Experimental And Clinical Research On The Treatment Of Oligomenorrhea With Kidney Deficiency And Blood Stasis Type By Nourishing The Kidney And Activating Blood

Objective:To explore the experimental and clinical basis of tonifying kidney and promoting blood circulation in the treatment of kidney deficiency and blood stasis.Methods:1)The Chinese medicinal materials with estrogen-like activity were summarized and classified,estrogen-like drugs were screened,and the representative monomer drug with kidney-tonifying and blood-activating effect-genistein was selected for the experiment,to observe the effect of genistein on the proliferation of endometrial epithelial cells and the expression of ER receptor protein:(1)selection of low concentration is 0.01,0.1,1 μmol/L and high concentrations of 10,25.50μmol/L form gradient of HEEC gold finches different flavin cells 24,48.72 h after the intervention respectively with CCK 8 method to detect cell activity;(2)the selection of low concentration of estrogen(1x10-8 mol/L)to carry on the building,use 0.01-50 μmol/L gradient under the concentration of gold finches different flavin on HEEC cells with CCK 8 after 48 h method to detect cell activity;(3)using laser immune confocal microscopy after estrogen building 0.1 μmol/L and 50 μmol/L gold finches different flavin concentration effect on HEEC cells after 48 h ER alpha,beta protein expression of ER.2)According to include and exclude standards receive 30 patients which is kidney deficiency and blood stasis type,collect general information of patients,after three courses of clinical drug therapy were conducted with the legislation of "tonifying kidney and promoting blood circulation",then through the PBAC and TCM syndrome integral table evaluation before and after treatment in the treatment of patients in the menstrual quantity and TCM symptom integral,observe the clinical efficacy of kidney invigorate the circulation method.Results:(1):(1)gold finches different flavin within 0.01～50 u mol/L promote HEEC cell proliferation(P<0.01),the role of 48h was most evident effect on promoting cell proliferation(P<0.01),genistein group was 0.1 mu mol/L concentration was most evident effect on promoting cell proliferation(P<0.01),and its effect on promoting proliferation presents downtrend with the action time and concentration.②Induced by estradiol(1×10-8 mmol/L),genistein promoted the proliferation of HEEC cells at low concentrations(0.01,0,1,1 μmol/L),and the proliferation was most obvious at 0.01 μmol/L for 48 h(P<0.01).The proliferation promotion of HEEC cells was decreased by high concentration of genistein(P<0.01).③Under the induction of estradiol(1×10-8 mmol/L),0.1μmol/L genistein increased the protein expression of Era and Erβ,and increased the ratio of Erα/Erβ(P<0.05),while 50μmol/L genistein inhibited the protein expression of Era and slightly increased the protein expression of Erβ,and decreased the ratio of Erα/Erβ(P<0.05).2)A total of 30 patients with renal deficiency and blood stasis were collected,ranging in age from 24 to 47 years,with an average age of 35.3±6.353 years,course of disease ranging from 0.2 to 3 years,average course of disease 1.288±0.783 years,average number of pregnancy and delivery 1.07±0.74,and frequency of intrauterine operation 2.033±1.273;The average score of PBAC before treatment was 17.3±7.920 points,and the average score after treatment was 33.0±11.241 points,the difference was statistically significant(P<0.01).The average scores of TCM symptoms were 34.700±7.779 before treatment and 15.900±6.059 after treatment,and there was statistical significance between the scores before and after treatment(P<0.01).The scores of menstrual volume,menstrual duration,menstrual chromaticity,lumbar and knee pain,dizziness and tinnitus and 5 symptoms were significantly decreased compared with those before treatment(P<0.01).The scores of symptoms of lower abdominal pain were also decreased compared with those before treatment(P<0.05).The differences before and after treatment were statistically significant.Although the symptoms of heel pain showed a decrease in scores,there was no significant difference before and after treatment(P>0.05).After 3 months of traditional Chinese medicine treatment,the total effective rate of 30 patients was 96.7%,1 invalid,23 effective,6 effective and 0 cured.The difference of curative effect between patients with different course of disease was statistically significant(P<0.01).Therapeutic effect difference was statistically significant among patients with different gestational order(P<0.01).Conclusion:1)the monomer of traditional Chinese medicine for tonifying kidney and promoting blood circulation--genistein can promote the protein expression mediated by ER receptor,thus exerting estrogen-like effects and promoting the proliferation of human endometrial cells;2)the method of tonifying kidney and promoting blood circulation can effectively treat the symptoms of deficiency of kidney and blood stasis,and effectively improve the menstrual volume,menstrual time,color quality,pain and softness of waist and knee,dizziness and tinnitus.