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Objective To investigate the efficacy of high-intensity focused ultrasound(HIFU) ablation combined with gestrinone for treating adenomyosis.Methods Sixty patients with adenomyosis were divided into the HIFU group(n=30) and HIFU combined medication group(n =30).The change of dysmenorrheal,menstrual volume,volumes of uterus and lesion in the two group were compared between before and after treatment.Results The menstrual volume and dysmenorrhea scores at 6,12 months after treatment showed a statistical difference between the two groups(P＜0.05);the volumes of and adenomyotic lesion and uterus after treatment in the combined medication group were lower than those in the HIFU group,but the difference was not statistically significant(P＞0.05).The hemoglobin level after 6-month treatment had statistical difference between the combined medication group and HIFU group(P＜0.05).During the follow-up period,there were 5 cases of pregnancy without recurrence cases in the combine medication group,8 cases had slight abnormality in the liver function transaminase and recovered to normal in re-examination at 1 month after drug withdrawal;1 case had pregnancy and 4 cases had recurrence in the HIFU group.Conclusion HIFU ablation combined with gestrinone can effectively alleviate the clinical symptoms in the patients with adenomyosis.
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Objective To investigate the clinical effect of laparoscopic ovarian surgery combined with gestrinone in the treatment of ovarian cysts and its effect on FSH, LH and E2, for the clinical diagnosis and treatment to provide reference. Methods 60 cases of ovarian cysts from June 2014 to June 2016 in our hospital were selected and randomly divided into control group and treatment group with 30 cases in each group. The treatment group was treated with laparoscopic ovariectomy with gestrinone, two group of patients were treated for 6 months as a course of treatment. FSH, LH and E2 were detected by radioimmunoassay, the number of antral follicles was measured under transvaginal ultrasonography. Results The total effective rate of the treatment group (80%) was significantly higher than that of the control group (40%), the difference was statistically significant (P<0.05), the treatment group and control group after oral administration of gestrinone FSH, LH and E2 levels and the number of antral follicles decreased, however, after oral administration of gestrinone FSH, LH levels and the number of antral follicles were compared with those of the control group, the differences were not statistically significant,E2 levels were compared with those before and after treatment, the difference was statistically significant (P<0.05) There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Laparoscopic ovariectomy combined with gestrinone treatment of ovarian cysts has significant curative effect, little side effect, safe and reliable, and high cost performance. And the ovarian function has a greater improvement, this method has clinical research value.
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OBJECTIVE:To investigate therapeutic efficacy and safety of Acetic acid goserelin sustained-release implants (AGRI) in the treatment of ovary endometrium cyst (OEC) recurrence after laparoscopic enuleation of ovarian cyst. METHODS:Totally of 60 patients with OEC recurrence after laparoscopic enuleation of ovarian cyst in Zhangjiagang First People's Hospital dur-ing Jan. 2013-Jan. 2015 were divided into control group and observation group according to random number table,with 30 cases in each group. Both groups were given Mifepristone tablets orally 25 mg,qd. Control group was given Gestrinone capsules orally 2.5 mg,twice a week. Observation group was given AGRI subcutaneously 3.6 mg,once a month. Both groups were treated for consec-utive 6 months. Clinical efficacies of 2 groups were observed as well as the levels of serum follicle stimulating hormone(FSH),lu-teinizing hormone(LH)and estradiol(E2),VAS scores of dysmenorrheal and chronic pelvic pain before treatment,3,6 months af-ter treatment. The occurrence of ADR and the prognosis of 12-month follow-up were observed in 2 groups. RESULTS:Total re-sponse rate of observation group was 86.67%,which was significantly higher than 70.00%of control group,with statistical signifi-cance(P0.05);after 6 months of treatment,the levels of FSH,LH and E2 in 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P0.05). The recovery rate of men-struation in observation group was 86.67%,the rate of dominant follicle formation was 60.00% and pregnancy rate was 53.33%, which were significantly higher than 46.67%,46.67% and 33.33% of control group,with statistical significance(P<0.05). CON-CLUSIONS:AGRI shows significant therapeutic efficacy for OEC recurrence after laparoscopic enuleation of ovarian cyst,can ef-fectively relieve dysmenorrhea and chronic pelvic pain,increase the rate of pregnancy. There is still recurrent cases after drug with-drawal. The incidence of ADR is high,but the symptoms are mild.
