Study On The Mechanism Of Prevention And Treatment Of Postoperative Recurrence Of EMT By Using Methods Of Invigorating Spleen And Soothing Liver,Clearing Dampness And Removing Blood Stasis To Intervene T Cell Subsets Of Th17/Treg In Rat Model Of Recurrent

Objective: A rat model of endometriosis(EMT)recurrence after operation was established,and the combined therapy of invigorating spleen and soothing liver,clearing dampness and removing blood stasis(oral Chinese medicine combined with Chinese patent medicine for rectal administration)was used to intervene,and the changes of related factors of Th17/Treg were analyzed.To explore the immune mechanism of this therapy in the prevention and treatment of recurrence after EMT.Methods:1.SD rat autologous endometrial transplantation method successfully established EMT model.2.The EMT model rats were fed for 28 days,and then part of the ectopic lesions were removed by surgical treatment to establish a rat model of recurrence after EMT.3.Randomly divide the rats in the recurrence state after EMT into 4 groups,namely leuprolide group,Chinese medicine medium dose group,Chinese medicine high dose group,and model group.A sham operation group was set up(only part of the uterus was treated by laparotomy,and no endometrial transplantation was performed).4.was given the corresponding dose of drugs by gavage and enema,the leproteroline group was given intramuscular injection of leproteroline acetate,and the model group and the sham operation group were given normal saline by gavage and enema for 28 days.5.After the last administration,the rats in each group were sacrificed,and the abdomen was opened for specimen collection.Cut a piece of tissue from the side of the uterus that did not undergo surgery and the ectopic lesions that recurred after the operation.Observe the histopathological performance of the two parts,and determine the expression concentration of IL-17 and TGF-β.Results:1.General situation of rats: All rats had no abnormal mental state and reaction,and there was no significant difference in body weight of rats before and after treatment(P>0.05).2.The size of the ectopic lesion:(1)There is no significant difference in the size of the ectopic lesion between the groups of the rats in the postoperative recurrence state(P>0.05).(2)After treatment: Compared with the model group,the ectopic lesions in the high-dose Chinese medicine group,the middle-dose Chinese medicine group,and the leuprolide group were significantly reduced(P<0.01).(3)Comparison of postoperative recurrence state model rats before and after treatment: Compared with before treatment,the average volume of ectopic endometrial lesions in the high-dose Chinese medicine group,Chinese medicine middle-dose group,and leuprolide group were significantly reduced after treatment(P<0.01).3.Changes in ovarian weight of rats in the recurrence state after EMT: Compared with the sham operation group,the ovarian weight of the leuprolide group was significantly decreased(P<0.01).The rats in the model group,the Chinese medicine medium-dose group,and the Chinese medicine high-dose group The weight of ovary has a downward trend(P>0.05).Compared with the model group,the ovarian weight of the leuprolide group was significantly decreased(P<0.01),and the ovarian weight of rats in the sham operation group,the Chinese medicine medium-dose group,and the Chinese medicine high-dose group all increased(P>0.05).4.Comparison of pathology of ectopic lesions in model rats after EMT: Comparison of neovascularization in each group: model group>leuprolide group,high-dose Chinese medicine group,middle-dose Chinese medicine group.Comparison of the proliferation of endometrioid epithelial cells and stromal cells in each group: model group> Chinese medicine medium dose group>leuprolide group> Chinese medicine high dose group.5.The expression of IL-17 in the recurrence state model rats after EMT:(1)The eutopic endometrium(conventional uterus): Compared with the sham operation group,the IL-17 concentration in the eutopic endometrium of the model group has a rising trend(P>0.05).Compared with the model group,the IL-17 concentration in the eutopic endometrium of rats in each group had a downward trend(P>0.05).(2)Ectopic lesions: Compared with the model group,the IL-17 concentration in the ectopic lesions of the leuprolide group was significantly reduced,and the difference was significant(P<0.01);while the high-dose group of Chinese medicine and the middle-dose group of Chinese medicine were different in rats The concentration of IL-17 in the lesions showed a downward trend(P>0.05).6.The expression of TGF-β in the recurrence state model rats after EMT:(1)The eutopic endometrium(conventional uterus): Compared with the sham operation group,the concentration of TGF-β in the eutopic endometrium of rats in the model group was significantly reduced(P<0.01).Compared with the model group,the concentration of TGF-β in the eutopic endometrium of rats in each group had a rising trend(P>0.05).(2)Ectopic lesions: Compared with the model group,the concentration of TGF-β in the ectopic endometrium of the rats in the high-dose Chinese medicine group and the leuprolide group increased(P<0.05);the ectopic endometrium of the rats in the middle-dose Chinese medicine group The concentration of TGF-β showed an upward trend(P>0.05).Conclusion: 1.Exploring and innovating the modeling method of recurrence model after EMT,and successfully establishing the rat model of recurrence state after EMT.2.The recurrence after EMT may be related to the immune imbalance of Th17/Treg.The combined therapy of invigorating spleen and dredging liver,clearing dampness and removing blood stasis may increase the expression of IL-17 and decrease the expression of TGF-β by regulating the immune balance of Th17/Treg,thereby reducing the ectopic lesions and achieving the effect of preventing and treating postoperative recurrence of EMT.