Study Of Mifepristone Related Adnormal Menstruation And Xianche Decoction Recovering Mechanism

This research is to study the potential risks of abnormal menstruation after medical abortion. Clinical measurements were based on therapy and control group for Xian Che Decoction (XCD). Blood serum levels (LH/FSH/P/E₂) were assayed before and after treatments. Results show that this kind of abnormal menstruation has higher occurrences in medical abortion age group over 35, abnormal menstruation patients prior to medical abortion, menarche age group over 17 and patients with multiple medical abortion history. Before XCD treatments, LH/FSH/P/E₂ level of all patients were within, or below, the scope of follicular phase. After treatment, sexual hormone levels had been raised to different degrees. Further investigation focused on abnormal menstruation mechanism and XCD recovering function. Rat model was established in order to measure ER/PR expression level in pituitary, ovaries and endometrium by immunohistochemistry. LH/FSH/P/E₂ level were assayed by radio immunity. The ultra microstructure of ovaries and endometrium were observed with transmission electron microscope. Results: Mifepristone significantly degrades ER/PR expression level in rat ovaries and endometrium (p<0.05). PR expression level in endometrium of medical abortion group is notably lower than that of impregnate group (p<0.05) that leads to cellular damages in endometrium. Damages further extend to basal membrane in medical abortion group. In ovaries, growing follicles diminish or disappear and granular cell apoptosis has taken place. It is more serious in medical abortion group. XCD, with different doses, could improve ER/PR expression to different degrees in pituitary, ovaries and endometrium. Neogenesis glandular is found in endometrium. Follicle and luteum of each stage have beenobserved in ovarian. This phenomenon is more obvious in high dose group. Conclusion: 1) Abnormal menstruation after medical abortion is related to the age of precedes abortion, menstruation state before abortion, menarche age, and medical abortion frequency. 2) Mifepristone depresses ER/PR expression level in ovaries and endometrium of rats, and at the same time lowers LH/FSH/E2/P level. Mifepristone also damages eudiometrical granular, restrains follicle growth, and induces granular cell apoptosis. Pregnant rats are particularly sensitive to Mifepristone. 3) Xianche Decoction enhances ER/PR expression level and raises sex hormone level. Better still, it recovers endometrium and ovaries. The therapeutic effect is dose dependent.