The specific embodiment
The present invention is further described with embodiment in conjunction with the accompanying drawings.
Embodiment one:
1 Progesterone 50g writes out a prescription
Glyceryl monostearate 150g
Ethanol 15ml
Micropowder silica gel 2g
Starch 12.5g
Make 1000
Preparation method
1. the 150g glyceryl monostearate is added in the 15ml ethanol, be heated to 60 ℃, add the 50g Progesterone and make its dissolving, take out, 40 ℃ of vacuum dryings 4 hours, comminution by gas stream, grinding particle size requires at 0~20um.
2. press recipe quantity, add micropowder silica gel, starch uniform mixing.
3. adorn capsule No. 0, packing.
Embodiment two:
2 Progesterone 50g write out a prescription
Glyceryl monostearate 80g
Sodium lauryl sulphate 1.5g
Ethanol 20ml
Micropowder silica gel 1.25g
Starch 12.5g
Make 1000
Preparation method
1. the 80g glyceryl monostearate is added in the 20ml ethanol, be heated to 60 ℃, add the 50g Progesterone, the 1.5g sodium lauryl sulphate makes its dissolving, take out, 40 ℃ of vacuum dryings 4 hours, comminution by gas stream, grinding particle size requires at 20~40um.
2. press recipe quantity and add micropowder silica gel, starch uniform mixing.
3. adorn capsule No. 0, packing.
Embodiment three
3 Progesterone 100g write out a prescription
PEG6000 50g
Acetone 30ml
Micropowder silica gel 1.5g
Starch 14g
Make 1000
Preparation method
1. 50gPEG6000 is added in the 30ml acetone, be heated to 60 ℃, add the 100g Progesterone and make its dissolving, 40 ℃ of vacuum dryings 4 hours, comminution by gas stream, grinding particle size requires at 60~80um.
2. press recipe quantity, add micropowder silica gel, starch uniform mixing.
2. adorn capsule No. 0, packing.
Embodiment four:
4 Progesterone 100g write out a prescription
Hexadecanol 100g
Lecithin 2.5g
Ethanol 20ml
Micropowder silica gel 1g
Starch 10g
Make 1000
Preparation method
1. the 100g hexadecanol is added in the 20ml ethanol, be heated to 60 ℃, add the 100g Progesterone, 2.5g lecithin makes its dissolving, take out, 40 ℃ of vacuum dryings 4 hours, comminution by gas stream, grinding particle size requires at 60~80um.
2. press recipe quantity, add micropowder silica gel, starch uniform mixing.
3. adorn capsule No. 0, packing.
Embodiment five: the progesterone capsule pharmacodynamics test
One. experiment material
(1), animal
Female New Zealand white rabbits, body weight 0.6-0.8kg; The ICR female mice, body weight 19-20g, 27-35g, available from Zhejiang Province's Experimental Animal Center, the animal quality certification number: accurate word 96001 is tested in Zhejiang.
(2), medicine
1. progesterone capsule: granule content 35.15%, following test dose all by the Progesterone cubage, is mixed with suspension with carboxymethyl cellulose during experiment, gastric infusion, every day 2 times, 6 hours at interval.
2. Progesterone injection: 20mg/ml, Xianju, Zhejiang Pharmacy stock Co., Ltd, lot number 960112, during experiment with the dilution of sterilization refined plant oil, subcutaneous or administered intramuscular, every day 1 time.
3. estradiol (E
2): content 99.5%, Shanghai No.12 Pharmaceutical Factory, lot number 95020 is prepared the subcutaneous injection administration with sterilization refined plant oil during experiment.