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Objective To compare the clinical effect between gestrinone and levonorgestrel intrauterine system in the treatment of patients with endometrial polyps after transcervical resection of polyp (TCRP).Methods A total of 225 endometrial polyps patients underwent TCRP were selected from January 2014 to January 2017 in Zhengzhou Central Hospital.The patients were divided into group A,B and C according to the postoperative treatment,75 cases in each group.The patients in group A were treated with gestrinone from the fifth day after operation.The patients in the group B were treated with levonorgestrel intrauterine system at the 3-5 days of the first menstruation after operation.The patients in group C were not given any treatment after operation.All patients were followed up for 6 months.The endometrial thickness,the recurrence of endometrial polyps and the improvement of abnormal uterine bleeding of patients in the three groups were observed.Results The recurrence rate of endometrial polyps in group A,B and C was 16.00％ (12/75),1.33％ (1/75) and 38.67％ (29/75) respectively;the improvement rate of abnormal uterine bleeding was 92.00％ (69/75),86.67％ (65/75) and 88.00％ (66/75) respectively.The recurrence rate of endometrial polyps in group A and B was significantly lower than that in group C (x2 =9.700,32.667;P ＜ 0.05),and the recurrence rate of endometrial polyps in group B was significantly lower than that in group A (x2 =10.191,P ＜ 0.05).There was no significant difference in the improvement rate of abnormal uterine bleeding among the three groups (x2 =1.170,P ＞ 0.05).There was no significant difference in endometrial thickness among the three groups before and one month after operation (P ＞ 0.05).Three months after operation,the endometrial thickness in group A and B was significantly less than that in group C (P ＜ 0.05),but there was no significant difference in endometrial thickness between group A and B (P ＞ 0.05).Six months after operation,the endometrium thickness in group B was significantly less than that in group A and C (P ＜ 0.05),but there was no significant difference in endometrial thickness between group A and C (P ＞ 0.05).Conclusion Gestrinone and levonorgestrel intrauterine system assisted TCRP for endometrial polyps can significantly reduce the recurrence rate of endometrial polyps,inhibit endometrial hyperplasia,and the effect of levonorgestrel intrauterine system is better than that of gestrinone.
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To study the effect of Tripterygium wilfordii glycosides and gestrinone on endometriosis and serum cytokine expression, 135 cases of endometriosis patients were divided into treatment group(n=69) and control group(n=68). The observation group was orally given with T. wilfordii glycosides, 20 mg, tid, for 4 weeks. Then, the dose decreased to 10 mg/time, tid. T. wilfordii glycosides combined with gestrinone capsule(2.5 mg) were given in the 1st and 4th day of a menstrual cycle. Later, the administration was fixed at two times every week. The course of treatment lasted for 3 months. The control group was treated with gestrinone capsule(according to the same intake method). The serum-related cytokine levels before and after treatment were determined, and the clinical efficacy was observed. The results showed the total effective rate of the observation group was 89.71%, which was obviously higher than that of the control group(74.63%), with statistically significant differences(P<0.05). After treatment, TDS showed varying degrees of decreases, with a better effect in the observation group (P<0.01). Before treatment, serum TGF-β, IL-10 and IL-4 level had no significant difference. After treatment, all of these cytokines decreased, particularly for the observation decreased(P<0.01). Before and after treatment, serum IL-17 had no obvious difference between the two groups. This study suggested that the integrated traditional Chinese medicine and western medicine has an obvious clinical efficiency in endometriosis. Its mechanism may be related to the effective regulation of cytokines.
