Clinical Observation Of Xiaoyao Shukun Decoction Combined With Xiaozhengsan In The Treatment Of SPID And Experimental Study On The Establishment And Evaluation Of Non-surgical Model Of SPID Rats

Objective:(1)To observe the clinical efficacy of xiaoyaoshukun decoction and xiaozhengsan in the treatment of SPID.(2)Preliminarily established and evaluated the non-surgical modeling method of SPID.Methods:(1)Clinical study:Seventy patients with SPID of qi stagnation and blood stasis were randomly divided into treatment group(oral xiaoyao shukun decoction,external xiaozheng powder)(35 cases)and control group(oral xuefu zhuyu oral solution,external xiaozheng powder)(35 cases)to observe the improvement of TCM symptoms and local signs before and after treatment in both groups.(2)Experimental study:180Wistar female rats were randomly divided into 6 groups.Includenon nonsurgical group(30),non-surgical simulation group(30),surgical group(30),surgical simulation group(30),incentive intervention group(30)and natural observation group(30).Non-surgical and non-surgical simulation group was given incentive intervention(hunger and fatigue intervention)after using transvaginal uplink infection of non-surgicalmethod of modeling,the surgical operation simulation group of pathogens and mechanical damage of the operation method is used to build mould,after the completion of the building,three point record oviduct ovarian rats Pelvic connective tissue morphology and microscopic morphology,flow cytometry used to observe and evaluate the efficacy of the building to obtain the rat peripheral blood mononuclear T cell subgroup Th to 17 and the expression of Foxp3 rate,enzyme-linked immunosorbent assay(ELISA)for detecting the fallopian tubes and ovaries,pelvic connective tissue and serum inflammation,regulating factor hyperplasia of IL-4 and repair factor secretion of MMP-2 protein molecules.QPCR method(real time fluorescence quantitative nucleic acid amplification testing)fallopian tube,ovarian,pelvic connective tissue and serum cytokines Il-4 and mmp-2 gene expression levels(IL-4MRNA,MMP-2MRNA secretion).Results:(1)Clinical study results: after medication,there was a significant difference between the two groups in the comprehensive efficacy of TCM syndromes and TCM signs(P < 0.05).(2)Experimental study results: Expression rates of T cells(th-17,Foxp3)in peripheral blood of the non-surgical group and the surgical group;Protein molecules and genes of Il-4 and mmp-2 in the oviduct,pelvic connective tissue and serum,after modeling,the content of Il-4 and mmp-2 increased,which was higher than that of the natural observation group(P<0.05).The third time point significantly higher than that of the same group at the first and second time points(P<0.05).Showed no significant difference between the groups at the same time point(P>0.05).The levels of cytokines(Il-4,mmp-2)protein molecules and genes in the ovaries of the six groups were similar to those of the natural observation group,with no significant difference(P>0.05).Conclusions:(1)Xiaoyaoshukun decoction and xiaozhengsan canobviously improve the clinical symptoms and signs of SPID patients with qi stagnation and blood stasis.(2)In this study,the non-operative rat model of vaginal implantation infection with SPID was successfully established under the intervention of fatigue and hunger inducement.There was no significant difference in the expression of Tcells(Th-17 and Foxp3)in abdominal adhesion,serum and tissue homogenates,as well as in the molecular and genetic levels of Il-4 and mmp-2.It belongs to the SPID animal model which conforms to the clinical characteristics and is suitable for the study of its pathogenesis and therapeutic mechanism.