Two. experimental technique and result
(1), young rabbit uterus inner membrance conversion test
36 of female New Zealand children rabbits, body weight 0.6-0.8Kg is divided into 7 groups at random, 5 every group.Other stays 1 to be normal young rabbit, raises not administration with condition.Each treated animal is in experiment 1-6 days, E
2Subcutaneous administration (sc) 5 μ g//d, tested 7-11 days, the administration group is Progesterone injection intramuscular injection (im) 0.78,3.13,12.50mg/kg/d or progesterone capsule oral administration (po) 7.80,31.30,125.00mg/kg/d respectively, matched group po equal-volume excipient 2ml//d.After the last administration 24 hours, dissect and take out the uterus, be fixed in the Bouin ' s liquid, every Aconitum carmichaeli Debx. palace gets respectively far, in, nearly 3 sections, paraffin section, after the HE dyeing, microscopy, observe the endometrium form, press the endometrial gland hyperplasia degree, make the classification of Mcphail index.
Mcphail index grade scale:
1 grade, lumen of gland develops along tube chamber, and is very short, and darker substrate does not reach deeply;
2 grades, the body of gland number increases, the length lengthening, and darker substrate part is still complete, and dyeing is bright;
3 grades, dark substrate is stretched in the body of gland expansion, and body of gland is narrower;
4 grades, the deeply near Musclar layer of body of gland, body of gland expansion, inner membrance fracture.
The conversion test of the young rabbit uterus inner membrance of table 1 (X ± SD)
| Group | Dosage (mg/kg/d) | Number of animals (only) | The Mcphail average index |
| Matched group Progesterone injection progesterone capsule (powder) | 0.78 3.13 12.50 7.80 31.30 125.00 | 5 5 5 5 5 5 5 | 0.0±0.0 3.2±0.2 3.6±0.3 3.8±0.2 3.0±0.3 3.1±0.2 3.6±0.4 |
The results are shown in Table 1, estrogen promotes uterine growth and endo cell division, thereby cause that neointimal hyperplasia thickens, and be converted into the proliferous type inner membrance, Progesterone is converted into endometrium the secreting type inner membrance on this basis: microscopy is the result show, normal young rabbit uterus is tiny, and body of gland (referring to Fig. 1) is seen at the end in the inner membrance; The matched group rabbit uterus under estrogen action, the uterus chap, uterine cavity increases, and is irregular shape, and minority body of gland (<10) is arranged, little, garden, straight, no branch, have a large amount of between matter (referring to Fig. 2), it is 0 that the Mcphail index is defined the level; Progesterone injection im 0.78,3.13,12.50mg/kg/d or progesterone capsule (powder) po 7.80,31.30,125.00mg/kg/d, it is all thicker that each organizes rabbit uterus, slightly be kermesinus, visible inner membrance body of gland increases under the mirror, prolong, crooked, and branch appears, dark substrate is stretched in some inner membrance body of gland expansion, body of gland narrows down, between matter greatly reduce (referring to Fig. 3-8), the Mcphail index is seen ginseng table 1: show that progesterone capsule has stronger progestin after oral, can promote the young rabbit uterus inner membrance glandular hyperplasia through the estrogen stimulation, its effect is suitable with the effect of 1/10 dosage injection.
(2), the mice deciduoma forms test
83 of ICR female mices, body weight 19-20g is divided into 8 groups, at random with pentobarbital sodium 60mg/kg, abdominal cavity (ip) anesthesia, under aseptic technique, from both sides, back spay, matched group is only done sham-operation, spay not, also not administration was tested 7-9 days, other group E every day
2Sc 2 μ g/, from E 10-17 days every days
2Sc 1 μ g/ only, the administration group is Progesterone sc injection 6.25,12.5,25.0mg/kg/d or progesterone capsule (powder) po62.5,125,250mg/kg/d simultaneously, matched group, the isopyknic excipient 0.5ml/ of model group po are only, in the 12nd day, the anesthesia of mice pentobarbital sodium, a silk thread is worn at 1/3 mesentery place at the left side cornua uteri, the 18th day with sacrifice of animal, take out the uterus, both sides, precision takes by weighing weight in wet base, and press Peter Hebborn method poor with both sides cornua uteri weight, and be the index of deciduoma growth, calculate deciduoma and increase percentage rate.
