祛瘀化痰消瘤汤联合亮丙瑞林治疗子宫肌瘤疗效及微血管密度、组织中表皮生长因子受体、雌孕激素受体表达

Efficacy of Quyu huatan xiaoliu decoction combined with leuprolide for treating patients with uterine fibroids and its effects on the microvessel density and the expressions of epidermal growth factor receptor, estrogen receptor, progesterone receptor in endometrial tissue of the patients

目的:探讨祛瘀化痰消瘤汤联合亮丙瑞林治疗子宫肌瘤疗效及对微血管密度、组织中表皮生长因子受体(EGFR)、雌激素受体(ER)、孕激素受体(PR)表达的影响。方法:选取2019年10月-2022年2月本院收治的子宫肌瘤患者86例,随机数字表法分为联合组、西医组各43例。两组均给予亮丙瑞林,联合组联用祛瘀化痰消瘤汤,均治疗3个月,比较两组治疗前后中医证候积分、子宫肌瘤体积、子宫体积、性激素指标[雌二醇(E_(2))、孕酮(P)、黄体生成素(LH)、卵泡刺激素(FSH)]水平、微血管密度、子宫内膜组织中EGFR、ER、PR表达,比较两组疗效及不良反应情况。结果:治疗后联合组中医证候积分(6.38±1.25分)、子宫肌瘤体积(6.24±1.06 cm^(3))、子宫体积(95.74±10.17 cm^(3))均低于西医组(9.26±1.67分、9.02±1.32 cm^(3)、106.25±13.08 cm^(3)),血清E_(2)(151.14±16.05 pmol/L)、P(12.47±1.86μg/L)、LH(11.06±2.57 U/L)、FSH(12.84±1.95 U/L)低于西医组(182.69±18.28 pmol/L、17.04±2.09μg/L、14.82±2.73 U/L、16.18±2.06 U/L),微血管密度(26.1±3.1条)、子宫内膜组织中EGFR(16.3%)、ER(30.2%)、PR(30.2%)阳性表达率均低于西医组(30.3±3.3、37.2%、53.5%、51.2%),治疗总有效率(90.7%)高于西医组(69.8%)(均P<0.05):治疗期间不良反应发生率(7.0%)与西医组(11.9%)无差异(P>0.05)。结论:应用祛瘀化痰消瘤汤联合亮丙瑞林治疗子宫肌瘤可进一步调节患者性激素水平,降低微血管密度与组织中EGFR、ER、PR表达,进而促进病灶消退,改善临床症状,安全有效。

Objective:To investigate the efficacy of Quyu huatan xiaoliu decoction combined with leuprolide for treating patients with uterine fibroids,and tostudy its effects on the microvessel density and the expressions of epidermal growth factor receptor(EGFR),estrogen receptor(ER),progesterone receptor(PR)in endometrial tissue of the patients.Methods:A total of 86 patients with uterine fibroids were selected and were divided into group A and group B(43 cases in each group)by random number table method from October 2019 to February 2022.The patients in group B were given leuprolide for 3 months,and the patients in group A were given Quyu huatan xiaoliu decoction combined with leuprolide for 3 months.The TCM syndrome scores,the uterine fibroids volume,the uterine volume,and the levels of sex hormone indexes,such as estradiol(E_(2)),progesterone(P),luteinizing hormone(LH),and follicle stimulating hormone(FSH)before and after treatment,the microvessel density,the levels of EGFR,ER,PR expression in endometrial tissue,the curative effect,and the adverse reactions of the patients were compared between the two groups.Results:After treatment,the TCM syndrome score(6.38±1.25 points),the uterine fibroid volume(6.24±1.06 cm^(3)),and the uterine volume(95.74±10.17 cm^(3))of the patients in group A were significantly lower than those(9.26±1.67 pints,9.02±1.32 cm^(3),and 106.25±13.08 cm^(3))of the patients in group B.The levels of serum E2(151.14±16.05 pmol/L),P(12.47±1.86μg/L),LH(11.06±2.57 U/L),and FSH(12.84±1.95 U/L)of the patients in group A were significantly lower than those(182.69±18.28 pmol/L,17.04±2.09μg/L,14.82±2.73 U/L,and 16.18±2.06 U/L)of the patients in group B.The microvessel density(26.1±3.1),the positive expression rates of EGFR(16.3%),ER(30.2%),and PR(30.2%)in endometrial tissues of the patients in group A were significantly lower than those(30.3±3.3,37.2%,53.5%,and 51.2%)of the patients in group B.The total effective rate(90.7%)of the patients in group A was significantly higher than that(69.8%)of the patients in group B(all P<0.05).There was no significant difference in the incidence of adverse reactions(7.0%vs.11.9%)of the patients between the two groups(P>0.05).Conclusion:The application of Quyu huatan xiaoliu decoction combined with leuprolide for treating the patients with uterine fibroids can regulate the their level of sex hormones,reduce their microvessel density and the expressions of EGFR,ER and PR in the endometrial tissue,thereby promoting the regression of the lesions and improving the clinical symptoms,which is safe and effective.