更血停治疗子宫肌瘤及其对雌孕激素受体的影响

作者	单位
陈正云	浙江大学医学院附属妇产科医院
金杭美	浙江大学医学院附属妇产科医院
石海燕	浙江大学医学院附属妇产科医院

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中文摘要:

目的探讨更血停治疗子宫肌瘤的疗效及其对雌孕激素受体的影响。方法选择临床诊断为子宫肌瘤并有手术指征的64例患者,按配对随机分为两组（各32例）,治疗组从月经第1天起每天给予更血停胶囊1粒,连续口服90天后行手术治疗;对照组只行手术治疗。两组均于卵泡期和手术前1天采用放射免疫法测定血清生殖激素[包括雌二醇（E₂）、孕酮（P）、促卵泡激素（FSH）、促黄体生成素（LH）]水平;彩色多普勒超声测定治疗组服药前后子宫及子宫肌瘤体积的变化,免疫组化链霉素抗生物素蛋白,即过氧化物酶连接法（SP法）检测子宫肌瘤及肌层组织的雌激素受体（ER）和孕激素受体（PR）的表达。结果服药后治疗组血清E₂为[（167.0±85.9）pmol/L]、P为（1.9±1.0）nmol//L、FSH为（10.4±2.1）IU/L、LH为（12.0±9.8）IU/L,均维持在早卵泡期水平;最大子宫肌瘤体积由（380.4±21.0）cm²缩小至（162.3±14.8）cm³（P<0.01）;治疗组子宫肌瘤组织中ER、PR的表达均明显低于对照组（P<0.01）。结论更血停可明显减少子宫肌瘤组织中的ER、PR的表达,使子宫肌瘤明显缩小。

英文摘要:

Objective To explore the clinical efficacy of Gengxueting(GXT)in treating hysteromyoma and its effects on estrogen receptor(ER)and progesterone receptor(PR).Methods Sixty-four hysteromyoma pa- tients with surgical indication were equally assigned to the treated group and the control group.Patients in the trea- ted group were treated with GXT one capsule every day for 90 consecutive days before surgical operation,while those in the control group were treated with surgery alone.Serum levels of reproductive hormones were determined in the follicular phase before medication and one day before operation by RIA,and colored Doppler ultrasound ex- amination was conducted for measuring the size of uterus and myoma.Moreover the protein expressions of ER and PR in tumor and uterine muscular tissues were detected by immunohistochemistry assay with streptomycin avidin-bi- otin peroxidase complex method.Results In the treated group after medication,the serum level of estradiol was (167.0±85.9)pmol/L,progesterone(1.9±1.0)nmol/L,follicle-stimulating hormone(10.4±2.1)IU/L, and luteinizing(12.0±9.8)IU/L,all reached the levels of early follicular phase,with the maximal size of myoma significantly decreased from(380.4±21.0)cm~3 to(162.3±14.8)cm~3(P<0.01);and the ER and PR expres- sions in tumor tissue were significantly lower than those in the control group respectively(P<0.01).Conclusion Expressions of ER and PR in hysteromyoma tissue could be significantly reduced by medication of GXT,which leads to significant shrinkage of tumor size and improvement of clinical symptoms.

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