活血化瘀法联合亮丙瑞林对绝经期前子宫肌瘤内膜COX-2、VEGF和微血管密度表达的影响及疗效  

Clinical Effect of Leuprolide Combined with Huoxue Huayu Method on Pre-Menopausal Uterine Fibroids,Endometrial COX-2 VEGF Expression and Microvessel Density

作　　者：李艳芳[1] 王洁[1] 张倩 LI Yanfang;WANG Jie;ZHANG Qian(Department of Gynaecology and Obstetrics,The First Affiliated Hospital of Nanyang Medical College,Nanyang 47305,Henan,China;Department of Ultrasound Imaging,The First Affiliated Hospital of Nanyang Medical College,Nanyang 473058,Henan,China)

机构地区：[1]南阳医学高等专科学校第一附属医院妇产科,河南南阳473058 [2]南阳医学高等专科学校第一附属医院超声影像科,河南南阳473058

出　　处：《中华中医药学刊》2018年第8期1950-1953,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河南省科技发展计划项目(0224630369)

摘　　要：目的：分析中医活血化瘀法联合亮丙瑞林治疗绝经期前子宫肌瘤临床疗效，及对子宫内膜环氧合酶-2（COX-2）、血管内皮生长因子（VEGF）和微血管密度表达的影响，为治疗方案的选择提供参考。方法：选择2015年2月-2016年2月医院收治的绝经期前子宫肌瘤患者108例，按照就诊顺序编号，采用数字随机表法将其分为对照组和观察组，每组54例，对照组采用亮丙瑞林治疗，观察组采用中医活血化瘀法联合亮丙瑞林治疗，比较两组患者治疗前、后子宫肌瘤大小、子宫大小、临床症状变化情况。完成3个月的治疗疗程后，对患者临床疗效进行评价并比较。治疗前、后于B超下穿刺取相同位置的子宫内膜，比较COX-2、VEGF及微血管密度的表达情况并比较，随访1年，比较两组治愈患者复发情况。结果：两组患者年龄、体质量、体质量指数、临床症状、子宫大小、子宫肌瘤大小、数量比较差异均无统计学意义（P〉0．05）。两组患者治疗3个月后，子宫肌瘤、子宫大小均较治疗前明显缩小，但观察组均明显低于对照组（P〈0．05）。两组临床症状均得到改善，但观察组临床症状率明显低于对照组（P〈0．05）。观察组临床总有效率明显高于对照组（P〈0．05）。治疗3个月后，两组患者子宫内膜COX-2、VEGF及微血管密度表达均较资料前明显降低，但观察组均低于对照组患者（P〈0．05），1年后，观察组子宫肌瘤治愈的患者复发率明显低于对照组治愈患者（P〈0．05）。结论：中医活血化瘀法联合亮丙瑞林可有效改善绝经期前子宫肌瘤患者临床症状，降低子宫内膜COX-2、VEGF及微血管密度表达，提高临床疗效，降低复发率，从根本上控制疾病病因，具有较高的临床价值。Objective ： To analyze the effect of leuprolide combined with TCM Huoxue Huayu method on pre - menopa- usal uterine fibroids, and the influence on the endometrium of cyclooxygenase - 2 （ COX - 2 ） , vascular endothelial growth factor （VEGF） and microvessel density and provide a reference for the choice of treatment. Methods： From February 2015 -February 2016 in our hospital, 108 cases of patients with uterine fibroids before menopause, according to the order of treatment, were randomly divided into control group and observation group, 54 cases in each group. The control group used leuprorelin treatment and the observation group were treated with TCM Huoxue Huayu method combined with leupro- relin treatment. We compared two groups＇ size of uterine fibroids, uterine size, changes of clinical symptoms before and after treatment. After 3 months treatment, the clinical efficacy of the patients was evaluated and compared. The endome- trium of the same place was taken under the B ultrasound before and after treatment, and the expressions of COX - 2,VEGF and microvessel density were compared. The patients were followed up for 1 year, and the recurrence of the two groups was compared. Results： There was no significant difference between the two groups in age, weight, body mass in- dex, clinical symptoms, uterine size, or the size of uterine fibroids （ P 〉 0. 05 ）. After 3 months treatment, uterine fi- broids and uterine size were significantly lower than those before treatment, but the observation group＇ s was significantly lower than that of the control group（P 〈 0. 05）. The clinical symptoms of the two groups were improved, but the clinical symptom rate of the observation group was lower than that of the control group （P 〈 0. 05 ）. The total effective rate of the observation group was significantly higher than that of the control group （ P 〈 0.05 ）. After 3 months treatment, two groups＇ endometrial COX - 2, VEGF and MVD were significantly decreased, but the observation group�

关 键 词：绝经期前 子宫肌瘤 活血化瘀 亮丙瑞林 临床疗效 影响指标 环氧合酶-2 血管内皮生长因子 微血管密度 

分 类 号：R711.74[医药卫生—妇产科学]