| ObjectiveEMs is one of the main impotortant cause of infertility, its morbidity is incresing nowadays, it is considered as one of the complicated disease in Gynecology. About 30%-60% infertile women are found to got EMs. For those got a diagnosis of endometriosis, the chance of assosicated with infertility is about 30%-50%, while the abortion rate is about 40%, the health and quality of life of women who have family planning are seriously be affected. To investigate the effect of chinese medicine on gestational function of EMs rats model, and to find out the treatment mechanism behind, so as to setting a guideline and reference for treating EMs associated with infertility.MethodsEMs rats model were established by endometrial auto-transplantation, the model rats were randomized divided into 3 groups, including Chinese medicine group (treating by Luo’s Neiyi Prescription), western medicine group (treatment by Gestrinone Capsules) and model group. Other sham operated rats were assigned as control group. After 8-weeks treatment, the following experiments were done:1. Before the estrus of the model rats, examined the content of Luteinizing hormone (LH) and Prolactin(PRL) in serum of the model rats by ELISA radioimmunodetection; after the estrus of the model rats, examine the content of Tumor necrosis factor-α (TNF-α), Estrogen(E2) and Progesterone(P) in serum of the model rats by ELISA radioimmunodetection.2. Compare the features, color, size and level of adhesion with surrounding tissues or organs of ectopic endometrium of model rats in the experimental groups. Eutopic and ectopic endometrium were collected for histopathologic examination.3. Rats were mated within the same cage, investigate and compare the gestational function by measuring the number of luteum, the number of survival embryo, the number of dead embryo, implantation rate, the weight of the embryo and the weight of the placenta of rats of the four experimental groups. ALL experimental results were presented as mean+standard deviation (X±S), with data preformed by spssl6.0. Analysis of variance and method of LSD was used for statistical analysis between groups. p<0.05 is considered as having significant difference in statistical analysis.ResultsCompare the serum LH level in rats among the four groups before the estrus, LH level of model group lower significantly than control group (p<0.01); There is no significant difference of serum LH level among Chinese medicine group, Western medicine group and control group (p>0.05). Compare the serum PRL level in rats among the four groups before the estrus, PRL level of model group higher significantly than control group and Chinese medicine group (p<0.01); There is no significant difference of serum LH level between model group and Western medicine group (p>0.05). Serum PRL level of Chinese medicine group lower significantly than Western medicine group (p<0.01). Compare the serum P level in rats among the four groups after the estrus, LH level of model group lower significantly than control group, Chinese medicine group and western medicine group (p<0.01);l There is no significant difference of serum P level between Chinese medicine group and Western medicine group (p>0.05). Compare the serum E2 level in rats among the four groups after the estrus, P level of model group higher significantly than control group, Chinese medicine group and western medicine group (p<0.01); There is no significant difference of serum P level between Chinese medicine group and Western medicine group (p>0.05). Compare the serum TNF-α level in rats among the four groups after the estrus, TNF-α level of model group higher significantly than control group, Chinese medicine group and western medicine group (p<0.01); There is no significant difference of serum TNF-α level between Chinese medicine group and control group (p>0.05). Serum TNF-α level of Chinese medicine group lower significantly than Western medicine group (p<0.01).Observe the size of ectopic endometrium of model rats, the size of ectopic endometrium of model group is larger significantly than that of Chinese medicine group and Western medicine group (p<0.01). In model group, there are 80% of rats’ectopic endometrium were dark red in color, there are 60% of rats’ectopic endometrium adhesion with bowel; In Chinese medicine group, there are 60% of rats’ectopic endometrium were light red in color, vascular system was not seen, no adhesion with surrounding tissues and organs. Histopathologic examination show that eutopic endometrium of model group and Western medicine group thinner significantly than control group, it shows atrophic changes, glandular atrophy, epithelium showed cube-shape or flat-shape, while the eutopic endometrium in Chinese medicine group is thicker, many epithelium and vascular system were found; When it comes to ectopic endometrium, its size is smaller in Chinese medicine group than in model group, apparently thinner than model group.Gestational function experiment shows that the 10 rats in control group and 12 rats in Chinese medicine group are all pregnant after mating, no stillbirth were found; 5 rats were not pregnant in 11 rats of Western medicine; 3 rats were not pregnant in 12 rat of model group, two still birth were found in the 9 pregnant rats. By measuring the number of luteum, the number of survival embryo, the number of dead embryo, implantation rate, the weight of the embryo and the weight of the placenta of rats in model group, all results were lower significantly than Chinese medicine group and control group (p<0.01). Compare Chinese medicine group and Western medicine group, the number of luteum, the number of survival embryo, the number of dead embryo, implantation rate, the weight of the embryo and the weight of the placenta of rats in Chinese medicine group are higher significantly then those in Western medicine group(p<0.01).ConclusionIt was showed that there were dysfunction of endocrine and immunity, weak pregnancy function and weak embryo development of rats in model group, this pathological condition consist with human who are suffered from endometriosis associated with infertility. Besides, histopathologic examination showed that the ectopic endometrium consist with normal endometrium, proving that this endometriosis rat models induced by endometrium auto-transplantation is feasible.The dysfunction of endocrine and immunity was corrected after treating by Chinese medicine; the pregnancy function was improved accordingly. So it came to a conclusion that dysfunction of endocrine and immunity may contribute to the low gestational function in the EMs rats.Luo’s Neiyi Prescription can increase the level of serum LH and reduce the level of PRL before the estrus, while increase the level of P and reduce the level of E2 and TNF-α after the estrus, it is concluded that Luo’s Neiyi Prescription can correct the endocrine and immunity dysfunction effectively. Compare the effect of Luo’s Neiyi Presciption with Gestrinone Capsules, Luo’s Neiyi Presciption shows a stronger effect on reducing the level of serum PRL and TNF-α in EMs rats, therefore better result in correcting the endocrine and immunity dysfunction then Gestrinone Capsules.It was found from the pathology analysis, the eutopic endometrium of model group and Western medicine group significantly thinner than Chinese medicine and control group, result in better implantation and the embryo of rats in Chinese medicine group can have a better development. Compare the ectopic endometrium among the four groups, the size of ectopic endometriunm of the EMs rats became thinner after treating by Luo’s Neiyi Prescription and Gestrinone Capsules, this result consist with clinical observation, showing that both Luo’s Neiyi Prescription and Gestrinone Capsules can inhibit the growth of ectopic endometrium, reduce the size of the ectopic endometrium. But the effect of Luo’s Neiyi Prescription only act on ectopic endometrium, but not the eutopic endometrium, while the effect of Gestrinone Capsules act on both the eutopic and ectopic endometrium, so the eutopic endometrium of rats in Western medicine group showed atrophic changes. This proves that Gestrinone Capsules inhibit the ovarian function while treating the endometrosis. Different from Gestrinone Capsules, Luo’s Neiyi Prescription treating endometriosis without affect the ovarian function, therefore it favors the pregnancy function more than western medicine.Compare the Gestational function of Chinese medicine group and Western medicine group, the test shows that the number of luteum, the number of survival embryo, the number of dead embryo, implantation rate, the weight of the embryo and the weight of the placenta of rats in Chinese medicine group are higher significantly then those in Western medicine group. It is proved that Luo’s Neiyi Prescription improves the pregnancy function and embryo development better than Gestrinone Capsule.To conclude, the pregnancy function of EMs rats can be enhanced effectively by Luo’s Neiyi Prescription, the mechanism may be based on the following: correct the immunity and endocrine system, improve the endometrium environment, eliminate ectopic environment and prevent adhesion in pelvic area. |
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