Table 2 mice deciduoma formation test (X ± SD)
| Group | Dosage (mg/kg/d) | Number of animals (only) | The Mcphail average index |
| Matched group model group Progesterone injection progesterone capsule (powder) | 6.25 12.5 25.0 62.5 125 250 | 10 11 10 10 10 10 12 10 | 7.9±10.0 9.9±18.4 29.7±20.0* 35.8±22.1** 55.9±14.8*** 19.3±18.5 35.2±25.0* 53.6±27.1*** |
Annotate: through the t check, compare with model group,
*P<0.05,
*P<0.01,
* *P<0.001
The results are shown in Table 2, progesterone capsule (powder) can bring out the growth of mice deciduoma significantly, show to have quite strong progestin, and tangible dose-response relationship arranged that the action intensity of progesterone capsule (powder) is equivalent to the action intensity of 1/10 dosage injection approximately.
(3), mouse pregnancy is kept test
The ICR female mice, body weight 27-30g, with 2: 1 and the same cage of male Mus, 8 o'clock of morning next day, observe the cloudy bolt of female Mus, serve as gestation the 1st day to find cloudy bolt, in conceived the 8th day, through pentobarbital sodium 60mg/kg, ip anaesthetizes from both sides, back spay, observes intrauterine and has or not embryo nidation, to determine that it has not pregnancy and discards the unpregnancy Mus, operation E2 sc 2 μ g/ on the same day/d, Progesterone injection sc 12.5 simultaneously, 25,50mg/kg/d or progesterone capsule (powder) po 125,250,500mg/kg/d, matched group, model group po equal-volume excipient 0.5ml/ only, continuous 6 days, until pregnant the 14th day, dissect, observe embryo's implant site and also write down the live embryo number.Matched group carries out sham-operation, does not give E2 and Progesterone.
The test of table 3 castration mouse pregnancy maintenance
| Group | Dosage (mg/Kg/d) | Number of animals (only) | Pregnancy rate (%) | The average tire number of living |
| Matched group model group Progesterone injection progesterone capsule (powder) | 12.5 25.0 50.0 125 250 500 | 10 10 10 10 10 10 10 10 | 90 0 0 60* 80* 0 30 70** | 9.3 0 0 4.5 6.1 0 5.7 6.0 |
Annotate: through the X2 check, compare with model group,
*P<0.05,
*P<0.01.
The results are shown in Table 3, mice because of female in the body, progesterone level descend, can not be kept gestation after spay, cause miscarriage.Progesterone has the formation that suppresses uterine smooth muscle intercellular substance joint, reduces the spontaneous activity of uterus muscle, reduces the irritability of uterus muscle cell, thereby helps pregnancy maintenance.Experiment proves that also progesterone capsule (powder) 500mg/kg can keep removal ovary mouse pregnancy 70%, and its effect is approaching with the effect of 1/10 dosage injection (80%).
The Progesterone clinical dysfunctional uterine bleeding that is mainly used in, threatened abortion and recurrent spontaneous abortion.Because progestogen can stimulate hormone (ICSH) by negative feedback inhibition antepituitary secretion interstitial cell, thereby reduce the Testosterone secretion.In addition, it can also optionally suppress absorption and the 5-alpha-reductase of prostaglandin to testosterone, stops testosterone to be converted into two hydrogen testosterones.Therefore, can be used for treating benign prostate hyperplasia and carcinoma of prostate, the clinical report Progesterone also can be treated urinary system calculus in recent years.
The above results proves, progesterone capsule (powder) is oral effectively, progesterone capsule (powder) po 7.80-125.00mg/kg/d can make the young rabbit uterus inner membrance of E2 under exciting be transformed to the secretory phase by proliferative phase, grows for the implantation of germ cell and blastocyst subsequently and prepares.The mice deciduoma forms evidence, and progesterone capsule (powder) po 125-250mg/kg/d can cause cell division, promotes the growth of mice deciduoma, and in addition, progesterone capsule (powder) can also be kept the gestation of removal ovary mice.The progestin of progesterone capsule (powder) is equivalent to the effect of 1/10 dosage Progesterone injection approximately.
