| Objective1. Study the mechanism of Yiqihuayu decoction in rats model of incomplete puerperal involution of uterus after medical abortion, mainly observed the effects that the hormonal regulation,angiogenesis,vasoconstriction,collagen degradation and other factors.2. Study the mechanism of Yiqihuayu decoction in Rats model of incomplete puerperal involution of uterus after inflammation postpartum, mainly observed the effects that inflammatory,hormonal regulation,platelet aggregation,collagen degradation and other factors.MethodsThe first part Experimental Study on the Intervention of Yiqihuayu decoction in Rats Model of Incomplete Puerperal Involution of Uterus After Medical AbortionBuild Rats medical abortion models with SD rats of clean grade, divide the rats with medical abortion models into 5 groups randomly: model group, Chanfukang group, Yiqihuayu decoction low dose group, Yiqihuayu decoction middle dose group, Yiqihuayu decoction high dose group and normal pregnancy group.Take the embryo by laparotomy at the 7th day of postnatal, observe the pathological morphology in light microscope, Statistics the amount of vaginal bleeding.detect each group the content of E2,P by radioimmunoassay;detect each group the content of TNF-α,t-PA by ELISA; detect each group the content of NO,NOS by Kit method;detect each group the expressions of ER and PR protein by immunohistochemical method(SABC); detect each group the expressions of VEGF,MMP-9and TIMP-1 gene by in situ hybridization.The second part Experimental Study on the Intervention of Yiqihuayu decoction in Rats Model of Incomplete Puerperal Involution of Uterus after inflammation postpartumBuild Rats inflammation postpartum models with SD rats of clean grade, divide the rats with medical abortion models into 5 groups randomly: model group, Chanfukang group, Yiqihuayu decoction low dose group, Yiqihuayu decoction middle dose group, Yiqihuayu decoction high dose group and normal pregnancy group.Take the embryo by laparotomy at the 7th day of postnatal, observe the pathological morphology in light microscope, Statistics the amount of vaginal bleeding.detect each group the content of E2,P,6-K-PGF1α,TXB2by radioimmunoassay;detect each group the content of TNF-a by ELISA; detect each group the content of NO,NOS by Kit method;detect each group the expressions of IL-1 protein by immunohistochemical method (SABC); detect each group the expressions of MMP-9and TIMP-1 gene by in situ hybridization.ResultsThe first part Experimental Study on the Intervention of Yiqihuayu decoction in Rats Model of Incomplete Puerperal Involution of Uterus after Medical Abortion1. Light microscope morphological observations suggest:①Control group with normal uterine tissue,wasnot infiltrated by lymphocytes, no macrophages, stromal vascular endothelial cells were integrity;②model group:cellular necrosis exuviation, succession endomembrane had abscised, more interstitial substance was infiltrated by inflammatory cells.Part of small vessels under endomembrane was expansion and engorgement, interstitial substance had puff edema.③Chan Fu Kang group and Yi Qi Hua Yu high dose group:succession endomembrane had gently abscised,less interstitial substance was infiltrated by inflammatory cells, whiles Part of small vessels under endomembrane was expansion and engorgement.There is no obvious uterine exudates.④Damnification of endepidermis in Yi Qi Hua Yu low and middle dose group is less light than model group, more graveness than Chan Fu Kang group and Yi Qi Hua Yu high dose group. 2.After medical abortion, both the high,middle,low shearing rate and the blood viscosity in serum in the model group were higher than the blank group (P<0.01), the Content of tPA and TNF-αwas especially higher.Each group of Yiqihuayu decoction could reduce the content of both the high,middle,low shearing rate,the blood viscosity and tPA,TNF-α.The content of each shearing rate,the blood viscosity and the tPA. in each Yiqihuayu decoction group showed no statistical meaning with Chanfukang group (P>0.05)3.After medical abortion, bleeding volume in each group of Yiqihuayu decoction was less than the model group (P<0.01). The content of E2 in serum rised and the content of P value reduced in each group of Yiqihuayu decoction, The expression of ER and PR were raised in each Yiqihuayu decoction group (P<0.05). The low and middle group of Yiqihuayu decoction showed no statistical meaning with Chanfukang group (P>0.05), while the high group of Yiqihuayu decoction showed a significant in statistic(P<0.05).4.After medical abortion, the Content of NO and NOS were especially higher. The content of NO and NOS in serum rised reduced in each group of Yiqihuayu decoction, showing no statistical meaning with Chanfukang group (P>0.05)5.After medical abortion,the expression of VEGFmRNA MMP-9mRNA in rats uterine tissues were especially lower,while the expression of TIMP-1mRNA was especially higher. The expression of VEGFmRNA,MMP-9mRNA in rats uterine tissues were raised,the expression of TIMP-1mRNA was reduced in each group of Yiqihuayu decoction, showing a significant in statistic with model group(P<0.05), no statistical meaning with Chanfukang group (P>0.05)The second part Experimental Study on the Intervention of Yiqihuayu decoction in Rats Model of Incomplete Puerperal Involution of Uterus after inflammation postpartum1.Pathomorphological observation Confirm:①the normal group(normal postpartum rats), endometrial tissue is normal,dropsy in cells, lymphocyte infiltrates of interstitial substance, no macrophages,complete vascular endothelium cells;②the model group, degeneration and necrosis of epithelium,interruption of endometrial continuity, mass leukocytic infiltration,minute intracranial vascular dilatation and congestion, interstitial relatively loose edema;③Chanfukang group and Yiqihuayu decoction high group:slight injury of epithelium, less leukocytic infiltration,,part of minute intracranial vascular dilatation and congestion, no obvious drainage in uterine Cavity.