Clinical Observation Of Guizhi Fuling Pills In The Treatment Of Uterine Fibroids And Its Effect On MiR-214 Gene Expression

Objective1.To explore the clinical efficacy of Modified Guizhi Fuling Pills in the treatment of uterine fibroids,and to provide a more objective basis for the treatment of uterine fibroids with traditional Chinese medicine.2.To verify the expression of mi R-214 and its downstream signaling molecules PIK3R1 and AKT3 through the effect of Modified Guizhi Fuling Pills,and to study the molecular mechanism of the drug for uterine fibroids by providing laboratory basis for medical treatment of uterine fibroids.MethodsChoose from gynecological outpatient clinics of Guang'anmen Hospital of China Academy of Chinese Medical Sciences from September 2016 to December 2018.Patients with uterine fibroids who have been diagnosed by gynecological examination and ultrasound or nuclear magnetic resonance,which meet the inclusion and exclusion criteria,according to intrauterine ultrasound uterine fibroids.The maximum value of the three-dimensional diameter line(multiple fibroids,whichever is the largest)was divided into small fibroid group(0<diameter<2.5cm),medium fibroid group(2.5?diameter<5cm),large fibroid group(diameter ?5cm).All three groups of patients were given Chinese medicine Modified Guizhi Fuling Pill for 3 months.Comparing the volume of fibroid before and after treatment,the monthly growth volume of fibroid,menstrual status,menstrual and non-menstrual symptoms,liver function;according to the principle of voluntary patients,the size of uterus and uterine fibroid after 8 treatments were smaller than those before treatment.Tumor patients were treated as the treatment group,and 10 healthy women were in the normal group.The expression of mi R-214 and its regulated downstream PIK3R1 and AKT genes were detected by RT-PCR.The results were statistically analyzed.Results1.A total of 100 patients were included in this study,and 96 cases were completed,including 44 cases in the small fibroid group,42 cases in the medium fibroid group,and 10 cases in the large fibroid group.2.Compared with before treatment,the monthly growth volume of 96 patients with fibroid was significantly reduced(P <0.01),and the volume of fibroid was reduced(P <0.05).Among them,the fibroid volume and the monthly growth of fibroid in the small fibroid group volumes were all reduced(P <0.01);the monthly growth volume of fibroid was significantly reduced(P <0.01),and the volume of fibroid decreased,but there was no significant difference(P> 0.05);The fibroid volume and the monthly growth volume of fibroid in the large fibroid group decreased,but there was no significant difference(P> 0.05).3.Before treatment,the monthly growth volume of the fibroid in the small and medium fibroid groups was significantly larger than that of the large fibroid group(P <0.05),but there was no significant difference between the two groups(P> 0.05).After treatment,there was no significant difference in the volume of fibroid growth between the three groups(P> 0.05).4.Statistical analysis was performed on the menstrual symptoms of 96 patients with fibroids,including menstrual flow,menstrual blockiness,menstrual symptoms such as dysmenorrhea,cold in the lower abdomen,and premenstrual breast swelling,and calculated the existence rate of the symptoms.Presence rates were significantly lower than before treatment(P <0.01);among them,the existence rate of all symptoms in the small fibroid group and medium fibroid group was significantly lower than before treatment(P <0.05);the large fibroid group had more menstrual symptoms The presence rate was significantly reduced(P <0.05),and the remaining symptoms were reduced,but there was no significant difference(P> 0.05).5.Analysis of the existence rates of 7 common symptoms of non-menstrual periods,such as chills,cold limbs,fatigue,hot hands and feet,dry mouth,bloating,uncomfortableness,irritability and irritability,etc.The results show that the prevalence of all symptoms in 96 patients after treatment All were lower than before treatment(P <0.01);among them,the prevalence of all symptoms in the small fibroid group was lower than before treatment(P<0.05).Except for the hand and foot heart heat in the medium fibroid group,the hand and foot heart were removed in the large fibroid group.In addition to heat and irritability,the presence of other symptoms was also significantly reduced(P <0.05).6.RT-PCR results showed that compared with normal,the expression of mi R-214 in uterine fibroids patients was up-regulated(2-??Ct> 1),and the expression of it after treatment was down-regulated(2-?? Ct> 1),which was consistent with the previous gene chip studies.Compared with normal,the expression of PIK3R1 and AKT3 in uterine fibroids patients was in an up-regulated tendency(2-??Ct<1).The expression of them atfer trentment were significantly down-regulated(2-??Ct> 1).Conclusion1.Modified Guizhi Fuling Pill can effectively reduce the volume of small fibroids and slow down the growth of medium and large fibroids.At the same time,it can improve the menstrual situation and clinical symptoms of patients.2.Modified Guizhi Fuling Pill can down-regulate the expression of mi R-214,which is consistent with the results of previous research;mi R-214-PI3K-AKT pathway may be one of the ways to block the growth of fibroids.