Embodiment six: progesterone capsule II phase clinical verification
One, case is selected
1. inclusion criteria:
1. menoxenia or amenorrhea;
2. basal body temperature is single-phase;
3. blood progesterone level<7nmol/L is surveyed in menstruation latter half;
4. the endometrium biopsy person that turns out to be the anovular menstruation.
MethodsThe cases enrolled meets 3 in the above-mentioned standard at least, according to feature separately above-mentioned case is reduced polycystic ovarian syndrome (Pcos), climacteric, anovulatory dysfunctional uterine hemorrhage, secondary amenorrhea and other respectively again.
2, exclusion standard: have following situation person should not be selected into
1. the person that has the digestive tract disease;
2. hepatic and kidney function obstacle person;
3. other endocrinopathy person is arranged;
4. diabetes or other metabolic disease person are arranged;
5. drug allergy history person is arranged;
6. pass by acceptance hormone therapy person in March.
3, rejecting standard:
The person that fails to turn out to be the anovulation; A variety of causes cause this case fail to finish 3 the course of treatment person.
Two, grouping
Plan MethodsThe cases enrolled 120 examples are divided into 2 groups by random fashion, and a winding is treated by MP, are checking group totally 60 examples, and another winding is subjected to the IP treatment to claim matched group totally 60 examples.
Those selected arranges in numerical order in proper order by prescription on individual diagnosis, according to system's arbitrary sampling method grouping.
Three, Therapeutic Method
1, medicine
Progesterone capsule
Progesterone injection Xianju, Zhejiang pharmaceutical Co. Ltd
Premarin Tablet
2, dosage
Premarin Tablet 1.25mg once a day, and is oral, totally 22 days
Progesterone capsule 200mg every day twice, oral in taking the 13rd day clothes of Premarin Tablet, totally 10 days (checking group)
Progesterone injection 20mg intramuscular injection once a day is in taking Premarin Tablet injection in the 13rd day, totally 10 days (matched group)
3, the every example of usage is observed 3 courses of treatment
1. amenorrhea person is diagnosed as the anovulation through hormone determination the person begins first course of therapy immediately, and second and third course of treatment is in withdrawal bleeding beginning in the 5th day medication.
2. anovulation can not passed through first course of treatment of person naturally in the treatment in the 5th day of passing through, and second and third course of treatment is in withdrawal bleeding beginning in the 5th day medication.
3. the anovulation anovulatory dysfunctional uterine hemorrhage in operation beginning in the 5th day first course of therapy, begins day second and third course of treatment ditto as the comprehensive dilatation and curettage person of row.
Four, observing time and project
1, observation of curative effect
1. need inquire withdrawal bleeding situation after the medication per course of treatment.
2. hormone determination: before the treatment and finish to measure respectively in preceding 3 days blood FSH, LH, E the 3rd course of treatment
2, P, T, PRL concentration.
3. some cases reached for the 3rd course of treatment end and gets the endometrium specimen and carry out histological examination before treatment.
2, safety is observed
1. measure routine blood test, liver, renal function respectively before the treatment and after the treatment end.
2. untoward reaction is observed.
Five, curative effect determinate standard
1, vaginal hemorrhage after the drug withdrawal
1. alleviate hemorrhage 3-7 days fully
2. the hemorrhage 8-10 of produce effects days
3. invalid hemorrhage>10 days
2, the blood progesterone level changes
1. alleviation>32nmol/L fully
2. produce effects 20-32nmol/L
3. progressive 7-19nmol/L
4. invalid<7nmol/L
3, endometrial tissue is learned and is changed
1. alleviate endometrium fully and be secretory reaction
2. the produce effects endometrium is secretory reaction early or hyposecretion
3. invalid endometrium is proliferation response
Six, case registration and summary
Register item by item by design table (schedule), and by implementing doctor and main researcher signature.
Seven, statistical analysis technique
All add up by the full-time staff, mainly adopt SPSS 10.0 statistical packages.