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Objective To study clinical effect of laparoscopy combined with gestrinone in treatment of ovarian endometriosis cyst and the prognoisi of patients. Methods A randomized, controlled, prospective study was used in this study, 78 patients with ovarian endometriosis cyst were selected in Sichuan province panzhihua city miyi people's hospital from august 2012 to august 2014, and were randomly divided into observation group and control group, 39 patients in each group. Patients in the observation group were treated with laparoscopy combined with gestrinone (2.5 mg/time, two times per week, for 6 months) intervention; patients in the control group were treated with laparoscopic intervention. After six months, the postoperative serum FSH (Follicle Stmi Ulating Hormone, FSH), Estradiol (E2) and Estradiol levels, ovarian biggest plane average diameter (D), the level of MMP-9 and TIMP -1 level, pregnancy outcome of two groups were compared and the outcome and the recurrence rate 18 months after treatment were followed up. Results Six months after treatment, the E2 and FSH levels in the observation group were better than control group, with statistically significant difference (P2 cm, the postoperative ovarian shrink rate was 51.28% in the observation group; there were 5 patients of D≤2 cm, 34 patients of D>2 cm ovarian shrink ratio was 12.82% in the control group, the ovarian shrink ratio of observation group was obviously higher than control group, with statistically significant difference (P<0.01) . Follow-up for 18 months, the recurrence rate was 5.13%in the observation group, which was significantly lower than thatin the control group (25.64%), with statistically significant difference (P<0.05);the pregnancy rate was 66.66%and 30.77%in the Observation group and control group, respectively, the difference had statistical significance (P<0.01) . Conclusion Laparoscopic surgery combined with gestrinone can protect ovarian function of patients with ovarian endometriosis cyst, improve pregnancy outcomes, and reduce recurrence rate, and has good clinical value.
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Objective To observe the comprehensive effect of different drugs for ectopic endometrium after laparoscopic surgery.Methods According to random number,75 intrauterine membrane patients with endometriosis treated by laparoscopy were divided into control group(25 cases),mifepristone group(25 cases)and gestrinone group (25 cases).The patients of the control group were not taken medication,the patients of mifepristone group in postop-erative clothing were treated with mifepristone,the patients of gestrinone groups in postoperative plus gestrinone treat-ment.All of the patients were taken 6 months treatment,therapy,pregnancy rates,and adverse reactions of three groups were observed.Results The total effective rate of the control group was 76.0%,which of the mifepristone group was 96.0%,the difference between the two groups was statistically significant (χ2 =4.15,P <0.05),which of the gestri-none group was 92.0%,and the difference between the two groups was statistically significant(χ2 =2.38,P <0.05). The incidence rate of side effects in mifepristone group was 12.0%,which was lower than 36.0% of gestrinone group,the difference was statistically significant (χ2 =8.39,P <0.05 ).The patients combined infertility were 17 cases,after the treatment for pregnancy 8 cases,the cumulative pregnancy rate of mifepristone group was 66.7%, which was higher than 20.0% of gestrinone group,and the difference was significant (χ2 =4.15,P <0.05).Conclusion Simple using abdominal mirror operation treatment uterine within film different bit syndrome patients of effect not too ideal,but operation through taking meters non -division ketone or pregnancy three ketone can obviously improve treat-ment has efficiency,reduced recurrence rate,while can increased pregnancy rate and reduced patients of bad reaction occurred rate,is a security efficient of treatment programme,worth promotion in the clinical treatment.
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Objective To investigate the incidence, influencing factors and intervention of gestrinone-related abnormal uterine bleeding at different dosage of gestrinone in the clinical treatment. Methods This was a multicenter, randomized, control study of 195 Chinese women with endometriosis or adenomyosis from June 2011 to November 2013. The subjects were randomized into three groups with oral administration of gestrinone, 2.5 mg dose at one time;twice a week group:67 cases with oral administration twice a week last three months;double dose first month group:67 cases with oral administration triple times a week at first month, then twice a week for two months; three times a week group: 61 cases with oral administration three times a week last three months. The improvement of the abnormal uterine bleeding, the changes in estrogen, liver function and blood coagulation were evaluated. At the same time, B-ultrasound examination evaluation were performed. Results (1) Three months later, the incidence of abnormal uterine bleeding in twice a week group was 30%(20/67), in double dose first month group and three times a week group were 7%(5/67) and 16%(10/61) respectively, there were significant difference between three groups (P0.05). The body mass index significantly increased in three group (P0.05). As for blood coagulation, there were also no significant differences between the groups (P>0.05). Conclusions Double dose of gestrinone in the first month could significantly decrease the incidence of gestrinone-related abnormal uterine bleeding. It is a more optimied dosage of gestrinone and without severe side effects. Clinical trial registration Chinese Clinical Trial Registry, registration number: ChiCTR- TRC-12002327.
