Objective To observe the therapeutic effect and side reactions of Tripterygium wilfordii Hook,f. ( GTW) glycosides on patients with uterine leiomyomas. Methods 65 normally cycling women with symptomatic uterine leiomy...Objective To observe the therapeutic effect and side reactions of Tripterygium wilfordii Hook,f. ( GTW) glycosides on patients with uterine leiomyomas. Methods 65 normally cycling women with symptomatic uterine leiomyomas received 40mg daily dose GTW for 3 to 6 months. Baseline ultrasound tests were obtained to evaluate the sizes of myomas and uterus, then repeated three and six months after treatment. Blood samples were collected to determine the hormonal levels of in the mid-follicular and mid-luteal phases of the menstrual cycles before GTW therapy and at 3~4 months and 5~6 months after treatment. Results Significant decrease in leiomy-oma volume was shown in 39 of 65 (60% ) and 28 of 40 ( 70% ) patients after 3~4 months and 5~6 months of treatment, respectively. The decrease of the volume of leiomyoma was time-dependent as while 27. 84% and 51.60% in 3~4 months and 5 ~ 6months, respectively. 25 of 65 patients had amenorrhea during the course of treatment. Tripterygium wilfordii glycosides treatment induced a significant increase in LH and FSH levels (P < 0. 01) as compared with pretreatment values. In contrary, a significant decrease in E2 and P levels (P <0. 05) was found, but no changes were observed in T and PRL levels after treatment. Conclusion Tripterygium wilfordii might serve as an effective therapeutic agent for leiomyomas with fewer side effects. A reversible inhibitory effect on the ovary by Tripterygium wilfordii glycosides may be one of the mechanisms of Tripterygium wilfordii in decreasing leiomyoma volume.展开更多
目的:本研究旨在尽量如实概括总结雷公藤及其制剂毒性引起的不良反应事件(Adverse Drug Reaction,ADR)情况,反映影响雷公藤毒性的各因素与报道出的ADR之间可能存在的关系。方法:系统检索Pubmed、中国知网、万方数据库、维普数据库和中...目的:本研究旨在尽量如实概括总结雷公藤及其制剂毒性引起的不良反应事件(Adverse Drug Reaction,ADR)情况,反映影响雷公藤毒性的各因素与报道出的ADR之间可能存在的关系。方法:系统检索Pubmed、中国知网、万方数据库、维普数据库和中国生物医学期刊数据库等5个数据库建库至2014年2月25日的雷公藤及其制剂毒性的所有相关文献,然后对其中的随机对照试验进行系统归纳、分析和总结。结果:纳入260篇随机对照试验,13 301例患者。分组分类统计结果显示,RCT1组和RCT2组的消化系统、生殖系统等的ADR发生率不同,RCT1和RCT2组的消化系统ADR发生率(每百人)为14.73和12.26,生殖系统为8.25和8.00,肝脏为6.50和5.66,肾脏为6.79和3.03,血液系统为6.73和6.50,心血管系统为2.35和0.67,皮肤粘膜系统为11.42和4.78。RCT1组和RCT2组治疗类风湿关节炎的文献都是最多,分别占22.17%和63.16%,ADR发生率为34.18和27.26。RCT1组RA、Ig A肾病、肾炎、肾病综合征、糖尿病肾病、银屑病、藓疹和子宫肌瘤等7类疾病对应的ADR发生率的标准差为8.69,RCT2组RA、Ig A肾病、银屑病和藓疹对应的ADR发生率的标准差为7.11。结论:临床使用雷公藤及其制剂可能引起的ADR分布为:消化系统、生殖系统和肝脏的ADR发生率最高,不同疾病(如类风湿关节炎、肾炎、肾病综合征等)对应的ADR发生率差异很大。因此,建议患者在使用雷公藤及其制剂时,选择合适的雷公藤制剂,做好护胃、护肝等措施;服用过程中注意患者的反应,适可而止,最大限度的避免可能产生的ADR。展开更多
文摘Objective To observe the therapeutic effect and side reactions of Tripterygium wilfordii Hook,f. ( GTW) glycosides on patients with uterine leiomyomas. Methods 65 normally cycling women with symptomatic uterine leiomyomas received 40mg daily dose GTW for 3 to 6 months. Baseline ultrasound tests were obtained to evaluate the sizes of myomas and uterus, then repeated three and six months after treatment. Blood samples were collected to determine the hormonal levels of in the mid-follicular and mid-luteal phases of the menstrual cycles before GTW therapy and at 3~4 months and 5~6 months after treatment. Results Significant decrease in leiomy-oma volume was shown in 39 of 65 (60% ) and 28 of 40 ( 70% ) patients after 3~4 months and 5~6 months of treatment, respectively. The decrease of the volume of leiomyoma was time-dependent as while 27. 84% and 51.60% in 3~4 months and 5 ~ 6months, respectively. 25 of 65 patients had amenorrhea during the course of treatment. Tripterygium wilfordii glycosides treatment induced a significant increase in LH and FSH levels (P < 0. 01) as compared with pretreatment values. In contrary, a significant decrease in E2 and P levels (P <0. 05) was found, but no changes were observed in T and PRL levels after treatment. Conclusion Tripterygium wilfordii might serve as an effective therapeutic agent for leiomyomas with fewer side effects. A reversible inhibitory effect on the ovary by Tripterygium wilfordii glycosides may be one of the mechanisms of Tripterygium wilfordii in decreasing leiomyoma volume.
