The Clinical And Experimental Research Of Dan Shen Treatment In Eclampsism (Stagnation Of Blood)

Objective:Pregnancy-induced hypertension(PIH)is a disease which occurs exclusively during pregnancy,Eclampsism is a severe development stage of PIH,and is currently an important cause of death in pregnant and puerperant women,as well as in perinatal infants.Among the hypothesis regarding the cause of disease in PIH, the Uterine/Placental Ischemia Theory,Vascular Endothelia Damage Theory,and Immuno- Theory have all been confirmed.An imbalance in the ratio of certain cytokines and polypeptides can affect placental development and the function of vascular endothelia,causing the onset of a series of PIH clinical symptoms brought about by poor placental trophocyte development,uterine and placental ischemia,and vascular endothelial malfunction.This research through using Dan Shen treatment of eclampsism patients, study clinical effect by observing the symptom score of western and Chinese medicine.Another respect,the research presented here is based upon the foundation of this preceding research.Through determination of changes in the levels of leptin,MMP-9,and TIMP-1 and the MMP-9/TIMP-1 ratio in blood serum and placental tissue,placing the findings within the parameters of obstetric eclampsism to conduct research regarding the cause of disease,especially as relates to eclampsism as a complication of late pregnancy,where research of the changes in leptin,MMP-9,and TIMP-1 and MMP-9/TIMP-1 ratio was done during early pregnancy before onset of disease,to further explain the mechanism of the above indicators in inhibiting physiological vascular molding in the placenta, evaluating MMP-9 and MMP-9/TIMP-1 ratio as a clinical preliminary screening method for early detection and prognosis determination of eclampsism,it's the new ideas of this investigation.We also observed the content changes of leptin, matrix metalloproteinases-9,tissue inhibitor of metalloproteinases-1,and the ratio changes of matrix metalloproteinases-9 to tissue inhibitor of metalloproteinases-1, and the pathology structure changes of placenta,which play an important role in the process of Dan Shen treatment eclampsism.To investigate the mechanism of effective treatment eclampsism(Stagnation of blood)by Dan Shen,which improves microcirculation and placental blood supply,to give thought to the use of dan shen and other traditional Chinese medicine components in the prevention of gestational complications caused by insufficient placental blood supply.Methods:1 Clinical research:The 36 cases of eclampsism(Stagnation of blood)patients,16 cases(treatment with Dan Shen)and 20 cases(without treatment with Dan Shen) were compared.To analyze the clinic effect throughing observe the amelioration condition and score of western and Chinese medicine syndrome before and after treatment by Dan Shen.2 Empirical research:ELISA and Western-Blot were used to determine the levels of leptin,MMP-9,TIMP-1,and the ratio of MMP-9/TIMP-1 in the early pregnancy and late pregnancy serum and post-delivery placental homogenate of 40 normal and 36 eclampsism pregnancy patients.To explain the role of those index in eclampsism pathogenesy,and evaluate the value of MMP-9 levels and the ratio of MMP-9/TIMP-1 in the prediction pathogenetic condition of eclampsism (Stagnation of blood)in early pregnancy.We also surveied the changes of Leptin, MMP-9,TIMP-1 levels and MMP-9/TIMP-1 ratio in serum and placenta tissue homogenate before and after treatmen with Dan Shen.To explain the therapeutic action of Dan Shen treatment eclampsism(Stagnation of blood),through the mechanism of Dan Shen improve placental blood and oxygen supply of eclampsism(Stagnation of blood)patients,to give experiment proof of using activating blood circulation to dissipate blood stasis traditional Chinese medicine components trentment gestational complications for clinic application. 3 Pathological placental tissue research:To observe changes of number of villi and number of blood vessels in intervillous space under high power lens of a light microscope in normal pregnancy group,control group(non-dan shen treatment group),Dan Shen treatment group,further to explain the mechanism of Dan Shen improve placental blood and oxygen supply of eclampsism(Stagnation of blood)patients on placental microscopic scale.Results:1 Clinical research:To observe the clinical effect of Dan Shen treatment eclampsism(Stagnation of blood)It can depress score of symptom of western and Chinese medicine after use Dan Shen to treat eclampsism(Stagnation of blood)patients,and improve clinical symptom.The effective power of western and Chinese medicine in Dan Shen treatment groups(8 cases of light eclampsim and 8 cases of servere eclampsim)is significantly higher than that in control groups(12 cases of light eclampsim and 8cases of servere eclampsim).2 Empirical research:2.1 The leptin,MMP-9,TIMP-1 levels and MMP-9/TIMP-1 ratio in serum and placental tissue homogenate of normal pregnancy and eclampsism(Stagnation of blood)patientsTo compare with eclampsism(Stagnation of blood)and normal pregnancy groups,leptin leverls in early pregnancy serum were no significant differences between these two groups;Leptin levels in late pregnancy serum and placental tissue homogenate in eclampsism groups were significantly higher than that in normal pregnancy groups;MMP-9 levels in early and late pregnancy serum and placental tissue homogenate in eclampsism groups were significantly lower than that in normal pregnancy groups;MMP-9/TIMP-1 ratio in early and late pregnancy serum in eclampsism groups were significantly lower than that in normal pregnancy groups.2.2 Determination of Leptin,MMP-9,TIMP-1 levels and MMP-9/TIMP-1 ratio in serum and placental tissue homogenate of eclampsism(Stagnation of blood) patients after having received Dan Shen treatment20 cases of light eclampsism(Stagnation of blood),Dan Shen groups(8 cases with treatment by Dan Shen)and control groups(12 cases without treatment by Dan Shen)were compared,the serum leptin levels was significantly lower and serum MMP-9 levels was significantly higher in Dan Shen groups than that in control groups.16 cases of servere eclampsim(Stagnation of blood),Dan Shen groups(8 cases with treatment by Dan Shen)and control groups(8 cases without treatment by Dan Shen)were compared,the serum leptin levels was significantly lower,serum MMP-9 and TIMP-1 levels were significantly higher,placental tissue homogenate MMP-9 levels was significantly higher,serum and placental tissue homogenate MMP-9/TIMP-1 ratio were significantly increaser in in Dan Shen groups than that in control groups.3 Light microscope examination of pathological placental tissue slidesTo compare with control groups(20 eclampsism patients without treatment by Dan Shen)and normal pregnancy groups(10 cases),number of villi and intervillous space blood vessels in placenta were significant decrease;Number of villi and intervillous space blood vessels in Dan Shen treatment groups(8cases of light eclampsim and 8cases of servere eclampsim)were compared with control groups,There was no significant difference between the number of villi in these two groups,Number of intervillous space blood vessels in Dan Shen treatment groups were significant increase than those in control groups.Conclusion:1 Dsn shen can effective improve the symptom of western medical and Chinese medicine in eclampsism(Stagnation of blood)patients,and has a significant clinical therapeutic effect.2 Dan Shen through regulated the express level of Leptin,MMP-9 and MMP-9/TIMP-1 and improve placental blood and oxygen to treat eclampsism (Stagnation of blood).3 Leptin,MMP-9 and MMP-9/TIMP-1 serve as an indicator of placental blood insufficiency and oxygen insufficiency,and may be participate the morbidity process of eclampsism(Stagnation of blood).4 Determination of MMP-9 and MMP-9/TIMP-1ratio in the early stages of pregnancy can provide a clinical means for early prediction of eclampsism (Stagnation of blood),and a screening method for determination of its prognosis.