桂枝茯苓胶囊联合亮丙瑞林治疗子宫肌瘤患者疗效及对卵巢功能、血清性激素与GPR30-EGFR信号通路的影响OA

Objective To investigate the efficacy of Guizhi Fuling Capsules combined with leuprorelin in treating patients with uterine fibroids and their effects on ovarian function,serum sex hormones,and the G protein-coupled estrogen receptor 30(GPR30)-epidermal growth factor receptor(EGFR)signaling pathway.Methods A total of 80 patients with uterine fibroids admitted to Nanyang City Center Hospital from January 2024 to January 2025 were enrolled and then were randomly divided into control group and observation group using a random number table method,with 40 cases in each group.The control group was treated with subcutaneous injection of leuprorelin acetate microspheres,while the observation group was treated with Guizhi Fuling Capsules on the basis of therapy for the control group.The treatment course was 12 weeks.The changes in traditional Chinese medicine(TCM)syndrome scores,ovarian function,and serum sex hormone levels were observed before and after treatment in both groups.The clinical efficacy and medication safety were evaluated,and the protein expression levels of the GPR30-EGFR signaling pathway were detected in both groups.Results(1)In terms of efficacy,after 12 weeks of treatment,the total effective rate was 90.00%(36/40)in the observation group and 72.50%(29/40)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)Regarding TCM syndrome scores,after 12 weeks of treatment,the scores for excessive menstrual flow,lower abdominal mass,abdominal pain refusing pressure,and unsmooth or fine pulse were decreased in both groups compared with those before treatment(P＜0.05),and the reductions in each TCM syndrom score in the observation group were significantly greater than those in the control group(P＜0.001).(3)Regarding serum sex hormones and ovarian function indicators,after 6 weeks of treatment,the serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E₂),progesterone(P),and testosterone(T)in the observation group,and the serum levels of E₂ and anti-Müllerian hormone(AMH)in the control group were significantly decreased compared with those before treatment(P＜0.05).Intergroup comparison showed that the serum levels of LH,E₂,and T in the observation group were significantly lower than those in the control group(P＜0.05).After 12 weeks of treatment,the serum levels of FSH,LH,E₂,P,and T in both groups and the serum AMH level in the control group were significantly decreased compared with those before treatment(P＜0.05).Moreover,the serum levels of FSH,LH,E ₂,P,and T in the observation group and the serum levels of LH,E ₂,P,and T in the control group were significantly decreased compared with those after 6 weeks of treatment(P＜0.05).Intergroup comparison showed that the serum levels of FSH,LH,E₂,P,and T in the observation group were significantly lower than those in the control group(P＜0.05),while the serum AMH level was significantly higher than that in the control group(P＜0.05).(4)Regarding the protein expression levels of the GPR30-EGFR signaling pathway,the mRNA and protein expression levels of GPR30 and EGFR in the observation group were significantly lower than those in the control group(P＜0.001).(5)In terms of safety,the incidence of adverse reactions was 12.50%(5/40)in the observation group and 7.50%(3/40)in the control group,with no statistically significant difference between the two groups(P＞0.05).Conclusion Guizhi Fuling Capsules combined with leuprorelin can significantly improve sex hormone levels in patients with uterine fibroids,inhibit the overactivation of the GPR30-EGFR signaling pathway,and do not affect ovarian reserve function,with good safety and promising clinical promotion value.