Efficacy Of Bushen Huoxue Sanyu Decoction On Endometriosis And Preliminary Exploration Of The Possible Mechanism

Objective:1. To evaluate the clinical effects of Bushen Huoxue Sanyu 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 observe the effect of Bushen Huoxue Sanyu Decoction on the proliferation and apoptosis of ectopic endometriotic stromal cells in vitro and to primarily explore the possible mechanism of Bushen Huoxue Sanyu Decoction in treating endometriosis, 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 were randomly assigned into two groups. Thirty cases for the treatment group took Bushen Huoxue Sanyu Decoction orally. Twenty cases for the control group took mifepristone tablets. The both 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. The ectopic endometriotic stromal cells were isolated and cultured. After treated with various concentrations of Bushen Huoxue Sanyu Decoction, the cellular morphology and number of ectopic endometriotic stromal cells were observed and the activation of caspase-8, caspase-9, and caspase-3 in ectopic endometriotic stromal cells were determined.Results:1. Clinical study:(1) the dysmenorrhea symptom scores after the treatment were significant lower than those before the treatment in the both treatment 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).There was significant difference between the traditional Chinese medicine symptom scores of the two treatment groups after the treatment (P<0.05). These results indicate that both Bushen Huoxue Sanyu Decoction and mifepristone tablets improved Chinese medicine symptoms and Bushen Huoxue Sanyu Decoction improved Chinese medicine symptoms better than mifepristone tablets. After the treatment, none were cured (0%),20 cases improved (83.33%), and 5 cases were ineffective (16.67%), with the total efficiency 83.33% in the treatment group, while 1 case were cured (5%),16 cases improved (80%), and 3 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 (P>0.05). The CA125 values after the treatment were significant lower than those before the treatment in the both treatment groups (P<0.05). There were no significant differences between the CA125 values of the two groups after the treatment (P>0.05).2. Experimental study:In the control group, the ectopic endometriotic stromal cells grew and proliferate well. Bushen Huoxue Sanyu Decoction obviously inhibited the proliferation of ectopic endometriotic stromal cells in a dose-dependent manner. Bushen Huoxue Sanyu Decoction induced apoptosis in ectopic endometriotic stromal cells with the cascade activation of caspases.Conclusion:Bushen Huoxue Sanyu Decoction improved dysmenorrhea and traditional Chinese medicine symptom scores, reduced the size of ovarian cysts and serum CA125 level in the patients of kidney deficiency and blood stasis type of ovarian endometriomas. Bushen Huoxue Sanyu Decoction 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 Bushen Huoxue Sanyu Decoction activated caspase-8, caspase-9, and caspase-3, thus induced apoptosis in ectopic endometriotic stromal cells.