Eight, result
1, physical data
The checking group is selected in 79 examples, and 5 examples that come off are rejected 6 examples, and several 68 examples of final effectively example are rejected reason, take drug dose mistake 1 example, incomplete 2 examples of final inspection data, diagnostic error (the blood progesterone level is in ovulation back level) 3 examples.5 examples that come off are to lose midway and visit.Matched group is selected in 71 examples, and 6 examples that come off are rejected 4 examples, and several 61 examples of final effectively example are rejected reason, and incomplete 2 examples of final inspection data are diagnosed imprecise 2 examples, and the reason that comes off mostly is to lose midway and visits, and wherein 1 example is found abnormal liver function (referring to table 4).
Table 4 a liang group is selected in, comes off, rejects case relatively
| | The checking group | Matched group |
| The selected routine number routine number that comes off is rejected the effective routine number of routine number | 79 5 6 68 | 71 6 4 61 |
x
2=0.98 P>0.05
Two groups are selected in, come off, reject relatively there was no significant difference of case.
Table 5 liang group age and Body Mass Index are relatively
| | The example number | Age | Body Mass Index |
| Checking group matched group t p | 68 61 | 31.3±8.6 38.0±9.3 0.775 0.439 | 21.3±3.1 21.6±2.9 0.627 0.532 |
Table 6 liang group Body Mass Index distribution (BMI)
| | Checking group (example) | Matched group (example) |
| <23 23~27 >27 | 46 21 1 | 41 18 2 |
x
2=0.473 P=0.789
BMI=body weight kg/ height m
2
Press domestic standard>23 for overweight,>27 is fat.Referring to table 5,6, two groups of ages, Body Mass Index (BMI) and the BMI difference that distributes that relatively there are no significant,
2, therapeutic outcome
(1) two groups of hormones change before and after the treatment
Referring to table 7, before all controlling, checking group and treatment of control group bleeding from anus progesterone level significantly increase, and rise to 48.9nmol/L and 1.7 by 1.90 respectively and rise to 13.3nmol/L.FSH and LH level have remarkable decline.
The blood hormonal readiness changes before and after the table 7 liang group treatment
| | The checking group | Matched group |
| FSH IU/L LH IU/L E2pmol/L Pnmol/L Tnmol/L PRLng/ml | Treat 1.83 (0.1~145.6) 9.18 (0.5~86.83), 86 (9~1388) 1.91 (0.06~6.33), front 11.405 (1.56~100) 25.29 (0.05~157.28) | 11 (0.46~45.9), 218.3 (29~1153.85) 48.88 (0.73~452.93) 2 (0.l~180.1), 7.26 (0.01~60.2) 7.9 (0.05~64.6) after the treatment | Z 3.18 4.931 3.913 9.726 0.212 1.453 | P <0.01 <0.01 <0.01 <0.01 0.832 0.146 | Treat 1.5 (0.5~179.10) 10.15 (0.65~48.01), 99.42 (9.9~2084.56) 1.7 (0.32~6.55), front 23.32 (2.1~127.4) 20.54 (1.26~129.2) | 1.075 (0.07~75.2) 11.425 (1.2~126.3), 235 (5.49~1592.78) 13.26 (0.64~46.11), 8.3 (0.7~68.2) 10.35 (0.24~53) after the treatment | Z 3.848 4.598 4.373 8.795 1.496 1.949 | P <0.01 <0.01 <0.01 <0.01 0.135 0.051 |
(2) the two groups of blood progesterone level groupings in treatment back relatively
The two groups of blood progesterone level groupings in table 8 treatment back relatively
| Progesterone level nmol/L | Checking group n=68 | Matched group n=61 | x
2 | P |
| >32 21-32 7-20 <7 | 45 5 16 2 | 9 11 30 11 | 36.5 | <0.01 |
Annotate: should reach 6.36nmol/L (2ng/ml) by ovulation bleeding from anus progesterone level
Corpus luteum peak period concentration reaches 31.8nmol/L (10ng/ml) at least, and referring to table 8, through X 2 test, the checking group is better than matched group.
