Intervention Study Of Zishui Qingganli Chongyin On Perimenopausal Symptoms Caused By EMT Application Of GnRHa

Objective1.To observe the effects of ZiShuiQingGanLiChongYin on perimenopausal sympt-oms,serum sex hormones and CA-125 in patients of deficiency of kidney and depres-sed liver with endometriosis after using GnRHa,and to explore the clinical efficacy of ZiShuiQingGanLiChongYin on perimenopausal symptoms in patients with endometr-ios is after using GnRHa.2.To observe the effects of ZiShuiQingGanLiChongYin on body mass and behav-ior of endometriosis model mice of treated with GnRHa.3.To explore the effect of ZiShuiQingGanLiChongYin on serum sex hormones?E₂,FSH,LH?on endometriosis model mice of treated with GnRHa.4.To study the effects of ZiShuiQingGanLiChongYin on monoamine neurotransm-itters?5-HT,NE,DA?in brain tissue of endometriosis model mice of treated with GnR-Ha.5.To observe the changes of immune factors?TNF-a,IL-1,MMP-2,TIMP-2?in euto-pic and ectopic endometrium tissues of endometriosis model mice treated with ZiShui-QingGanLiChongYin.Methods1.Using the method of randomized controllod trial,40 patients with pelvic endo-metriosis were selected and treated with GnRHa.The syndrome belongs to the type o-f deficiency of kidney and depressed liver with endometriosis.There are 20 cases in the control group and 20 cases in the Traditional ChineseMedicine group.Two groups of patients were treated with GnRHa subcutaneously on the first day of menstruation after conservative surgery.The injection was repeated at 28 days interval for three ti-mes.The Chinese Medicine Group was treated with GnRHa injection.At the same ti-me,oral Chinese medicine was given for three months.While the control group was given GnRHa injection without other drugs.The perimenopausal symptoms of the pati-ents were scored by improved Kupperman scoring method before treatment and 3 mo-nths after treatment.Serum estradiol?E₂?,follicle stimulating hormone?FSH?,luteiniz-i ng-hormone?LH?and serum CA-125 were measured with radioimmunoassay.The res-ults were compared with those of patients treated with GnRHa alone.It was aimed a-t exploring the result of ZiShuiQingGanLiChongYin with GnRHa in patients with end-o metriosis.2.EMT mice model was established by intraperitoneal injection.By observing t-he location and morphology of ectopic lesions in pelvic and abdominal cavity and ve-rifying the histopathological examination to ensure the success of the model.The exp-eriment was divided into normal group,disease model group,GnRHa group,high-dos-e group medium-dose group and low-dose group.The experiment lasted for 30 days,with high,medium and low doses of ZiShuiQingGanLiChongYin as intervention treat-ment,and the rest groups were treated with normal saline.On the first day after adm-inistration,the body weight of mice was measured and the open field test was condu-cted to compare the differences among groups.To study the effects of ZiShuiQingGa-nLiChongYin on body mass and behavior of EMT mice after treated with GnRHa.C-onduct the assaying of E₂,FSH and LH in serum of mice by radioimmunoassay to e xplore the effects of ZiShuiQingGanLiChongYin on serum E₂,LH and FSH of EMT mice after treated with GnRHa.The contents of monoamine neurotransmitters 5-HT,N-E and DA in the brain tissue of EMT mice treated with gonadotropin releasing horm-on e-agonist?GnRHa?were detected were investigated by ELISA,and the expression of i mmune factors?TNF-a,IL-1,MMP-2,TIMP-2?in each group was detected by immunohi-stochemical method.The effects of ZiShuiQingGanLiChongYin on monoamine neurotr-ansmitters in the brain tissue of EMT mice treated with GnRHa were observed.Det-e ction of immunological factors?TNF-?,IL-1,MMP-2,TIMP-2?in ectopic and ectopic e ndometrial tissues verifies the safety of their application.Results1.Clinical study of ZiShuiQingGanLiChongYin on perimenopausal symptoms in patients with endometriosis after treated with GnRHa.?1?Kupperman score:After 3 months of GnRHa treatment,Kupperman score inc ontrol group was significantly higher than that before treatment?P<0.01?,and Kuppe-r man score in each group was lower than that in control group?P<0.01?.?2?Hormone level:After three months of GnRHa treatment,the levels of serum E₂,LH and FSH in the two groups were significantly lower than those before treat-m ent?P<0.01?,and the levels of serum E₂ in the treatment group were higher than t-ho se in the control group?P<0.01?,while there was no significant change in FSH an-d LH?P>0.05?.?3?CA125:After 3 months of treatment,the level of serum CA125 in the two groups was significantly lower than that before treatment?P<0.01?,and the level of s-erum CA125 in the treatment group was significantly lower than that in the control g-roup?P<0.01?.2.Experimental study of ZiShuiQingGanLiChongYin on perimenopausal