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目的以雌激素效应相关因子、血管生成相关因子及其相互作用为靶点,探讨比较中西医治疗方法对子宫腺肌病(adenomysis,AM)小鼠子宫在位及异位内膜的不同作用机制。方法对8周龄ICR雌鼠施行雄鼠垂体宫腔内移植手术,术后分别饲养3月,形成模型组。选择导师行气化瘀法临床验方(蒲灵化瘀止痛方)为实验药物(A组),孕三烯酮组为西药对照组(B组),未造模同期小鼠为空白对照组。各组分别给药3月。运用免疫组化技术观察雌激素效应相关因子(p450、COX-2、ERa)及血管生成相关因子(VEGF、CD31、MMP-2)在模型组、用药组的变化。结果在位内膜:与空白组比较,模型组CD31表达显著下降,MMP-2、VEGF显著升高;治疗后,A、B组CD31上调,A组显著优于B组,MMP-2、VEGF表达与模型组比较均显著下调,各组之间无统计学差异。异位内膜:与模型组比较,A、B组CD31表达显著下降,组间比较无统计学差异。治疗后A、B组MMP-2均显著下降,B组显著低于A组。在位及异位内膜p450、COX-2模型组显著高于空白组,治疗后p450、COX-2表达与模型组比较A、B组显著下降,组间比较无统计学差异。与模型组比较,A、B组治疗后ERa在位内膜及异位内膜显著下调,各组间比较无统计学差异。结论蒲灵化瘀止痛方可以有效改善在位内膜的缺血缺氧状态,与西药比较有明显优势,通过终止疾病的始动环节而达到治疗该病的目的。中药治疗可以有效减少异位内膜雌激素水平,疗效与西药孕三烯酮比较无明显差异。
Objective To explore the different mechanism of action of Chinese and Western medicine on eutopic and ectopic endometrium in adenomyosis (AM) mice by using estrogen related factors, angiogenesis-related factors and their interaction as targets . Methods Male 8-week-old ICR female rats were implanted intrauterine organ intrauterine pituitary. After operation, they were kept for 3 months to form a model group. Select the tutor of Qi and blood stasis clinical prescription (Puling Huayu analgesic side) for the experimental drug (A group), gestrinone group for the western medicine control group (B group), non-model control mice as a blank control group. Each group were administered March. The changes of estrogen-related factors (p450, COX-2, ERa) and angiogenesis related factors (VEGF, CD31, MMP-2) in model group and treatment group were observed by immunohistochemistry. Results Eutopic endometrium: compared with the blank group, the expression of CD31 in the model group was significantly decreased, and the levels of MMP-2 and VEGF were significantly increased. After treatment, CD31 in group A and group B was significantly higher than that in group B The expression was significantly down-regulated compared with the model group, with no significant difference among the groups. Ectopic endometrium: compared with the model group, the expression of CD31 in group A and group B decreased significantly, with no significant difference between the two groups. After treatment, MMP-2 in group A and group B decreased significantly, while group B was significantly lower than group A. In eutopic and ectopic endometrium, the levels of p450 and COX-2 in model group were significantly higher than those in blank group. After treatment, the expression of p450 and COX-2 in group A and B were significantly decreased compared with model group. There was no significant difference between the two groups. Compared with the model group, the ERa eutopic endometrium and ectopic endometrium of group A and B were significantly down-regulated after treatment, and there was no significant difference among the groups. Conclusions Puling Decoction for Relieving Blood Stasis and Analgesic Decoction can effectively improve the ischemia and hypoxia status of eutopic endometrium, and has obvious advantages compared with Western medicine. The purpose of treating the disease is achieved by stopping the initial link of the disease. Chinese medicine treatment can effectively reduce the ectopic endometrial estrogen levels, efficacy and gestational fentanyl no significant difference.