摘要
目的:通过观察宫腔粘连(IUA)患者月经血中细胞外基质(ECM)降解相关因子表达水平的变化,评估补肾活血方在宫腔修复过程中的作用。方法:选择2018年9月—2020年9月于上海中医药大学附属曙光医院因IUA入院行宫腔粘连分解手术(TCRA)患者49例,随机分为中药组(24例)和对照组(25例)。TCRA术后,两组均激素治疗,中药组在对照组基础上添加补肾活血方治疗,于TCRA术前1个月经周期及术后第3个月经周期,第2~3天留取经血,比较治疗前后月经量情况,排卵日阴道超声监测子宫内膜厚度及子宫动脉阻力指数(RI),RT-PCR检测两组月经血组织物中PI3K、MMP-9、TIMP-1、COL1A1 mRNA表达水平。结果:TCRA术后中药组内膜厚度较对照组增厚(P<0.05),RI较对照组降低(P<0.05),经血组织中MMP-9、PI3K mRNA相对表达量显著高于对照组(P<0.05)。结论:补肾活血方可上调子宫内膜MMP-9、PI3K的表达,达到抑制ECM沉积,促进子宫内膜血管新生的作用,有助于增加IUA患者术后子宫内膜厚度,改善子宫内膜血流,预防宫腔再次粘连。
Objective:To evaluate the intervention effect of Bushen Huoxue Decoction on intrauterine adhesions(IUA)patients in the process of uterine cavity repair by observing the changes in the expression levels of ECM degradation-related factors in menstrual blood of patients with IUA.Methods:From September 2018 to September 2020,49 patients who were admitted to Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine due to IUA were selected and randomly divided into Chinese medicine group(24 patients)and control group(25 patients).After TCRA operation,the control group of 24 patients were treated with oral Estradiol valerate and dydrogesterone,while the TCM group of 25 patients were treated with Bushen Huoxue Decoction and also combined with oral Estradiol valerate and dydrogesterone.The patients of these two groups,whose menstrual blood was collected on the second or third day of before the operation and the third menstrual cycle after operation be detected the mRNA expression levels of PI3 K,MMP-9,TIMP-1,and COL1 A1 by qRT-PCR.The endometrial thickness and the uterine artery resistance index RI of these two groups of patients were measured under vaginal ultrasound on ovulation day,and were calculated.Results:After TCRA,the endometrial thickness of the Chinese medicine group was thicker than that of the control group(P<0.05),and RI of the Chinese medicine group was lower than those of the control group(P<0.05).The relative expression levels of MMP-9 and PI3 K mRNA in menstrual blood tissue of the Chinese medicine group were higher than those of the control group(P<0.05).Conclusion:Bushen Huoxue Decoction has the effects of increasing the endometrial thickness of postoperative IUA patients,improvivg the endometrial blood flow,by promoting the expression of MMP-9 and PI3 K in menstrual blood tissue and inhibiting extracellular matrix deposition,but also it could obviously promote the recovery of patients after operation and the prevention of IUA again.
作者
章晓乐
迟令侃
苟凤钗
张琼
闫晓彤
齐聪
ZHANG Xiao-le;CHI Ling-kan;GOU Feng-chai;ZHANG Qiong;YAN Xiao-tong;QI Cong(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2022年第1期523-526,共4页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家重点研发计划“中医药现代化研究”重点专项(No.SQ2018YFC170061)。
