囊对气滞血瘀证子宫肌瘤瘤体的抑制作用  

Inhibitory Effect of Gongliuning Capsules Combined with Mifepristone on Hysteromyoma with Stagnation of Qi and Blood

作　　者：杜亚青[1] 贾林燚[1] 赵爱民[1] 董润之[1] 

机构地区：[1]邢台市人民医院,河北邢台054001

出　　处：《中国实验方剂学杂志》2016年第24期177-181,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：邢台市科技局医学卫生基金(2014WS0528)

摘　　要：目的:评价宫瘤宁胶囊联合米非司酮治疗子宫肌瘤气滞血瘀证的临床疗效及对血清中血管内皮生长因子(VEGF),基质金属蛋白酶9(MMP-9),转移生长因子-β1(TGF-β1),表皮生长因子(EGF)表达的影响。方法:将146例患者采用随机按数字表法分为对照组和联合组各73例。对照组采用米非司酮片,月经第1天开始,25 mg·d^(-1),晨服。联合组在对照组治疗的基础上加用宫瘤宁胶囊,6粒/次,3次/d。两组疗程均为3个月。采用彩超测量治疗前后肌瘤和子宫大小;进行治疗前后气滞血瘀证评分;检测治疗前后促卵泡刺激素(FSH),促黄体生成素(LH),雌二醇(E2)和孕激素(P)水平;检测治疗前后VEGF,MMP-9,TGF-β1和EGF水平;随访6个月,记录复发情况。结果:联合组临床疗效总有效率为92.31%,高于对照组的78.13%(P<0.05);治疗后联合组肌瘤和子宫体积小于对照组,气滞血瘀证评分低于对照组(P<0.01);治疗后联合组E2,P,FSH,LH水平均低于对照组(P<0.01);治疗后联合组VEGF,MMP-9,TGF-β1和EGF水平均低于对照组(P<0.01);联合组复发率24.62%,低于对照组的48.44%(P<0.01)。结论:宫瘤宁胶囊联合米非司酮治疗气滞血瘀型子宫肌瘤在缩小瘤体,改善症状,提高临床疗效,降低复发率方面均优于单纯的米非司酮治疗,其作用机制可能与下调性激素水平,调节VEGF,MMP-9,TGF-β1和EGF等因子的表达有关。Objective： To evaluate the clinical efficacy of Gongliuning capsules combined with mifepristone in treating hysteromyoma（ stagnation of Qi and blood） and their effect on vascularendothelial growth factor（ VEGF）,matrix metalloproteinase-9（ MMP-9）,transforming growth factor-β1（ TGF-β1） and epidermal growth factor（ EGF）. Method： One hundred and forty-six patients were divided into control group（ 73 cases） and combination group（ 73 cases） by random number table. Patients in control group received mifepristone tablets in the morning,menstruation begins first days,25 mg / day. In addition to the therapy of control group,patients in combination group were also given Gongliuning capsule,6 grains / time,tid. The courses of treatment were 3months. Before and after treatment,sizes of fibroid and uterus were detected by color doppler ultrasound. Scores of stagnation of Qi and blood were evaluated. Levels of follicle-stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E2）,progesterone（ P）,VEGF,MMP-9,TGF-β1and EGF were detected. Recurrence was recorded during the 6-month follow-up visit. Result： The total clinical therapy in observation group was 92. 31%,which was superior to 78. 13% in control group（ P〈0. 05）. After treatment,sizes of fibroid and uterus in combination group were smaller than those in control group,and scores of stagnation of Qi and blood were lower than those in control group（ P〈0. 01）. Levels of E2,P,FSH,LH,VEGF,MMP-9,TGF-β1and EGF were lower than those in control group（ P〈0. 01）. And recurrence rate in combination group was 24. 62%,which was lower than 48. 44% in control group（ P〈0. 01）. Conclusion： The effect of Gongliuning capsules combined with mifepristone was better than mifepristone in treating hysteromyoma（ stagnation of Qi and blood）,ameliorating symptoms,improving clinical effect,and reducing recurrence rate,and the mechanism of action may be correlated with decrease in levels of sex hormone,and regulation

关 键 词：子宫肌瘤 宫瘤宁胶囊 血管内皮生长因子 表皮生长因子 基质金属蛋白酶9 转移生长因子-Β1 

分 类 号：R287[医药卫生—中药学]