亮丙瑞林联合大黄牡丹汤治疗子宫肌瘤疗效及对患者血清MMP-9、COX-2水平影响

Efficacy of Dahuang mudan decoction combined with leuprorelin for treating patients with uterine fibroids and its impacts on the serum matrix metalloproteinase-9 and cyclooxygenase-2 levels

目的:探讨亮丙瑞林联合大黄牡丹汤治疗子宫肌瘤疗效及对患者血清基质金属蛋白酶-9(MMP-9)、环氧化酶-2(COX-2)水平的影响。方法:将2022年4月-2023年11月本院收治的106例子宫肌瘤患者,采用随机数字表法分为中西药组和西药组各53例,两组均采用亮丙瑞林治疗,中西药组同时联合应用大黄牡丹汤辅助治疗,两组治疗周期均为3个月。比较两组中医证候积分、瘤体大小、子宫体大小、雌孕激素、血清MMP-9、COX-2及血管内皮生长因子(VEGF)水平变化,评估其临床疗效及药物安全性。结果:治疗后,中西药组总有效率(90.6%)高于西药组(73.6%),两组中医证候(小腹坠痛、月经量增加、经期延长、白带异常、面色暗沉)积分、瘤体体积、子宫体积、雌孕激素、血清因子水平均低于治疗前,且中西药组上述指标降幅均大于西药组,中西药组MMP-9(1.06±0.35μg/ml)、COX-2(0.19±0.06 pg/L)低于西药组(1.38±0.46μg/ml、0.25±0.08 pg/L),不良反应发生率中西药组(3.8%)低于西药组(15.1%)(均P<0.05)。结论:亮丙瑞林联合大黄牡丹汤治疗子宫肌瘤可有效提高治疗总有效率,降低患者中医证候积分,缩小瘤体体积及子宫体积,有效控制患者雌孕激素水平,降低血清MMP-9、COX-2及VEGF水平,降低不良反应。

Objective:To explore the efficacy of Dahuang mudan decoction combined with leuprorelin for treating patients with uterine fibroids,and to study its impacts on the serum matrix metalloproteinase-9(MMP-9)and cyclooxygenase-2(COX-2)levels of the patients.Methods:From April 2022 to November 2023,106 patients with uterine fibroids were included and were randomly divided into two groups(53cases in each group)by random number table method.The patients in the two groups were given treatment of leuprorelin for 3months,and the patients in the study group received the Dahuang mudan decoction additionally.The changes of the traditional Chinese medicine syndrome scores,the uterine fibroids size,the uterine size,and the levels of estrogen,progesterone,MMP-9,COX-2 and vascular endothelial growth factor(VEGF)of the patients were compared between the two groups.The clinical efficacy and the drug safety of the patients in the two groups were assessed.Results:After treatment,the total effective rate(90.6%)of the patients in the study group was significantly higher than that(73.6%)of the patients in the control group.The scores of TCM syndromes(abdominal pain,increased menstrual volume,prolonged menstrual period,abnormal leucorrhea and dark complexion),the uterine fibroids volume,the uterine volume,and the levels of estrogen,progesterone and serum factors of the patients in the two groups after treatment were significantly lower than those before treatment,and the decreasing amplitude of which of the patients in the study group were significantly more than those of the patients in the control group.The levels of MMP-9(1.06±0.35μg/ml)and COX-2(0.19±0.06pg/L)of the patients in the study group were significantly lower than those(1.38±0.46μg/ml and 0.25±0.08pg/L)of the patients in the control group.The incidence of adverse reactions(3.8%)of the patients in the study group was significantly lower than that(15.1%)of the patients in the control group(all P<0.05).Conclusion:Dahuang mudan decoction combined with leuprorelin for treating the patients with uterine fibroids can effectively improve their total effective rate,decrease their traditional Chinese medicine syndrome scores,reduce their uterine fibroids volume and uterine volume,can effectively control the levels of estrogen and progesterone,can decrease their serum MMP-9,COX-2,and VEGF levels,and can reduce their side effect rate.