Effect Of Huayu Tongluo Method On Hemodynamics And Vascular Neoplasms Of Pelvic Blood Stasis Microenvironment In Sequela Of Pelvic Inflammatory Diseases

Objective. Sequelae of pelvic inflammatory diseases (SPID) is very common in women, seriously affecting women’s health. Modern medicine is currently not so effective on treatment of the disease. However, traditional chinese medicine (TCM) has certain advantages on this aspect. In TCM theory, blood stasis is the major pathogenesis of SPID, throughout the development of the disease. Therefore, we proposed the concept - "blood-stasis microenvironment" and hypothesized that resolving blood stasis and unblocking collaterals could improve the blood-stasis micro environment. This study intended to establish integrated thinking system to evaluate the pelvic hemodynamics and angiogenesis level in SPID and the effect of resolving blood stasis and unblocking collaterals therapy on the two aspects. Methods. The subject consisted of experimental and clinical studies, which objectively evaluated effect of the therapy——resolving blood stasis and unblocking collaterals on blood-stasis microenvironment of SPID. Animal experiment:the SPID murine model was copied by intrauterine injection of M.muridarum. The SPID mice were given Danzhi decoction for consecutive 3 estrous cycles, and then observe the following parameters:(1) the uterine artery peak systolic (PSV), the ovarian artery blood peak systolic (PSV), the mesenteric microcirculation perfusion and pelvic-wall microvascular perfusion; (2) the protein levels of VEGF, Ang-2 and OPN in the reproductive tract tissues (including uterus, fallopian tubes, ovaries, connective tissues). Clinical Research:72 SPID outpatients of cold-stagnation and blood-stasis type from Dongfang hospital were randomly divided into the observation group and the control group. The observation group were given Danzhi decoction and the control group received Guizhifulin decoction for 3 menstrual cycles, then pelvic hemodynamics, VAS score, local physical score and chinese medicine symptom complex score were observed to evaluate the efficacy of Danzhi decoction on pelvic blood-stasis microenviroment. Results. (1) SPID mice were inferior to normal mice on pelvic hemodynamics SPED, and after chinese medicine’s intervention, the hemodynamics and pelvic pain was significantly improved. The mid-dose of Danzhi decoction had better efficacy than high dose and small dose; (2) hemodynamics and chronic pelvic pain were correlated; (3) VEGF, Ang-2 and OPN were overexpressed in the reproductive tract of SPID mice, after drug intervention, these cytokines were expressed lower, high-dose and mid-dose Danzhi decoction could significantly downregulate these cytokines; (4) SPID of cold-stagnation and blood-stasis type had significant differences in pelvic hemodynamics before and after treatment. VAS score, local physical score and chinese medicine symptom complex score were significantly decreased after drug intervention. Conclusions. After the animal experiment and clinical study, it could be concluded that:(1) SPID patients suffered pelvic blood-stasis microenvironment; (2) pelvic hemodynamics of SPID correlated with the severity of chronic pelvic pain; (3) VEGF, OPN and Ang-2 were overexpressed in the upper genital tract in SPID mice, which meant pathological angiogenesis; (4) resolving blood stasis and unblocking collaterals could improve pelvic blood-stasis microenvironment by promoting pelvic hemodynamics;(5) resolving blood stasis and unblocking collaterals could inhibit angiogenesis, which could help the body repair damaged tissues to prevent further damages; (5) resolving blood stasis and unblocking collaterals therapy is effective on the treatment of chronic pelvic pain, local physical score and Chinese medicine symptom complex score in SPID, worthy of recognition.