加味平積湯對子宮肌瘤患者雌激素受體基因α單核苷酸多態(tài)性不同分型影響的臨床研究
發(fā)布時間：2018-08-12 15:54
【摘要】：目的：觀察子宮肌瘤患者外周血ERα基因rs9340799位點的分型(AA/AG型)。評估加味平積湯對子宮肌瘤患者外周血ER α基因rs9340799位點的分型(AA/AG型)的臨床療效。探討子宮肌瘤的發(fā)生發(fā)展與ER α基因rs9340799位點的分型(AA/AG型)相關(guān)性。探索加味平積湯治療子宮肌瘤的特色和優(yōu)勢,為子宮肌瘤的中醫(yī)藥防治方法和藥物的研究提供一些參考,評估加味平積湯對ER α基因特定位點不同基因分型的有效率,從而更好的指導(dǎo)臨床的治療。 方法：選擇符合納入標準的子宮肌瘤患者60例,用加味平積湯分別治療純合(AA)組30例、雜合(AG)組30例,在非經(jīng)期服藥,療程為3個月,于療程結(jié)束后,統(tǒng)計分析治療前后中醫(yī)證候評分及子宮肌瘤體積的變化。 結(jié)果：1.中醫(yī)證候積分改善情況：AA組與AG組肌瘤患者的臨床癥狀都得以改善(P0.05),治療后兩組中醫(yī)證候積分均有降低,且AA組優(yōu)于AG組,差異有統(tǒng)計學(xué)意義(P0.05)。2.子宮體積及肌瘤大小、積分改善情況：兩組治療后子宮體積、肌瘤面積、肌瘤積分差異無統(tǒng)計學(xué)意義(P0.05)。兩組的子宮體積及肌瘤面積治療前后比較差異均有統(tǒng)計學(xué)意義(P0.05)。AA組肌瘤積分治療前后差異有統(tǒng)計學(xué)意義(P0.05),AG組肌瘤積分治療前后差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)合均值可知,加味平積湯對AA組縮小子宮體積、縮瘤及降低肌瘤積分效果要優(yōu)于AG組。3..療效比較：AA組與AG組中醫(yī)證候療效分別是73.3%與33.3%；兩組治療后肌瘤療效分別是33.3%和10%;綜合療效分別是80%與40%�？芍�,AA組可明顯改善臨床癥狀,對縮小肌瘤面積有一定的作用,效果較AG組顯著；AA組綜合療效明顯優(yōu)于AG組。 結(jié)論：加味平積湯可明顯改善臨床癥狀,同時中藥的扶正化瘀、清利散結(jié)的作用,祛邪而不傷正,在一定程度上抑制和延緩了肌瘤的發(fā)展,這一點是經(jīng)過臨床驗證的。通過基因篩查,在基因藥物未成熟之前,通過中醫(yī)藥則能更好的對子宮肌瘤患者進行個體化治療,減輕患者的經(jīng)濟負擔,著實很有意義。
[Abstract]:Objective: to observe the typing of ER 偽 gene rs9340799 locus (AA/AG type) in peripheral blood of patients with uterine leiomyoma. To evaluate the clinical effect of Jiawei Pingji decoction on the classification of ER 偽 gene rs9340799 locus (AA/AG type) in peripheral blood of patients with uterine leiomyoma. To investigate the relationship between the occurrence and development of uterine leiomyoma and the type of ER 偽 gene rs9340799 (AA/AG type). To explore the characteristics and advantages of Jiawei Pingji decoction in the treatment of uterine leiomyoma, to provide some references for the prevention and treatment of uterine leiomyoma with traditional Chinese medicine, and to evaluate the effective rate of Jiawei Pingji decoction for different genotyping of ER 偽 gene. So as to better guide the clinical treatment. Methods: sixty patients with uterine leiomyoma who met the inclusive criteria were treated with Jiawei Pingji decoction for 30 cases in pure (AA) group and 30 cases in heterozygous (AG) group. The course of treatment was 3 months after the end of the course of treatment. The changes of TCM syndrome score and uterine myoma volume before and after treatment were statistically analyzed. The result is 1: 1. The improvement of TCM syndromes score was improved in group A and AG (P0.05). After treatment, the score of TCM syndromes in group AA was lower than that in group AG, and the difference was statistically significant (P0.05). Uterine volume and myoma size, integral improvement: there was no significant difference in uterine volume, myoma area and myoma score between the two groups after treatment (P0.05). There were significant differences in uterine volume and myoma area between the two groups before and after treatment (P0.05). There was significant difference before and after treatment in AA group (P0.05). There was no significant difference between AG group and AG group before and after treatment (P0.05). Combined with the mean value, the effect of Jiawei Pingji decoction on reducing uterine volume, shrinking tumor and reducing integral of myoma in AA group was better than that in AG group. The curative effects were 73.3% and 33.33.3% in group A and group AG, 33.3% and 10.1% in group A and group AG, respectively, and 80% and 40% in group A and group AG, respectively. It can be seen that the group A can obviously improve the clinical symptoms and has a certain effect on reducing the area of leiomyoma, and the comprehensive effect of AA group is significantly better than that of AG group. Conclusion: Jiawei Pingji decoction can obviously improve the clinical symptoms, and at the same time, the effect of traditional Chinese medicine on strengthening and removing stasis and clearing away the interests and dispersing the knot, dispelling evil but not harming the right, to a certain extent, inhibits and delays the development of myoma, which has been proved by clinical practice. Through gene screening, before gene medicine is mature, Chinese medicine can better individual treatment for patients with uterine leiomyoma, reduce the economic burden of patients, it is very meaningful.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33
