Exploration On Mechanisnis Of Inhibition Effect On Endometriosis Recurrence By Traditional Chinese Medicine Danchi Decociton From The Perspective Of Eutopic Endometirum And Immunologic Balance

Objective:To research the relationship of the eutopic endometrium of paients withEMs and immunologic balance and the recurrence of pelvic endometriosis after aconservative operation; To evaluate the clinical effectiveness of the Danchi decoction forcontrolling the recurrence of endometriosis of qi stasis causes blood stagnation after aconservative operation,and to investigate the mechanisms of endometriosis recurrence.Methods: The study was a multi-center,randomized,positive drug control,prospective clinical trial. Drugs were given to patients during1–5days of the firstmenstruation after a conservative operation in Chinese herbal medicine group and Westernmedicine group.Patients with endometriosis were treated for3months. The patients in theChinese herbal medicine group (CMG) were treated using the Danchi decoction whilePatients in the Western medicine group (WMG) were treated using GnRH-a or Gestrinone.Any cases of dysmenorrheal, menstruation and any adverse reactions of patients wererecorded. During the period,patients underwent type B ultrasonography of the pelvis andmeasurements of serum CA125levels, routine evaluations of blood, urine, hepatic function(GPT levels), renal function (BUN levels) and electrocardiograms. The two treatmentswere compared for clinical recurrence rates and the incidence of adverse reactions.The patients in the study were asked to collect the examples of the eutopicendometrium during the preoperative periods and discontinuing the medicine for3months.To collect the venous blood of the patients during the preoperative, treatment anddiscontinuing the medicine for3months. To choose the eutopic endometrium and venousblood in normal group as the control article. In the research,the expressions of P450arom and survivin in eutopic endometrium of patients with EMs were determined with Westernblotting,RT-PCR and immunhistochemisty preoperative period and discontinuing themedicine for3months, and the expressions of IL-2,IL-6,IL-2/IL-6and CA125inperipheral blood were evaluated by ELISA preoperative,3months after treatment anddiscontinuing the medicine for3months.Result: The Danchi decoction can control the recurrence of endometriosis after aconservative operation effectually, which is equivalent to Western Medicine like GnRH-aor Gestrinone. It has not affect to normal physiological functions and also can have theaccommodation to the patients with endocrine dyscrasia. The rate of the incidence ofadverse reactions and amenorrhea of Danchi decoction is lower than Western Medicine（P<0.05）.The research indicate that the expressions of P450,survivin,IL-6,IL-2and CA125ofpreoperative period in Chinese Medicine group(CM) and Western Medicine group(WM)were significantly different from the Controlling group(CG)（P<0.05）. The levels ofP450arom,survivin and mRNA of discontinuing the medicine for3months in CM groupand WM group were lower than preoperative period（P<0.05）,and the group comparisonwere not significantly (P＞0.05). The expressions of serum IL-6and CA125aftertreatment and discontinuing the medicine for3months were lower, and the expressions ofserum IL-2and the ratio of IL-2/IL-6were higher than preoperative period in ChineseMedicine group and Western Medicine group (P<0.05). Whatever after treatment ordiscontinuation of medicine, the expressions of factors in Chinese Medicine group andWestern Medicine group were not significantly different from the Controlling group(P＞0.05).Conclusions: The Danchi decoction can control the recurrence of endometriosis aftera conservative operation effectually which is less the incidence of adverse reactions andhas not affect to normal physiological functions. The excessive expression of aromatizingenzyme and the decreased cell apoptosis in eutopic endometrium may be the one ofmechanisms of endometriosis recurrence. Controlling the recurrence of by DanchiDecoction, through to control the abnormal secretion of aromatizing enzyme and regulatethe cell apoptosis in eutopic endometrium. Serum IL-2and IL-6break the immunebalance,which is one of the important factors of causation and pathogenesis ofendometriosis. Danchi Decoction can control the recurrence of endometriosis by regulating the level of cytokine and immune disbalance,and the Danchi Decoction hasdown-regulation function on serum CA125.This result has laboratory evidence for clinicalapplication to control the recurrence of endometriosis...