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Objective To compare the efficacy and safety of different drugs in the treatment of patients with endometriosis by laparoscopic conservatism operation.Methods 165 patients with endometriosis met the inclusion were included as research subjects.All patients were treated with laparoscopic conservatism operation,then were divided intoⅠgroup (goserelin),Ⅱ group (mifepristone),Ⅲ group (gestrinone)according to different postoperative medica-tion,55 cases in each group.The clinical efficacy and safety were observed.Results The E2 ,CA125,EMAb,dys-menorrhea VAS scores of Ⅰ group after treatment were (136.7 ±3.8)pmol/L,(18.0 ±2.8)u/mL,(200.8 ± 52.1)pg/mL,(1.91 ±0.35)points,those of Ⅱ group were (155.0 ±3.5)pmol/L,(29.4 ±3.3)u/mL,(265.1 ± 49.8)pg/mL,(1.98 ±0.44)points,those of Ⅲ group were (158.0 ±3.2)pmol/L,(31.1 ±3.5)u/mL,(278.2 ± 45.6)pg/mL,(1.95 ±0.45)points,those in three groups after treatment were significantly lower than before treat-ment(tⅠgroup =10.257,9.029,13.311,7.802,tⅡgroup =8.441,7.083,10.54,6.703,tⅢgroup =7.702,6.448,8.671, 6.784,all P <0.01).There were significant differences between the three groups in E2 ,CA125,EMAb(F =11.375, 8.002,7.671,all P <0.01).The E2 ,CA125,EMAb ofⅠgroup after treatment were significantly lower than Ⅱ,Ⅲgroup(tⅠgroup -ⅡgrouP =3.562,5.017,3.631,tⅠgroup -Ⅲ group =3.268,4.573,4.023,all P <0.05).The total effective rate of I group was 90.91%,which was significantly higher than Ⅱgroup,Ⅲ group(χ2 =10.456,P <0.05).The 1 -year pregnancy rate of I group was 50.91%,which was significantly higher than Ⅱgroup,Ⅲ group(χ2 =7.700,P <0.05).The incidence rate of adverse reactions of I group was 18.18%,which of Ⅱ group was 3.64%,which of Ⅲgroup was 29.09%(χ2 =12.732,P <0.01).Conclusion The goserelin has exact effect in the treatment of patients with endometriosis by laparoscopic conservatism operation,and has better treatment compliance,lower relapse rate and incidence of adverse reactions,higher pregnancy success rate,but the mifepristone has better economy and safety,the patients should be selected according to specific circumstances.
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Objective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.
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Objective Based on the immunologic balance, to investigate the mechanisms of Danchi decoction for controlling the recurrence of endometriosis (EMs) of qi stagnation and blood stasis after conservative operation. Methods A multi-center and randomized clinical trial was adopted. EMs patients were divided into Chinese medicine group (CG, 20 cases) and western medicine group (WG, 10 cases). The two groups were given Danchi decoction and GnRH-a or gestrinone respectively for 3 months. The serum IL-2, IL-6 and IL-2/IL-6 were detected before operation, after 3 months of treatment and 3 months after withdrawal, and compared with the control group (5 cases of simple ovarian cysts). Results Before operation, the serum IL-2 level of CG and WG was lower than control group (P0.05), but 3 months after withdrawal, IL-2/IL-6 of WG was significantly lower than that of control group (P<0.05). Conclusion Immune imbalance is closely related to the occurrence and development of EMs. Danchi Decoction or GnRH-a or gestrinone can prevent the recurrence of EMs by adjusting the disorder of immune response, and Danchi Decoction has better effect on long-term result.
