米非司酮联合消瘤方对子宫肌瘤气滞血瘀证患者血液流变学及GPR30-EGFR信号通路的影响

Effects of Mifepristone combined with Xiaoliu Prescription on hemorheology and GPR30-EGFR signaling pathway in uterine fibroid patients with syndrome of qi stagnation and blood stasis

目的探讨米非司酮联合消瘤方对肌壁间子宫肌瘤气滞血瘀证患者临床疗效、血液流变学及GPR30-EGFR信号通路的影响。方法选取云南中医药大学第一附属医院2021年12月至2022年3月收治的80例肌壁间子宫肌瘤气滞血瘀证患者,按照随机数字表法将其分为对照组(40例)和试验组(40例)。对照组采用米非司酮治疗,试验组采用米非司酮联合消瘤方治疗,两组疗程均为3个月(经期停药)。比较两组临床疗效及治疗前后的子宫体积、肌瘤面积、血流变学指标,采用实时荧光定量PCR及Western blot检测两组G蛋白偶联受体30(GPR30)、表皮生长因子受体(EGFR)的mRNA及蛋白表达水平。结果试验组脱落4例;对照组脱落5例,剔除1例。试验组临床疗效优于对照组(P<0.05)。治疗后,两组子宫体积、肌瘤面积、血浆黏度均低于治疗前,且试验组低于对照组(P<0.05)。治疗后,试验组全血黏度高、低切值均低于本组治疗前和对照组(P<0.05)。治疗后,试验组GPR30、EGFR mRNA及蛋白表达水平均低于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。治疗期间两组均未见肝、肾功能的异常改变。结论米非司酮联合消瘤方能够有效治疗肌壁间子宫肌瘤,缩小子宫体积及子宫肌瘤面积,改善血液流变学指标,降低GPR30、EGFR表达,且安全性高。

Objective To investigate the effects of Mifepristone combined with Xiaoliu Prescription on clinical efficacy,hemorheology,and GPR30-EGFR signaling pathway in intermyowall uterine fibroids patients with syndrome of qi stagnation and blood stasis.Methods Eighty intermyowall uterine fibroids patients with syndrome of qi stagnation and blood stasis admitted to the First Affiliated Hospital of Yunnan University of Chinese Medicine from December 2021 to March 2022 were selected and divided into control group(40 cases)and experimental group(40 cases)according to random number table method.The control group was treated with Mifepristone,and the experimental group was treated with Mifepristone combined with Xiaoliu Prescription.The treatment course of both groups was three months(withdrawal of the drug during menstrual period).The clinical efficacy and uterine volume,fibroid area,hemorheology indexes before and after treatment were compared between the two groups.Real-time quantitative PCR and Western blot were used to detect the mRNA and protein expression levels of G-protein-coupled receptor 30(GPR30)and epidermal growth factor receptor(EGFR)in two groups.Results Four cases fell off in the experimental group.In the control group,five cases were shed and one case was eliminated.The clinical effect of experimental group was better than that of control group(P<0.05).After treatment,uterine volume,fibroid area,and plasma viscosity in two groups were lower than those before treatment,and experimental group was lower than control group(P<0.05).After treatment,the whole blood high and low shear viscosity values of experimental group were lower than those of experimental group before treatment and control group (P<0.05). After treatment, the mRNA and protein expression levels of GPR30 and EGFR in experimental group were lower than those in control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). No abnormal changes of liver and kidney function were observed in both groups during treatment. Conclusion Mifepristone combined with Xiaoliu Prescription can effectively treat intermyowall uterine fibroids, reduce uterine volume and uterine fibroid area, improve hemorheology indexes, reduce GPR30 and EGFR expression, with high safety.