| Objective: Endometriosis(for short"EM") is one of a complex diease in gynecology, it happens to most of the women who are in child-bearing period. The pathogeny and episodic mechanism of endometriosis is not clear completely heretofore. There are many thoerys about the episodic mechanism of endometriosis. Most scholar approbated the thoery of Sampson.The growth of endometrium which flowed into celiac inside must depend on adhering of endometrium issue. People were cognizant of the importance of the function of Cellular adhersion molecules. At present, druggery therapies and surgery are used for treatment of endometriosis. But there are some problems: the rate of recurrence after surgery is high; And after the pseudomenopause therapy and spurious pregnancy therapy also have the problems of recurrence and ill effect; So it is an important topic that explore the episodic mechanism and effective therapy of endometriosis.In order to explore the episodic mechanism of endometriosis and provide an effective therapy,we invest therapeutic effect of endometriosis by treatment of Bushen Wenyang Huayu principle (BSWYHY, Tonifying Kidney,Warming Yang and Removing Blood Stasis).Methods:1 Clincical observation:Thirty patients who fitted the diagnostic standard, included standard, excluded standard and traditional Chinese medicine standard in differentiation of symptoms and signs of EM coming from the fourth hospital of city Shijiazhuang during October 2005 to Decemberr 2006 were collected.Thirty cases with endometriosis were treated by the tonifying kidney warming yang removing blood stasis method for three menstrual cycles.During the observed course ,the patients did not take any other herb or western drug. we collected three milliliter blood in ulnar vein and centrifuge for serum in pretherapy amd postreatment. The serum would be conserved in refrigerator below zero 70 centidegree for measurement. The other 30 cases with peritoneal fluid were collected while operating, diagnosis was confirmed by pathological examination. 30 voluntary subjects were selected as serum control group eliminating disease in heart, kidney or endocrine system etc. While 30 cases with peritoneal fluid were collected as normal endometrium and peritoneal fluid control group,diagnosis was confirmed by pathological examination.Detected the contents of sICAM-1,sVCAM-1,E2,P,CA125 in serum and peritoneal fluid by means of radio immunoassay or enzyme linked immunosorbent assay. Since the control group cases had no significant difference with the patients in age, they were comparable.The amelioration of the symptoms and physical signs were determined.we can measure the changes of Serum hormones and Cellular adhersion molecules to discuss the episodic mechanism of endometriosis.2 Experimental research: 60 depuratory and healthy SD females rats with normal estrous cycle(4-5days),200±50g in body weight,50 rats were used methord JONES to duplicate the model of endometriosis.After 4 weeks,chose the rats that duplicate model triumphantly and divided them into 4 groups stochasticly:low-dose group ,high-dose group,Danazol group,model group.There were 10 rats in each group.Control group were raised by routine feed.Those rats of low dose and high dose groups were administrated in dose of 15.41g/kg,61.76g/kg separately,once per day for 4 weeks.The rats of Danazol group were in dose of 25mg once daily.Model group were given the same voluminal distilled water.Fasting eight hours after last administration ,sacrificed the rats by decapitation during anestrum. Disseced and got rats endometrium quickly,slighlty wiped with filter paper.Fixed endometrium in 4% Polyoxymethylene,paraffin embedded ,slice in 5μm.Detected the expression of ICAM-1 and NF-κB in endometrium tissue by means of immunohistochemistry.Results:1 Clincical observation: Thirty cases with endometriosis treated with TCM. Three months treatment successively is a course.The amelioration of the symptoms and physical signs were determined. The number of sufferer which was cure was 22 and the rate of availability was 73.33%.Serum concentration of P were no significant difference between EM women and control group(P>0.05),and the concetration were increased after cure (P<0.01).Serum concentration of E2 in EM women was higher than that in control group(P<0.01),and the concetration were descend after cure (P<0.01).Serum concentration of sICAM-1 and sVCAM-1 in EM women were higher than that in control group(P<0.05, P<0.01), and the concetration were descend after cure (P<0.01,P<0.01). Peritoneal fluid concentation of sICAM-1and sVCAM-1 in EM women were higher than that in control group(P<0.01,P<0.05), Serum concentration of CA125 in EM women was higher than that in control group(P<0.01),and the concetration were descend after cure (P<0.01).2 Animal experiment indicate:After treat 4 weeks,the cubage of implant in high dose and Danazol groups were lower than that in model group,(P<0.01,P<0.01),There were no significant difference between low dose group and model group(P>0.05).Positive expression of ICAM-1 was located mainly in the cellular plasma. In model group,expression of ICAM-1 were located in cellular plasma, and the expression of ICAM-1 was increased(P<0.01). Expression of ICAM-1 in high-dose, low-dose and Danazol groups were lower than that in model group(P<0.01,P<0.01,P<0.01).There were no significant difference between high-dose group and control group(P>0.05) Positive expression of NF-κB were located in the intracytoplasm.In control group,expression of NF-κB was not obviously,mostly located in intracytoplasm,seldom in nucleus.In model group,expression of NF-κB were located in intracytoplasm.Expression of NF-κB in model group were higher than control group(P<0.05). Expression of NF-κB in high-dose and Danazol groups were lower than that in model group(P<0.01,P<0.01). There were no significant difference between low- dose group and model group(P>0.05).There were no significant difference between high-dose group and control group(P>0.05).There were positive correlation between expression of ICAM-1 and activation of NF-ΚB in endometrium tissue.(r=0.698,P<0.05).Conclusions:1 Bushen Wenyang Huayu principle not only can reduce focus ,loosen conglutination, alleviate ache,furthermore,it can adjust the fuction of ovary.The side-effect of Chinese traditional medicine was trifling,it is good among the effective method which treat EM.2 The level of sICAM-1and sVCAM-1 were all increased in EM group. We consider that it influenced immunity surroundings of EM patient, and it can accelerate ectopic adhering. It is very importance of the episodic mechanism of endometriosis.3 The activity of NF-κB in endometrium of model rats of EM were increased, and it showed positive correlation with the expression of ICAM-1,which indicated that strong adhesively of ICAM-1 was relate to the strong expression of NF-κB likelihood. Bushen Wenyang Huayu principle adjust the activity of NF-κB achieve to adjust the expression of CAMs . |
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