| ObjectiveTo establish endometriosis model in SD rats by using abdominal injection with endometrial debris of other SD rats and investigate the effects of different doses Luoshi Neiyi Prescription in the endometrial receptivity of the endometriosis model SD rats by detecting the E-cadherin,the pinopodes and the estradiol and progesterone.The aim of this study was to explore the influence in different doses of Luoshi Neiyi Prescription,respecting to find the initial effective dose.The clinical part was to choose the patients with Endometriosis and Infertility which were diagnosed by laparoscopic operation and learn about the quality of life and the characteristic of Traditional Chinese Medicine physique in these patients by questionnaires.The statistical analysis about the relationship between the constitution and the quality of life in patients with Endometriosis and Infertility could help us to understand the physical characteristics and quality of life in different constitution of these patients and provide the evidence for clinical,in order to achieve physical and mental health and improve their quality of life.MethodsExperiment: 90 SD rats were divided into six groups at random: high dose group(group A),medium dose group(group B),low dose group(group C),model group(group D),sham operation group(group E)and blank group(group F).In addition to the sham operation group and the blank group,the rats were injected in abdominal cavity with endometrial debris to establish the endometriosis model in SD rats.After the success of the model,the mice were given different doses Luoshi Neiyi Prescription and sterilization water for8 weeks.In the fourth day of pregnancy,the left uterus of the rats were taken out for detecting the E-cadherin by Western Blotting and the right one for observing the pinopodes under the electron microscope.And the parallel orbital blood were collected to detect the levels of estradiol and progesterone in serum with ELISA.Clinical part: Study on the quality of life and the characteristic of Traditional Chinese Medicine physique in patients who were selected from three gynecology ward in the First Affiliated Hospital of Guangzhou Chinese Medicine University during January 2017 to February 2018 and had been diagnosed with Endometriosis and Infertility.After signing the relevant informed documents,a total of 120 qualified cases were investigated with Constitution in Chinese Medicine Questionnaire from Wang qi and WHOQOL-BREF under the guidance of investigators and their answer were analyzed by statistics to explore whether there were differences in the quality of life between different constitution.Result:Experiment:1.The success rate in establishment of Endometriosis model in SD rats was93.3%;2.E-cadherin: After 8 weeks of intragastric perfusion,compared with the group F,the group A to group D was different(P<0.05).The group C was the same as the group D(P>0.05),but the group A and group B were opposite(P<0.05).There was significant difference between group A,group B and group C(P<0.05).The group A was the same as group B(P<0.05).3.Pinopodes: After 8 weeks of intragastric perfusion,compared with the group F,the group A and group C were different(P<0.05)which were the same as the group D(P>0.05).The group B was the same as the group F(P>0.05)and different with the group D(P<0.05).4.Progesterone in serum: After 8 weeks of intragastric perfusion,compared with the group F,the group D was lower(P<0.05).The group A to group C were different with the group F(P<0.05).There was no significant difference between group A,group C and group D(P>0.05)but group A and group group C were different with group B(P<0.05).There was significant difference between group B and group D(P<0.05).Estradiol in serum: After 8 weeks of intragastric perfusion,compared with the group F,the group D was lower(P<0.05).The group A to group C were lowerthan the group F(P<0.05).There was no significant difference between the group A,group C and group D(P>0.05).The group B were different with group D(P<0.05)and higher than group A and group C(P<0.05).Clinical part:A total of 120 questionnaires were issued in this study and 105 questionnaires were collected,including 102 valid questionnaires and 18 invalid questionnaires.The effective questionnaire rate was 85% and the invalid questionnaire rate was 15%.1.The physical distribution characteristics of patients with Endometriosis and Infertility: these patients for basic physical type of biased constitution,the largest proportion was blood stasis physique(79cases,74.53%),followed by were qi depression physique(9 cases,8.49%),yang deficiency physique(8 cases,7.55%),phlegm dampness physique(4 cases,3.77%),warm physique(3 cases,2.83%),yin deficiency physique(2 cases,1.89%),qi deficiency physique(1 cases,0.94%),special physique(0%).2.The quality of life: the average score for the quality of life of