本文編號：2179539
[Abstract]:Objective: to observe the typing of ER 偽 gene rs9340799 locus (AA/AG type) in peripheral blood of patients with uterine leiomyoma. To evaluate the clinical effect of Jiawei Pingji decoction on the classification of ER 偽 gene rs9340799 locus (AA/AG type) in peripheral blood of patients with uterine leiomyoma. To investigate the relationship between the occurrence and development of uterine leiomyoma and the type of ER 偽 gene rs9340799 (AA/AG type). To explore the characteristics and advantages of Jiawei Pingji decoction in the treatment of uterine leiomyoma, to provide some references for the prevention and treatment of uterine leiomyoma with traditional Chinese medicine, and to evaluate the effective rate of Jiawei Pingji decoction for different genotyping of ER 偽 gene. So as to better guide the clinical treatment. Methods: sixty patients with uterine leiomyoma who met the inclusive criteria were treated with Jiawei Pingji decoction for 30 cases in pure (AA) group and 30 cases in heterozygous (AG) group. The course of treatment was 3 months after the end of the course of treatment. The changes of TCM syndrome score and uterine myoma volume before and after treatment were statistically analyzed. The result is 1: 1. The improvement of TCM syndromes score was improved in group A and AG (P0.05). After treatment, the score of TCM syndromes in group AA was lower than that in group AG, and the difference was statistically significant (P0.05). Uterine volume and myoma size, integral improvement: there was no significant difference in uterine volume, myoma area and myoma score between the two groups after treatment (P0.05). There were significant differences in uterine volume and myoma area between the two groups before and after treatment (P0.05). There was significant difference before and after treatment in AA group (P0.05). There was no significant difference between AG group and AG group before and after treatment (P0.05). Combined with the mean value, the effect of Jiawei Pingji decoction on reducing uterine volume, shrinking tumor and reducing integral of myoma in AA group was better than that in AG group. The curative effects were 73.3% and 33.33.3% in group A and group AG, 33.3% and 10.1% in group A and group AG, respectively, and 80% and 40% in group A and group AG, respectively. It can be seen that the group A can obviously improve the clinical symptoms and has a certain effect on reducing the area of leiomyoma, and the comprehensive effect of AA group is significantly better than that of AG group. Conclusion: Jiawei Pingji decoction can obviously improve the clinical symptoms, and at the same time, the effect of traditional Chinese medicine on strengthening and removing stasis and clearing away the interests and dispersing the knot, dispelling evil but not harming the right, to a certain extent, inhibits and delays the development of myoma, which has been proved by clinical practice. Through gene screening, before gene medicine is mature, Chinese medicine can better individual treatment for patients with uterine leiomyoma, reduce the economic burden of patients, it is very meaningful.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.33
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