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雷公藤多甙治疗子宫肌瘤的临床研究 |
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高玉平 陈德甫
【摘要】 目的 观察雷公藤多甙治疗子宫肌瘤的疗效及副作用。方法 随机将患者分为两组，实验组服用雷公藤多甙40 mg/d治疗3～6个月，对照组服用米非司酮25 mg/d治疗3个月。治疗前后均用B超测量子宫及其肌瘤大小，用放射免疫法(RIA)测血清促卵泡素(FSH)、促黄体生成素(LH)、垂体催乳素(PRL)、雌二醇(E2)、孕酮(P)和睾酮(T)水平。结果 实验组患者子宫肌瘤于服药3～4个月时缩小(27.84±3.69)%，5～6个月时缩小(51.60±3.92)%，呈时间依赖关系。治疗3～4个月后60.0%患者治疗有效，而治疗达5～6个月的40例患者中70.0%治疗有效。治疗后3～4个月和5～6个月后，分别与治疗前比较,外周血E2、P水平明显下降(P<0.01,P<0.05）；FSH和LH水平明显上升（P均<0.01)；T和PRL治疗前后无明显变化（P均>0.05）。上述性激素水平在停药后1～3个月内均恢复正常。实验组患者服药期间出现轻微胃部不适,均能自行缓解。结论 雷公藤多甙40 mg/d的剂量，治疗子宫肌瘤有效，且副作用不明显。雷公藤多甙对性腺轴有可逆性的抑制作用，可能是其治疗子宫肌瘤的主要机理之一。
【关键词】 子宫肿瘤； 平滑肌瘤； 雷公藤； 米非司酮；性腺
Clinical Study on Effect of Tripterygium Wilfordii Hook. f. on Uterin Leiomyoma
GAO Yuping, CHEN Defu.
（Department of Pathology, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China）
【Abstract】 Objective To observe the therapeutic effect of Tripterygium wilfordii Hook. f. on patients with uterine leiomyoma. Methods Baseline ultrasound examinations of myomas and uterine were obtained and repeated three months, six months after treatment. Blood samples were collected in the mid-follicular or mid-luteal phase of the menstrual cycle before initiation of Tripterygium wilfordii Hook. f. therapy and after treatment 3～4 months and 5～6 months, for determination of estradiol, progesteron, testosterone, follicle-stimulating hormone, luteinizing hormone and prolactin by radioimmunoassay. Results Significant decrease in leiomyoma volume was detected in 39 of 65 (60.0%) patients after 3～4 months of Tripterygium wilfordii Hook. f. treatment and 28 of 40 (70.0%) patients after 5～6 months of treatment. The decrease in leiomyoma volume with Tripterygium wilfordii Hook.f. treatment was time-dependent while 27.84% in 3～4 months, 51.6% in 5～6 months. 25 of 65 patients were amenorrheic during the course of treatment. Compared with pretreatment values, Tripterygium wilfordii Hook.f.treatment induced an increase in mean [1] [2] 下一页
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