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Objective To explore the clinical value of gonadotropin-releasing hormone analogue (GnRH-a) by analyzing the efficiency of GnRH-a treatment for moderate and severe endometriosis after laparoscopic conservative operations.Methods Two hundred and sixty-five females who accepted laparoscopic conservative operation were enrolled in this study,and they were confirmed by pathology for ovarian endometriosis cyst,in phase Ⅲ andⅣ,47 patients had fertility desire.According to whether use the drug and auxiliary species the postoperative cases were divided into 5 groups:102 cases without endocrinal therapy(untreated group),GnRH-a group of 3 months in 64 cases,GnRH-a group of 6 months in 31 cases;gestrinone group of 3 months in 38 cases,and gestrinone group of 6 months in 30 cases.All patients were followed up for 2 years,observed drug clinical effects,remission rate,improvement rate,recurrence rate,pregnancy outcomes and side effects.Results The remission rate in GnRH-a group of 6 months and gestrinone group of 6 months was significantly higher than that in untreated group [83.9％ (26/31),73.3％ (22/30) vs.52.9％(54/102)],the remission rate in GnRH-a group of 6 months was significantly higher than that GnRH-a group of 3 months [64.1％ (41/64)],there was significant difference (P ＜ 0.05).The recurrence rate in GnRH-a group of 3 months,GnRH-a group of 6 months,gestrinone group of 6 months was significantly lower than that in untreated group [12.5％ (8/64),9.7％ (3/31),10.0％ (3/30) vs.27.5％ (28/102)] (P ＜ 0.05).The recurrence rate in gestrinone group of 6 months was significantly lower than that in gestrinone group of 3 months (P ＜ 0.05).The recurrence time of GnRH-a group of 3 months,GnRH-a group of 6 months,gestrinone group of 6 months was significantly longer than that in untreated group [(14.05 ± 1.97),(16.76 ± 1.53),(16.12 ±2.15)months vs.(12.85 ± 1.80)months] (P ＜0.05).The recurrence time of gestrinone group of 3 months and untreated group had no significant difference(P ＞ 0.05).The pregnancy rate of GnRH-a group and gestrinone group was higher than that in untreated group,but there was no significant difference (P ＞ 0.05).The rate of menopausal symptom in GnRH-a group was higher than that in gestrinone group [50.5％ (48/95) vs.16.2％ (11/68)].The rate of abnormal bleeding in vagina,acne and side-effect of aminotransferase in GnRH-a group were significantly lower than those in gestrinone group [1.1％(1/95) vs.7.4％(5/68),0 vs.8.8％(6/68),0 vs.5.9％(4/68)](P＜ 0.05).Conclusions Laparoscopic conservative operations combined with GnRH-a on treatment of moderate and severe ovarian endometriosis can significantly improve remission rate,decrease recurrence rate.GnRH-a or gestrinone for 6 months,the pregnancy rate increases.In addition the side reactions of the two medicine have statistic difference,which of GnRH-a is lower.
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Objective To explore the clinical effects of laparoscopic surgery combined with marvelon,gestrinone and leuprolide in treatment of chronic endometriosis.Methods 50 cases of endometriosis were collected.They were randomly divided into observation group and control group,each group having 25 cases.The control group underwent laparoscopic surgery and the observation group underwent laparoscopic surgery combined marvelon,gestrinone and leuprolide for 3 months.The two groups were compared in clinical effects,recurrence and pregnancy rate,as well as the operation situation.Results The effective rate was 92.0％ (23/25) in the observation group and 64.0％ (16/25) in the control group.The effective rate of observation group was obviously higher than that of the control group(P ＜ 0.05).The recurrence rate was 8.0％ (2/25)in the observation group,and 32.0％ (8/25) in the control group.The recurrence rate of combination group was obviously lower than that of the simple surgical group(P ＜ 0.05).The pregnancy rate was 80.0％ in the observation group;and 48.0％ in the control group after treatment.The pregnancy rate of the observation group was obviously higher than that of the control group(P ＜ 0.05).Liver damage or other adverse reactions didn't occur to any group after the treatment.The mean time of leaving bed was (1.4 ± 0.4) d after operation in the observation group vs (3.6 ± 1.5) d after operation in the control group.Length of hospital stay was (7.6 ± 3.5) d in the observation group vs (11.5 ± 3.9) d in the control group.The difference had statistical significance(all P ＜ 0.05).Conclusions Laparoscopic surgery combined with marvelon,gestrinone and leuprolide is superior to pure surgery group in treatment of endometriosis.It can improve the effective and pregnancy rate,and reduce the recurrence rate.No obvious adverse reactions can be found,thus it is worth of clinical promotion.
