Study On The Clinical Effect Of Removing Stasis And Eliminating Phlegm In The Treatment Of Adenomyosis And Its Related Mechanism

Objective:1.To observe the clinical effect of tongmaihua Syndrome decoction in treating adenomyosis of phlegm and blood stasis;2.To observe the mechanism of endometrial neovascularization in mice inhibited by Tongmai Huazhen Decoction.Methods:1.In the clinical part,patients with adenomyosis were randomly assigned to the observation group and the control group after signing informed consent voluntarily.The observation group was given tongmaihua Syndrome Decoction,and the control group was given Sanjie Zhentong capsule.The scores of each syndrome of patients were recorded three months after taking medicine,and the clinical efficacy was evaluated.2.Animal studies,selecting female ICR mice 45,45 male ICR mice,random points after the cage,female ICR mice naturally conceived,randomly randomly selected building successful 50 female ICR mice were randomly divided into model group,Chinese medicine lavage dose in low dose group,Chinese medicine lavage group,Chinese medicine lavage high dose group and gestrinone,choose 10 only blank group.Experimental animals were purchased from Beijing Weitong Lihua Animal Breeding Co.,LTD.Blank group and model group are not treated specially;Low dose group,medium dose group and high dose group were given tongmai Huasheng Decoction.Getrienone group was intragastric with getrienone aqueous solution.The expression levels of VEGF,MMP-2,MMP-9 and NF-κB in serum CA125 of newborn ICR mice and in focal tissues of adenomyosis were observed.Results:1.In the clinical part(1)Menstrual volume score and lost blood clot score: there was no obvious difference between the two groups after treatment,and the improvement effect of the two treatment methods on the menstrual score and lost blood clot score of patients with adenomyosis was close,but compared with the treatment before and after the treatment of the two groups,the treatment effect of the experimental group was obvious compared with the control group.(2)TCM syndrome integrals: The main,secondary symptoms and comprehensive scores of TCM after treatment in the two groups were statistically different(P<0.05)compared with before treatment,indicating that both methods can significantly improve the clinical symptoms of patients with adenomyosis.At the same time,the experimental group had a better effect on improving menstrual cycle disorder than the control group(P<0.05),but there was no obvious advantage in improving the main symptoms such as blood clots in the menstrual purple color,less abdominal pain and discomfort during menstruation and before and after menstruation,and gradual exacerbation.For the therapeutic effect of secondary chest tightness and vomiting and phlegm,the experimental group was obvious compared with the control group(P<0.05),but the treatment effects of the two groups were not significantly different compared with the thick,painful intercourse and anal fall(P>0.05).At the same time,the changes in the comprehensive integrals of the two groups were compared,indicating that the experimental group was better than the control group(P<0.05)in terms of improving TCM symptoms between the two treatment methods.(3)Efficacy of TCM symptoms: Comparing the total integrals and total effective rate of the two groups,the comparison between the two groups before and after treatment was statistically significant,indicating that both groups could improve the TCM syndrome integrals of patients with adenomyosis,but there was no statistical significance in the comparison between the two groups before and after treatment,indicating that in terms of improvement of TCM syndrome,the therapeutic efficacy of the two groups was comparable.2.Animal experimental research(1)In HE staining,the endometrium and muscle layer of the model group were unclear and disordered,and the glands and interstitial cells were visible in the muscle layer.Blank groups are not visible.All the dosage groups of Tongmaihua Syndrome decoction could reduce the invasion of endometrium and gland into muscle layer,and the effect of tongmaihua syndrome decoction high-dose group and getrienone group was the most obvious.(2)Immunohistochemical and Western Blot results showed that the expression of VEGF,MMP-2,MMP-9 and NF-κ B in model group was significantly increased(P < 0.05).The expressions of VEGF,MMP-2,MMP-9and NF-κ B were decreased in tongmaihua Syndrome Decoction high-dose group and getrienone group,and the effect was the most significant(P <0.05),but there was no significant difference between them(P > 0.05).(3)Elisa: The results showed that the level of CA125 in the model group was significantly higher than that in the blank group(P < 0.05),and the expression of CA125 in the other treatment groups was decreased,but there was no statistical significance among the treatment groups(P >0.05).Conclusion: 1.Clinical study part,phlegm and blood stasis elimination method in the treatment of phlegm and blood stasis mutual junction uterine adenomyosis clinical curative effect,can effectively alleviate the excessive menstrual quantity of patients after taking the drug,reduce the loss amount of blood clots,relieve uterine adenomyosis master of traditional Chinese medicine syndrome,a disorder syndrome,and so on,can obviously improve the quality of survival,provide new diagnosis and treatment way for clinical treatment.2.In animal experiment,it was observed that Tongmaihua Syndrome Decoction could inhibit the formation of endometrial neovasculogenesis by down-regulating the expression of VEGF,MMP-2,MMP-9,NF-κB and CA125 in the intima of model mice,among which tongmaihua Syndrome decoction high-dose group and getrienone group had the most significant effect.The expression of CA125 in serum of model mice in tongmai Huazi Decoction group and getrienone group was down-regulated,and no significant difference was found.The therapeutic effect of each group was similar.