the patients with Endometriosis and Infertility was 3.2±0.51,which was between3 points(general)and 4 points(good).The average answer to their health was 2.65 ± 0.56,which was between 2 points(differential)and 3 points(general).The average scores in each field : there was 11.67±1.65 in the physiological field,11.65±2.23 in the psychological field,10.59±2.20 in the social field and 10.59±2.20 in the environment field.Compared with the national norm,the scores of the four areas were all low and the difference was statistically significant(P<0.05).3.There were no significant difference in subjective judgement of quality of life and health among the different constitution in the patients with Endometriosis and Infertility(P>0.05),but there were significant differences in physiological,psychological,social and environmental fields(P<0.05).In physiological field,the lowest score was qi deficiency physique(1cases,10.29 points),the second was blood stasis physique(11.16±1.43),and followed by were qi depression physique,phlegm dampness physique,yang deficiency physique,warm physique,normal physique and yin deficiency physique.In psychological field,the lowest score was qi depression physique(10.67±2.36),the second was blood stasis physique(11.05±1.89),followed by were phlegm dampness physique,yang deficiency physique,warm physique,normal physique and yin deficiency physique.In Social field,the lowest score was blood stasis physique(11.97±2.08)in the social field,the second was phlegm dampness physique(12.0±1.09),followed by were qi depression physique,yang deficiency physique,qi deficiency physique,normal physique,warm physique and yin deficiency physique.In environmental field,the lowest score was phlegm dampness physique(9.50±1.47),the second was blood stasis physique(10.09±2.05),followed by were qi depression physique,qi deficiency physique,yang deficiency physique,yin deficiency physique,warm physique and normal physique.ConclusionExperiment:1.This experiment has a high molding rate and a certain repeatability and operability.2.Compared with normal SD rats,the expression of E-cadherin in endometriosis SD rats showed a low level,the development of the pinopodes was not synchronized that there was a decline phenomenon without entering maturity stage,and the levels of estradiol and progesterone in serum decreased.3.Compared with the model group,the change about three indexes had no statistical significance in low dose group,indicating that the low dose of Luoshi Neiyi Prescription had no significant intervention on the endometrial receptivity of SD rats.4.Compared with the model group,medium dose of Luoshi Neiyi Prescription can improve E-cadherin expression,promote the maturation of pinopode and increase the level of estradiol and progesterone in serum,indicating that the medium dose of Luoshi Neiyi Prescription can improve the endometrial receptivity of rats.5.The effect of high dose of Luoshi Neiyi Prescription on the expression of E-cadherin was not significantly different from that in the medium dose group,but had no significant effect on promoting the maturation of the pinopodes and increasing the level of estradiol and progesterone in serum.6.To sum up,the medium dose of Luoshi Neiyi Prescription may be the initialeffective dose.Clinical part:1.The survey results showed that the patients with Endometriosis and Infertility were basically biased.The proportion of blood stasis physique was the largest,followed by were qi stagnation physique,yang deficiency physique,phlegm dampness physique,warm physique,yin deficiency physique and qi deficiency physique.2.The patients with Endometriosis and Infertility were at normal on the quality of life and health status.The level of physiological field,psychological field,social field and environmental field were lower than the national norm,which suggested that the quality of life in these patients were not good and the disease would produce the adverse effects on the quality of life.3.In terms of subjective feeling towards the quality of life and health,there was no significant difference between the different physique of the patients with Endometriosis and Infertility that explained the disease have a major impact on the subjective experience of the patients because of long duration,pain and physical and psychological pressure which came from infertility.There were significant differences between different physique patients in the fields of physiology,psychology,society and environment.The results indicated that the patients with different constitution had different quality of life.In terms of the four fields above,the average scores of the patients with blood stasis physique were lower,indicating that the influence of blood stasis physique on the quality of life of these people is more significant than that of other physique. |
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