symptoms caused by GnRHa in endometriosis.?1?Effects of ZiShuiQingGanLiChongYin on body mass and open field test of m-ice with endometriosis after treated with GnRHa:Compared with the disease model g-roup,the body weight of GnRHa group was significantly reduced?P<0.01?,comPare-d with GnRHa group,the body weight of each dose group of Traditional Chinese Me-dicine was significantly increased?P<0.01?;Compared with the disease model group,t he latenct state of mice in GnRHa group was prolonged and the number of spanningg rids was reduced.Compared with GnRHa group,the latency time of each dose grou-p was shortened,the number of spanning squares was increased,the number of partic-u late matter in shit was significantly increased?P<0.05?.Compared with GnRHa group,th e latency time of each dose group was shortened,the number of spanning squares w as increased,the times of standing was increased,the number of particulate matter insh it was decreased,the time of peripheral standing was prolonged?P<0.01?.There wasno significant correlation between the therapeutic effect and the concentration of each dos e group of ZiShuiQingGanLiChongYin.?2?Effects of ZiShuiQingGanLiChongYin on serum sex hormones in mice with e-ndometriosis after GnRHa application:Compared with the disease model group,the s-erum FSH and LH contents in GnRHa group increased,while the E₂ content decreas-e d?P<0.01?.Compared with GnRHa group,the contents of FSH and LH in high an-d middle dose groups of Traditional Chinese Medicine decreased and E₂ content incre-as ed?P<0.01?.?3?The contents of 5-HT,NE and DA in brain tissue after GnRHa application:C-ompared with the normal group,the contents of 5-HT,NE and DA in the brain tissu-e of the disease model group had no statistical significance?P>0.05?;Compared with the disease model group,the contents of 5-HT,NE and DA in the brain tissue of the GnRHa group was decreased?P<0.05?;Compared with the GnRHa group,the contents of 5-HT in the brain tissue of the GnRHa+traditional Chinese medicine group increase-d?P<0.01,P<0.05?.The content of 5-HT in brain tissue increased in each dose of Gn RHa+Chinese herbal medicine group?P<0.01,P<0.05?,while the content of NE and D A in brain tissue was increased in medium and high dose of GnRHa+Chinese Medi-ci ne Group?P<0.01?.?4?Changes of immunological factors in eutoPic and ectopic endometrium afterGnRHa application:Compared with the disease model group,the expression of TNF-a,IL-1 and MMP-2 in eutoPic and ectopic endometrium decreased,while the expressiono f TIMP-2 was increased?P<0.01?;There was no condition that the effect of TNF-a,I L-1 and MMP-2 was promoted and the effect of TIMP-2 was eliminated of Traditio-n al Chinese Medicine groups?P>0.05?.Conclusion1.Clinical findings show thatZiShuiQingGanLiChongYin can reduce the improved Kupperman score,improve t-he similar perimenopausal symptoms caused by GnRHa,increase the level of serum E₂in patients,but it has no significant effect on the level of serum FSH and LH,and c-a n reduce the level of serum CA125 in patients,and improve the quality of living o-f patients.The purpose of this study is to provide ideas and methods for the TCM t-re atment of perimenopausal symptoms caused by GnRHa in patients with endometrios-is.2.The experimental results show thatAccording to the results of behavioral manifestations,serum E₂,LH,FSH conce-n tration and monoamine neurotransmitter content in brain tissue of mice,we can learn t hat GnRHa subcutaneously injected could cause endocrine disorder in EMT mice,w-hi ch was similar to perimenopausal symptoms.The results showed that FSH and LH co ntents were increased in anxiety and depression state,E₂ content decreased,andmonoamine neurotransmitter 5-HT,NE and DA contents in brain tissue was decreased.ZiShuiQingGanLiChongYin can improve the anxiety and depression state of similar t-o perimenopausal syndrome in EMT mice after GnRHa application;high and middle do ses of ZiShuiQingGanLiChongYin can improve the changes of sex hormones in viv-o casued by GnRHa application in EMT mice,it can effectively raise the levels of m-o noamine neurotransmitters 5-HT,NE and DA in brain tissue of mice,and adjust the di sorders of perimenopausal-related neurotransmitters caused by GnRHa.Through the d-e tection of immune factors related to endometriosis,it was found that ZiShuiQingGan-L iChongYin did not increase the expression of immune factors while improving the p-er imenopausal symptoms of mice.It indicate that it did not cause the increase of im-m une factors and aggravation of the condition of endometriosis while improving the s-id e effects caused by GnRHa.It is very safe.The purpose of this study was to provi-de experimental basis for the improvement of neural endocrine immune network in mi-ce with endometriosis by ZiShuiQingGanLiChongYin...