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Objective To study the efficacy of gestrinone and Sanjie zhentong capsule for the adjunctive treatment of endometriesis cyst of ovary after laparoscopic operation.Methods 116 patients with ovarian endometriosis cyst after laparoscopic operation were randomly divided into three groups:A group(gestfinone and Sanjie Zhentong capsule,n=42),after operation were given gestrinone(2.5mg each time,two times per-week for 3～months)and Sanjie zhentong capsule(4 pills each time,three times everyday for 3 months);B group(gestrinone,n=38),after operation were only given gestrinone(2.5mg each time,two times per-week for 3-6 months);C group(Sanjie zhentong capsules,n=36),after operation were only given Sanjie zhentong capsules(4 pills each time,three times everyday for 3 months).All patients were followed up for 6～12 months.Results The follow-up visit rate was 96.5%(112/116).A group,B group and C group,their excellence rate was respectively 97.5%,67.6%and 65.7%,their recurrence rate was respectively 2.5%,24.3%and 22.9%.There was significant difference between A group and B group.C group(P＜0.05).Incidence rate of three groups'side effects was respectively 35.0%,29.7%and 14.3%,there was no significant difference among three groups(P＞0.05).Conclusion The efficacy of gestfinone and Sanjie zhentong capsule for the adjunctive treatment of endometriosis cyst of ovary after laparoscopic operation was better than that of the only medicine treatment.
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Objective To investigate the role of mifepristone in endometriosis after laparoscopic surgery. Methods One hundred and forty-three women diagnosed with endometriosis after laparoscopic surgery were divided into two groups: one group with 78 cases were given mifepristone at 10 mg once daily (mifepristone group),and the other group with 65 cases were given gestrinone at 2.5 mg,twice every week (gestrinone group). All patients were followed-up 1 to 2 years and observed curative effect, compared the therapy effect on endometriosis as well as the side effects of two drugs. Results The clinical symptom and sign were improved at 3, 6, 12 months in two groups (P< 0.01). The rate of efficiency was 85.9%(67/78) in mifepristone group,and 84.6%(55/65) in gestrinone group, there was no significant difference between two groups (P > 0.05). The rates of acne, weight gain, joint ache, aminotransferase increase was lower in mifepristone group than those in gestrinone group (P <0.01 or <0.05). The recovery time of ovulation or menstruation was shorter in mifepristone group [(12.0 ± 2.9), (26.8 ± 3.9) d]than those in gestrinone group [(25.3 ±3.7), (35.0±4.1) d](P<0.05). Conclusions Mifepristone seems to be an effective,safe,and convenient treatment for endometriosis with low-cost and few side effects. Therefore,it can be used as first choice for treatment of endometriosis after laparoscopic surgery.
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Objective To observe the clinical curative effects of treating endometriosis with decoction for removing blood stasis.Methods 49 patients with endometriosis were randomly divided into a treatment group and a control group.The treatment group was treated with decoction for removing blood stasis with one dosage per day until menstruation began.The control group was taken gestrinone orally with 2.5mg for each time,twice per week and contraception methods were taken dunng the therapeutic period.Results The treatment group had abetter recovery rate of symptoms and signs of pain than the control group(P＜0.05).Conclusion Decoction for removing blood stasis had good clinical effects in treating endometriosis.
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OBJECTIVE: To evaluate the effects of estrogen treatment in combination with gestrinone on an experimental rat model of endometriosis. METHODS: Uterine transplants were attached to the peritoneum of female Wistar rats via a surgical autotransplantation technique. The implanted area was measured during the proestrus phase and after hormonal treatment. We performed morphometric analysis and examined the macroscopic and morphometric alterations of endometrial implants after hormonal treatment in ovariectomized rats. RESULTS: The high dose of estrogen caused macroscopic increases in the endometrial implant group compared with other groups, which were similar to increases in the proestrus phase. The low dose showed morphometric development of implants, such as an increase in number of endometrial glands, leukocyte infiltration and mitosis. Gestrinone antagonized both doses of estrogen. CONCLUSION: Our findings suggest that gestrinone antagonizes estrogen's effects on rat peritoneal endometrial implants.
