| Objective:1. To evaluate the clinical effects of Wenshen XiaoZheng Decoction on the kidney deficiency and blood stasis type of ovarian endometriomas by observing the changes of dysmenorrhea, traditional Chinese medicine syndrome scores, sizes of ovarian cysts, and serum CA125 values before and after the treatment, in order to provide a clinical basis for Chinese medicine in treating ovarian endometriomas.2.To explore the possible mechanism of Wenshen XiaoZheng Decoction in treating the kidney deficiency and blood stasis type of ovarian endometriomas, by observing the changes of peritoneal immune factor tumor necrosis factor (TNF-a), transforming growth factor (TGF-β1) expression level, in order to provide theoretical basis for its clinical use.Methods:1. Fifty cases that were diagnosed as the kidney deficiency and blood stasis type of ovarian endometriomas with the size of ovarian endometriomas less than three centimeters were randomly assigned into two groups. Thirty cases for the Chinese traditional medicine group took Wenshen XiaoZheng orally. Twenty cases for the control group took mifepristone tablets. All groups were treated for 3 months. The changes of dysmenorrhea, traditional Chinese medicine syndrome scores, sizes of ovarian cysts, and serum CA125 values before and after the treatment were observed.2. Choosed thirty cases that diagnosed as the kidney deficiency and blood stasis type of ovarian endometriomas with the size of ovarian endometriomas more than three centimeters. All of them took Wenshen XiaoZheng Decoction orally for three months as the treatment group. Then all the patients had surgical treatment. Excluded the lost cases and with the postoperative pathological diagnosis of ovarian endometriomas, we collected 13 cases of the treatment group (7 cases of stage III,6 cases of stage IV). At the same time, we chose 15 cases as the blank control group (9 cases of stage Ⅲ,6 cases of stage IV).14 cases hospitalized patients who had an operation with uterine fibroids removal as control group. Using Enzyme-Linked Immunosorbnent Assay, we detected the expression of TNF-α、TGF-β1 in peritoneal fluid of different groups,and compared the differences among different groups, difference stages.Results:1. Clinical study:(1) the dysmenorrhea symptom scores after the treatment were significant lower than those before the treatment in two groups (P<0.01). But after the treatment, there were no significant differences of the dysmenorrhea symptom scores between the two groups (P>0.05). The traditional Chinese medicine symptom scores after the treatment were significant lower than those before the treatment in the both groups (P<0.01), But after the treatment,there were no significant differences of the traditional Chinese medicine symptom scores between the two groups (P>0.05). After the treatment, none were cured (0%),25 cases improved (83.33%), and 5 cases were ineffective (16.67%), with the total efficiency 83.33% in the Chinese traditional medicine group. One case were cured (5%),16 cases improved (80%), and three cases were ineffective (15%), with the total efficiency 85% in the control group. There were no significant differences between the two groups after the treatment (P>0.05). After the treatment, the sizes of ovarian cysts were smaller than those before the treatment, although the differences were not significant between the two groups (P>0.05). The CA125 values after the treatment were significant lower than those before the treatment in the two group (P<0.01). There were no significant differences of the CA125 values among the three groups after the treatment (P>0.05).2. Experimental study:2.1 The expression level of TNF-α, TGF-01 of treatment group and the blank control group were significantly higher than the control group, the differences were statistically significant.The expression level of TNF-α, TGF-β1 of treatment group was significantly lower than the blank control group, the differences were statistically significant.2.2 The expression of TNF-α, TGF-β1 in phase Ⅲ and Ⅳ of treatment group and blank control group had no significant difference. (P>0.05).2.3 There was no obvious relativity between the expression of TNF-α, TGF-β1.Conclusion:Wenshen XiaoZheng Decoction improved dysmenorrhea and traditional Chinese medicine symptom scores, reduced the serum CA125 level in the patients of kidney deficiency and blood stasis type of ovarian endometriomas. Wenshen XiaoZheng has certain clinical curative effect on the treatment of the kidney deficiency and blood stasis type of ovarian endometriomas, with no significant side effects and adverse reactions. The possible mechanism may be that Wenshen XiaoZheng Decoction can suppress the activity of immune factors TNF-α, TGF-β1, and hinder the development of endometriosis way, so as to achieve the clinical result. |
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