| Objective Endometriosis(EMs)is a common and frequently occurring disease with high recurrence rate among women of childbearing age in moderm society.The pathogenesis of EMS is not yet clear,but inflammation is one of the key factors.Studies have shown that triggering receptor expressed on myeloid cells-1(TREM-1)is an important part of mediating the occurrence of inflammatory response.In this study,we observed the effect of Bushen Huoxue Decoction on EMs model rats,and further observed the clinical samples to explore the effect and mechanism of TREM-1 on inflammation related reactions in EMs.furthermore,this study has provided some scientific evidences of Chinese medicine in treating EMs via improving chronic inflammation.Methods(1)After the preliminary experiment,70 female SD rats in sexual maturity,60 of them were used to construct the EMs model by autologous transplantation(including 20 spare rats).After the model was successfully constructed,screening out 56 of them were randomized into 4 groups:model group,mifepristone group,low-dose BHD group,and high-dose BHD group.14 in each group,and 10 in the blank control group without model.After establishing the EMs model,each group was intervened by corresponding drugs or saline.After the last intervention for 24 hours,the peripheral blood samples of rats were collected by eyelid blood collection method and the peritoneal lavage samples of rats were collected by peritoneal lavage.In addition,ectopic endometrial samples were collected at this time.The content of Term-1 in the peripheral blood samples and peritoneal lavage fluid samples were detected by ELISA and the same method was used to detect the contents of VEGF and hs-CRP in peripheral blood.In addition,the size of ectopic endometrium in each group was also detected.(2)According to the diagnostic criteria of endometriosis and the standard of "kidney deficiency and blood stasis"in Chinese medicine,50 cases of clinical trials were finally included after screening by exclusion criteria.These 50 patients were randomly divided into 3 groups:20 cases in the Chinese medicine Bushen Huoxue recipe group,20 cases in the GnRH-a treatment group,and 10 cases in the integrative medicine treatment group.The levels of serum FSH,LH and E2,TREM-1 and hs-CRP were detected before and after treatment.The differences between groups before and after treatment were analyzed and compared.Results(1)Bushen Huoxue Decoction reduced the volume of ectopic endometrial tissue in EMs rats,and the volume of endometrial tissue in high dose group is significantly lower than that in model group.Further,the effect of high dose of Chinese medicine is similar to that of mifepristone,a kind of progesterone receptor antagonist.(2)The content of Term-1 in peripheral blood and peritoneal lavage fluid in model group was significantly higher than those in blank control group.The content of Term-1 decreased after the treatment with Bushen Huoxue Decoction.Especially,the content of Term-1 in high dose group was significantly lower than that in model group,while was similar to mifepristone group.(3)The contents of VEGF and hs-CRP in the peripheral blood samples of model group were significantly higher than those in the blank control group,while the contents of VEGF and hs-CRP decreased after the treatment of Bushen Huoxue Decoction.The VEGF in both of the low dose group and the high dose group were significantly lower than that in the model group,and there was no significant difference of VEGF content between the high dose group and the mifepristone group.The hs-CRP content of the high dose group was significantly lower than that in the model group,and there was no significant difference between high-dose BHD group and mifepristone group.(4)The results of clinical trials showed that treatment of each group had no significant effect on FSH and LH in patients with EMs,but GnRH-a and integrative treatment had significant down regulation on estradiol.BHD,GnRH-a and integrated treatment can effectively reduce the levels of Term-1 and hs-CRP,two inflammation related indicators.In particular,the inhibitory effect of Bushen Huoxue Formula on Term-1 is significantly stronger than that of GnRH-a,which reflects its role in reducing chronic inflammation.Conclusions(1)Bushen Huoxue Decoction can effectively reduce the content of Term-1(in peripheral blood and peritoneal cavity)in animal and clinical research showing a dose-dependence.(2)Bushen Huoxue Decoction has no obvious effect on sex hormones,but it can relieve or treat EMs by reducing inflammatory reaction.This study also reflected the modern scientific connotation of Bushen Huoxue Decoction in treating kidney deficiency and blood stasis by nourishing kidney,nourishing Yin,clearing heat,and activating blood circulation.Above all,this study provides a basis for further research. |
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