Comparative Study on the Efficacy of Yiweining (异位宁) and Gestrinone for Post-operational Treatment of Stage Ⅲ Endometriosis

Objective： To observe the clinical efficacy and safety of Yiweining （异位宁, YWN） and gestrinone （GT） in treating post-operational patients of stage Ⅲ endometriosis （EM-Ⅲ）. Methods： Fifty-two patients of EM-Ⅲ after operation were randomly assigned into three groups, the YWN group （20 patients） was treated through oral intake of YWN 200 ml, twice a day; the GT group （19 patients） treated with gestrinone 2.5 mg, twice every week, with the medication starting from the 7th post-operational day and lasting for 6 months. The control group （13 patients） was untreated. Six months was one therapeutic course, and follow-up study was carried out in the 6-30 months after the end of the medication. Results： The recurrence rate in the YWN group and the GT group were 5.0% and 5.3% respectively, showing insignificant difference between the two groups, but they were lower than that in the control group （30.7%, P〈0.05）. Besides, the adverse reaction rate in the YWN group was lower than that in the GT group （ 10.0% vs 31.6%, P〈 0.05）. Conclusion： Application of YWN to prevent the post-operational recurrence of endometriosis is effective and safe, and its efficacy is similar to that of GT.

Effect of Yikun Neiyi Wan on the Expression of Aromatase P450,COX-2,and ER Related Receptor in Endometrial Cells in Vitro from Patients with Endometriosis

To investigate the effect of Yikun Neiyi Wan （益坤内异丸YKNYW） and gestrinone on the expression of aromatase P450 （P450arom）, cyclo-oxygenase-2 （COX-2） and estrogen receptor （ER） in isolated ectopic and normal endometriat stroma cells in vitro. Methods： Digestion and serial filtration were used to isolate and culture the ectopic and eutopic endometrial cells from patients with chocolate cyst in virto Transformation of the cell morphology was observed in a inverted microscope. The effect of YKNYW on the expression of aromatase P450, cyclo-oxygenase-2, estrogen receptor in cultured endometriosis cells were detected by immunohistochemical method. Results： The expression levels of P450arom, COX-2 in glandular epithelium cells in vitro were decreased significantly by YKNYW compared with gestrinone （P〈0.05）. ER expression in mesenchymal cells of endometriosis was increased by YKNYW in the large and medium dosage groups compared with gestrinone. Conclusion： The mechanism by which YKNYW alleviates endometriosis pain is possibly related to the decrease in ectopic endometrial P450 arom and COX-2 expression in glandular epithelium, contrary to gestrinone, and the increase in ER expression in mesenchymalis, consistent with gestrione in patients with endometriosis.