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Animals , Female , Rats , Endometriosis/drug therapy , Estrogen Antagonists/therapeutic use , Estrogens/therapeutic use , Gestrinone/therapeutic use , Progestins/therapeutic use , Disease Models, Animal , Drug Evaluation, Preclinical , Endometriosis/pathology , Ovariectomy , Rats, WistarABSTRACT
Objective To evaluate the efficiency and safety of mifepristone and gestrinone in subsidiary treat- ment after endometriosis surgery.Methods Totally 151 patients diagnosed as endometriosis with conservative surgery treatment or laparoscopic operation were divided into three groups;49 cases in the group of mifepristone re- ceived mifepristone tablets 10mg every day for 6 months from the first week of postoperation,60 cases in the group of gestrinone received gestrinone capsules 2.5mg twice every week for 6 months.Cases in the group of control did not receive any postoperative medical treatment.The duration of follow-up after surgery was censored at 3～18 months.Patients'controlling rate of ache symptoms and signs,clinical efficiency,recurrence rate,sex hormone level, menstrual and weight changes,liver and renal functions were recorded and compared.Results The follow up rate is 97.4 %,the efficacious rate and symptoms controlling rate of mifepristone group and gestrinone group were 78.7 %, 93.1% respectively,which of the control group were 34.8 %,58.7 % respectively.There were significant differ- ences,x~2=44.31,P
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Objective To investigate the role of tumor suppressor gene PTEN(phosphatase and tension homologue deleted on chromosome 10,PTEN)in apoptosis of ectopic endometrial cells induced by gestrinone. Methods Ectopic endometrium cells obtained from endometriosis were cultured and exposed to gestrinone in different concentrations. The inhibition of the cells during 48 hours was determined by MTT assay, and the cell growth curve was plotted. Then the morphological changes in cells treated with gestrinone for 24h were observed with transmission electron microscope, and the apoptosis rate, cell cycle of the cells and PTEN expression were assessed with flow cytometry analysis (FCM) at the same time. Results Gestrinone in different concentrations could inhibit the growth and proliferation of ectopic endometrium cells in a does and time dependent manner, and the cell growth curve was changed accordingly. After 24 hours exposure to gestrinone in the concentrations of 10 -6 to10 -4 mol/L, some apoptotic changes were observed in the cells under transmission electron microscope. FCM showed that after the exposure to gestrinone, the apoptotic rate of ectopic endometrial cells was 1.3% in 10 6 mol/L group and 15.0% in 10 -4 mol/L group, indicating that there was significantly increase in apoptosis when compared with the control group. At the same time the level of PTEN expression was also increased. Conclusion Gestrinone can significantly inhibit the growth and proliferation of ectopic endometrial cells in endometriosis, and this effects seems to be related to an increase in PTEN expression.
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Objective To investigate the effects of gestrinone on growth and apoptosis, as well as the expression of phosphatase and tension homologue deleted on chromosome 10(PTEN) in isolated ectopic endometrium cells in vitro and the underlying mechanisms. Methods Ectopic endometrium cells were cultured and exposed to gestrinone of different doses of 0, 10 -6 and 10 -4 mol/L respectively. The inhibition of the cells during 48 hours was determined by methylthiazolyl tetrazolium (MTT) assay, and the cell growth curve was made. Gestrinone was administered to the cells and at 24 hours the morphological changes were observed by transmission electron microscopy and the apoptosis rate, cell cycle and PTEN expression were monitored by flow cytometry (FCM) at the same time. Results Gestrinone at different concentrations could inhibit the growth and proliferation of ectopic endometrium cells in a dose- and time-dependent manner. The inhibition rate of cell growth after exposed to gestrinone for 8,16,24,32,40 and 48 h was 99.6%,87.3%,79.8%,62.3%,51.7% and 44.2% in the 10 -6 mol/L group,and 99.2%,77.1%,69.6%,51.1%,33.7% and 23.6% in the 10 -4 mol/L group (P