Clinical Research Of ERα,ERβ,P450arom Of Ju Li San Jie Bolus On Treating Hysteromyoma

Objective:Julisanjie bolus is created by the late well-known national gynecological experts Professor Luo Yuankai and its main drug composition is Juhe,,li zhi nuclear,renewal broken,small fennel,Lindera aggregata, Chuan Lianzi,algae,Ezhu,the system Shouwu,KongNim-kan,dangshen,the Health and oysters,wind SU carcasses,motherwort,and so on.A line of gas Huoxue Po Yu Xiao,Ruan jian san jie and other effects,mainly for Qizhixueyu or phlegm and blood stasis among guitar certification benign uterine fibroids and ovarian tumors.Nearly 20 years of clinical practice shows that Julisanjie bolus treatment of uterine fibroids significant effect.Preliminary studies on the mechanism of the treatment of a few and found that Julisanjie bolus in reducing fibroids volume,improve symptoms of patients at the same time improve the level of NK cells,lower uterine fibroids organizations and muscular organizations ER,PR and the PRmRNA Level.However,the exact incidence of uterine fibroids cause and the mechanism is unclear,but it is an estrogen-dependent tumors has been recognized.Research shows that estrogen synthesis of the final step in the speed of P450arom leiomyoma cells in the uterine fibroids so that over-expression in the androgen(testosterone, Androstenedione)to estrogen(estradiol,estrone)transformation.Local organizations so that high estrogen levels and high estrogen may stimulate the fibroids and development.At the same time estrogen must be combined with estrogen receptor can play its biological effects,in 1996 before people have always been thought that only one estrogen receptor,1993 reported a successful ERαknockout strain of mice.In this mice found that some organizations are still specific estrogen combination of features,there is still a second estrogen receptor.1996 first isolated from cDNA cloning of typeⅡestrogen receptor,it will be "classic" of the estrogen receptor called ERα,would later found the estrogen receptor called ERβ.Some scholars have found that uterine fibroids normal myometrium organizations and organizations both ERα,ERβexpression and ERαexpression was significantly higher than ERβexpression of fibroids in ERαlevel was significantly higher than the surrounding normal myometrium,and ERβin leiomyoma The expression is higher than the surrounding normal myometrium,the current domestic and foreign research results in inconsistency.Based on the above causes of pathology, from estrogen receptorα,βand two subtypes of aromatase cytochrome P450arom two areas to explore Julisanjie bolus for the mechanism.Methods:Select January 2007 to March 2008 to the Guangzhou University of Traditional Chinese Medicine hospital the first leg of the final pathology confirmed by surgery for uterine fibroids patients,in line with standards and exclusion criteria included the 40 cases of patients with uterine fibroids. Observation of the out-patient treatment Julisanjie bolus taking a pill course of treatment(three months)and require surgical operation indications were 20 cases for the treatment group had not taken any drugs for 20 patients admitted to hospital for surgery control group.The treatment group,aged 30 to 52-year-old,the average(40.75±7.00)years;course of a month to eight years,the average(2.17±1.0);fibroids average volume(31.69±11.04) cm3;control group aged 29 to 51 years old,Average(37.9±6.37)years; course of two months to five years,the average(2.15±0.96);fibroids average volume(26.62±5.80)cm3;two groups of patients in age,disease,the average size of fibroids,and other aspects,There was no significant difference (P＞0.05),are comparable.Both groups were in operation before the first period 2-7 days using ELISA test two weeks in patients with intravenous serum E2,P,T content,but also treatment,detection aloof weeks before intravenous serum E2,P,T content.Comparison of serum Sex hormone treatment before and after the change after both groups and organizations around the tumor from normal myometrium organizations reserved for specimens,by immunohistochemistry of the samples detected the ERα,ERβand P450arom level.Result:The two groups in age,disease,the treatment group before treatment and control groups,such as fibroids in volume.There was no significant difference comparable treatment before and after treatment serum sex hormone, the difference was not significant(P＞0.05);treatment Before and after treatment compared with fibroids volume was significant(P＜0.05);treatment and control groups,organizations and uterine fibroids muscle tissue ERαexpression was significantly higher than ERβ;There is no significant difference of sex hormones in serum between treated group and control group(P＞0.05);Before and after the fibroid treatment,a significant volume compared;Whether the treatment group or control group,whether it is muscular uterine fibroids organizations or organizations ERαexpression was significantly higher than ERβ;ERα,β,P450arom level of tumor tissue is higher than muscle tissue(P＜0.05),ERα,β,P450arom level in control group is markedly higher than treated group(P＜0.05).The treatment group myometrium ERαsignificantly lower than the control group myometrium organizations ERβ,P450arom comparison was not significant Treatment and control groups, organizations and uterine fibroids muscle tissue ERαexpression was significantly higher than ERβ;treatment and control groups in leiomyoma ERα,β,P450arom water higher than the average muscle organization(P＜0.01);and The treatment group leiomyoma ERα,β,P450arom was significantly lower than the treatment group(P＜0.05);treatment group myometrium ERαsignificantly lower than the control group myometrium organizations(P＜0.05)and ERβ,P450arom comparison was not significant (P＞0.05).It is also found that Julisanjie bolus can significantly improve menorrhagia,microgastropods pain or tingling accompanied by symptoms.Conclusion:(1)This study once again proves that Julisanjie bolus can significantly reduce the volume fibroids,and it can reduce the amount of menstruation,shortening and other menstrual symptoms improve.(2)This study show that patients with uterine fibroids to reduce the tumor in the ERα,β,P450arom level and myometrium ERαlevel may be Julisanjie bolus treatment of uterine fibroids one of the main mechanism.It is also found that patients with their sex hormones had no effect.As the incidence of uterine fibroids development process is very complicated,Julisanjie bolus is also through other mechanisms of uterine fibroids to be studied further.