④The degree of endothelium injury in Yiqihuayu decoction low and middle group was minor compared with the model group,while serious compared with the Chanfukang group and Yiqihuayu decoction high group.2. Inflammation postpartum, bleeding volume in each group of Yiqihuayu decoction was less than the model group (P<0.01). Both the high,middle,low shearing rate and the blood viscosity in serum in the model group were higher than the blank group (P<0.01).The content of both the high,middle,low shearing rate and the blood viscosity were reduced in each group of Yiqihuayu decoction, showing a significant in statistic with model group(P<0.05), no statistical meaning with Chanfukang group (P>0.05)3.Inflammation postpartum,the content of E2,P in serum were especially lower than the blank group. The content of E2,P were raised in each Yiqihuayu decoction group (P<0.05). showing a significant in statistic with model group(P<0.05), no statistical meaning with Chanfukang group (P>0.05)4.Inflammation postpartum,the content of TXB2 in serum were especially higher than the blank group, while the content of 6-K-PGF1αin serum were especially lower than the blank group(P<0.05).The content of TXB2 were reduced,while the content of 6-K-PGF1αwere raised in each Yiqihuayu decoction group (P<0.05), showing a significant in statistic with model group(P<0.05), no statistical meaning with Chanfukang group (P>0.05)5.Inflammation postpartum, the content of TNF-α,NO. NOS in serum were especially higher than the blank group,while the expression of IL-1 was especially higher than the blank group. The content of TNF-α,NC,NOS were reduced, while the expression of IL-1 was reduced in both each Yiqihuayu decoction group and chanfukang group, showing no statistical meaning(P>0.05).Yiqihuayu decoction high group showed a significant in statistic with chanfukang group(P<0.05). 6.Inflammation postpartum, the expression of MMP-9mRNA was especially higher than the blank group, while the expression of TIMP-1mRNA was especially lower than the blank group. The expression of MMP-9mRNA was reduced, while the expression of TIMP-1mRNA was raised in both each group of Yiqihuayu decoction and chanfukang group, showing a significant in statistic with model group(P <0.05). Yiqihuayu decoction high group showed a significant in statistic with chanfukang group(P<0.05).Conclusion1.Based on years of experience in treatment of incomplete puerperal involution of uterus, teacher Professor You Zhao Ling account that the major clinical manifestations of incomplete puerperal involution of uterus is deficiency,blood,pain.The deficiency due to impairment of body Qi and uterus is injured when childbirth,The blood due to injured uterus and its vessels or failure fixating function because impairment of body Qi.The pain due to injured uterus and its vessels or staying haemostasis and unobstructed venation.Qi-deficiency and Blood-stagnation is the main pathogenesis of incomplete puerperal involution of uterus.Its treatment focuses on both replenishing qi and resolving stagnation and supporting healthy qi and removing pathogenic factors. Yiqihuayu decoction is formulated by Professor You and the decoction has been used for clinical treatment of Qi-deficiency and Blood-stagnation of incomplete puerperal involution of uterus, whose clinical manifestation is postpartum lochiorrhea and postpartum abdominal pain after induced abortions medical abortion or Gynecologic surgery.2.The blood of women after medical abortions is in hypercoagulable state. The research of pharmacology Confirm:Yiqihuayu decoction promotes puerperal involution of uterus through①improving blood circulation., inhibiting coagulation;②regulating hormone levels after medical abortion, improving endometrium hyperplasia and peeling and repairing;③inhibiting the production of toxicity cytokines,promoting endothelial cells growth and formation of new vessels,repairing the wound.④remodeling uterine spiral arteries,promoting the constriction of blood vessels,enhancing the stabilization of lysosome membrane.3.The blood of women after inflammation postpartum is in hypercoagulable state. The research of pharmacology Confirm:Yiqihuayu decoction promotes puerperal involution of uterus through①improving blood circulation;②keeping pace with the hormone levels, promoting endometrial hyperplasia and repairing;③inhibiting platelet aggregation, promoting the constriction of blood vessels,preventing thrombosis;④suppressing the inflammation,alleviating cardiovascular injury,prompting the formation of vascular intima,participating the regulation of blood flow of uterine, remodeling the endometrium and uterine spiral arteries;①regulating balance between MMP-9 and TIMP-1,Maintaining normal ECM degradation and reconstruction,promoting endometrial repairing. |
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