(3) treatment back endometrium changes
Do the endometrium biopsy before and after the some cases treatment, endometrium all is proliferative phase or fails to obtain inner membrance before the treatment, and treatment back internal film tissue learns and changes referring to table 9.
Table 9 a liang group treatment back endometrial tissue is learned and is changed relatively
| Endometrial tissue is learned | The checking group | Matched group |
| A (example) B (example) C (example) adds up to | 17 8 3 28 | 22 1 4 27 |
x
2=6.21 P<0.05
Annotate A: the endometrial secretion phase
B: endometrium is secretory phase or hyposecretion early
C: endometrial hyperplasia phase or do not have inner membrance
(4) vaginal hemorrhage is compared after the drug withdrawal
The vaginal hemorrhage natural law relatively after the table 10 liang group drug withdrawal
| Hemorrhage natural law | The checking group | Matched group | x
2 | P |
| 3-7 days (example) | 8-10 days (example) | >10 days (example) | 3-7 days (example) | 8-10 days (example) | >10 days (example) | | |
| The course of treatment 123 | 63 65 67 | 4 3 1 | 1 | 59 60 57 | 2 1 2 | 0 0 2 | 1.42 0.83 | >0.05 >0.05 |
Referring to table 10, the vaginal hemorrhage natural law compares there was no significant difference after two groups of drug withdrawals.
3, treatment finishes the back curative effect relatively
(1) progesterone level evaluation
Table 11 blood progesterone level is estimated
| Curative effect | Checking group (example) | Matched group (example) |
| Alleviate the invalid total effective rate of produce effects progress fully | 45 5 16 2 97% | 9 11 30 11 82% |
Ridit`s check u=5.23 P<0.01
Referring to table 11, finish inspection in preceding 3 days the 3rd course of treatment, checking group blood progesterone level 97% raises, surpass ovulation back level, matched group 87% surpasses ovulation back level, and checking group progesterone level reaches luteal phase peak person and accounts for 67%, through the Ridit`s check, the checking group is better than matched group.
(2) endometrial tissue is learned to change and is estimated
Table 12 endometrial tissue is learned to change and is estimated
| Curative effect | Checking group (example) | Matched group (example) |
| Alleviate the invalid total effective rate of produce effects fully | 17 8 3 89.3% | 20 1 4 84% |
Ridit`s check u=0.95 P>0.05
Have endometrium biopsy specimen person to analyze referring to table 12 after finishing the course of treatment, checking group and matched group total effective rate reach 89.3% and 84% respectively, and through the Ridit`s check, two groups are not had significant difference.
(3) vaginal hemorrhage natural law
Vaginal hemorrhage natural law therapeutic evaluation after the table 13 liang group drug withdrawal
| Curative effect | Checking group % (example) | Matched group % (example) |
| Alleviate fully | Produce effects | Invalid | Total effective rate | Alleviate fully | Produce effects | Invalid | Total effective rate |
| 1 2 3 | 92.6(63) 95.6(65) 98.5(67) | 5.9(4) 4.4(3) 1.5(1) | 1.5(1) 0 0 | 98.5(67) 100(68) 100(68) | 96.7(59) 98.4(60) 93.4(57) | 3.3(2) 1.6(1) 3.3(2) | 0 0 3.3(2) | 100 100 96.7(59) |
Referring to table 13, the vaginal hemorrhage natural law is limited within 7 days in accordance with regulations after two groups of drug withdrawals, and the results suggest inner membrance peels off fully, relatively checks there was no significant difference through Ridit`s between each course of treatment and between two groups.
Above experimental result shows that progesterone capsule 400mg/ day, oral post-absorption was good, can significantly improve progesterone level, and acts on endometrium and make it to be converted into secretory reaction by hypertrophy, does not find serious adverse reaction on probation.Oral progesterone capsule is safe in utilization, and is effectively convenient, and the patient that must use natural progesterone is selection preferably.
Need not further to elaborate, believe and adopt the disclosed content in front, those skilled in the art can use the present invention to greatest extent.Therefore, the preferred specific embodiments of front is interpreted as only illustrating, but not limits the scope of the invention by any way.