雷公藤多甙治疗子宫肌瘤的疗效

目的观察雷公藤多甙(GTw)治疗子宫肌瘤疗效和副作用及其对子宫肌瘤细胞超微结构的影响。方法雷公藤多甙40mg/d治疗子宫肌瘤患者3～6个月，治疗前后B超测量子宫及肌瘤大小，放射免疫法(RIA)测FSH、LH、PRL、E2、P和T水平。电镜观察肌瘤细胞超微结构变化。结果 60.71％的患者于治疗3～4个月后子宫肌瘤体积明显缩小，其中40例治疗5～6个月者70.00％有效。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。治疗后外周血E2、P水平明显下降(P均＜0.01)，FSH和LH水平明显上升(P均＜0.01)。T和PRL无变化(P均＞0.05)。GTW治疗后肌瘤组织中出现大量的凋亡细胞。结论雷公藤多甙40mg/d，治疗子宫肌瘤有效，副作用不明显。雷公藤多甙对性腺轴有可逆性的抑制作用，引起肌瘤细胞凋亡，可能是其治疗子宫肌瘤的主要机理之一。

The Effect of Tripterygium Wilfordii Hook. f. on Uterin Leiomyoma and Their Ultrastructure

Objective To observe the therapeutic efficacy of Tripterygium Wilfordii Hook. f. (GTW) on patients with uterine leiomyoma and the effect on ultrastructure. Methods Ultrasound examination on the myoma and uterine was preformed and repeated three months, six months after treatment. Ultrastructural studies of the leiomyomas were carried out by electron microscopy. Blood samples were collec-ted to determine the levels of E2, P, T, FSH, LH and PRL by RIA. Results Significant decrease in the volume of leiomyoma was shown in the patients after treatment. 12 cases showed no obvious ultrastructural differences from the control, but leiomyomas from treated cases showed more apoptosis cells. Compared with pretreatment values, GTW treatment cases showed an increase in mean LH, FSH levels and a decrease in mean Ea, P levels. Conclusion GTW may be an effective therapeutic agent for leiomyomas with few side effects. It showed a reversibly inhibitory effect on the ovary. GTW therapy induce cell apoptosis in leiomyoma. This may be the mechanism of GTW may to showed decrease leiomyoma.