Clinical study of Guizhi-Fuling pill combined with danazol in the treatment of ;endometriosis / 国际中医中药杂志

ABSTRACT

Objective To investigate the therapeutic effect of Guizhi-Fuling pill combined with danazol for endometriosis and its possible therapeutic mechanisms. Methods A total of 316 patients with endometriosis were recruited and randomly divided into a routine treatment group and a combined treatment group, 158 in each group. The conventional treatment group were treated by oral danazol tablets, and the combined treatment group by oral danazol and Guizhi-Fuling pill for 28 days. The serum levels of vascular endothelial growth factor (VEGF), VEGF receptor Flk-1, estrogen receptorα(ERα), 17β-estradiol (E2), IL-2, IL-6 and IL-8 were detected by the enzyme-linked immunosorbent assay. The expressions of VEGF and Flk-1 mRNAs in the ectopic endometriotic stromal cells were determined with the reverse transcriptase-polymerase chain reaction. Results The total effective rate in the combined treatment group was significantly higher than that in the routine treatment group (93.7% vs. 78.5%; χ2=13.968, P<0.01), and the recurrence rate was significantly lower (5.4%vs. 13.7%;χ2=19.984, P<0.01). After the treatment, the serum levels of VEGF (2.93 ± 0.07 pg/ml vs. 6.85 ± 0.12 pg/ml;t=354.679, P<0.01), Flk-1 (2.97 ± 0.12 pg/ml vs. 5.87 ± 0.17 pg/ml;t=175.179, P<0.01), ERα(4.93 ± 0.29 pg/ml vs. 6.85 ± 0.37 pg/ml;t=51.337, P<0.01), E2 (11.69±1.09 pg/ml vs. 14.10 ± 0.78 pg/ml;t=22.601, P<0.01), IL-2 (2.27 ± 0.12 pg/ml vs. 2.31 ± 0.16 pg/ml;t=2.514, P<0.05), IL-6 (0.39 ± 0.03 pg/ml vs. 0.59 ± 0.06 pg/ml;t=37.476, P<0.01) and IL-8 (0.47 ± 0.04 pg/ml vs. 0.81 ± 0.09 pg/ml;t=43.393, P<0.01) in the combined treatment group were significantly lower than those in the routine treatment group;the expressions of VEGF (0.69 ± 0.08 vs. 2.11 ± 0.09; t=148.229, P<0.01) and Flk-1 (4.67 ± 0.14 vs. 5.61 ± 0.22;t=45.311, P<0.01) mRNAs in the ectopic endometriotic stromal cells in the combined treatment group were significantly lower than those in the routine treatment group. Conclusions Guizhi-Fuling pill combined with danazol can downregulate the expressions of VEGF and Flk-1 in the ectopic endometriotic stromal cells, reduce the serum levels of VEGF, Flk-1, ERαand E2, alleviate inflammation, and improve symptoms.