Reflection And Research On Interference Of Kidney-nourishing And Stasis-resolving Method In Endomitriosis

Endometriosis(EMS) is one of the diseases that starts at cellular level and ends at pelvic pain and infertility.The mechanism of its development is not clear and no satisfactory treatment has been found currently.Chinese medicine has some achievement by resolving stasis and removing aberrant locations,and the individual treatment of Chinese medicine also presents the necessity of further study.We try to study further in the relative factors of EMS and the attachment—invasion—angiogenesis process,such as the participation of integrin in the attachment and invasion of ectopic endometrium to peritoneum.We suppose that on the premise of nourishing kidney,combined with the method of stasis softening and resolving in order to regulate the disordered internal environment of EMS and interfere with the "invasion process" of EMS at the aim of seeking both temporary and permanent solutions.Objective:1.To observe the effect of stasis softening and resolving therapy treating EMS.2.To investigate the mechanism of sequential therapy by nourishing kidney(including Zi Yin Decoction and Bu Yang Decoction) combined with stasis softening and resolving therapy(San Jie Zhen Tong Formula) treating EMS.Methods:The clinical research on the effect of stasis softening and resolving therapy treating EMS.Morphological changes of their pathological tissues between eutopic and ectopic endometrium are observed by using light and electron microscope. The expression of integinαv and integinβ3 in the eutopic and ectopic endometrium of EMS rats are detected by the method of immunohistochemistry on protein level and of real-time fluorescent quantitative(PCR) on gene level.Results:The clinical research shows that stasis-resolving and mass-eliminating herbs can improve symptoms and signs of EMS patients,as dysmenorrhea and pelvic pain can be alleviated,but the pregnancy rate of infertile patients does not show significance.Light and electron microscopy shows that the sequential therapy by nourishing kidney combined with stasis softening and resolving therapy can significantly improve the local pathological changes in the three treating groups (combined group,kidney nourishing group,stasis softening and resolving group) for EMS rats.Results of immunohistochemistry method shows that distribution of integrinαvβ3 decreased a lot in ectopic endometrium of EMS rats,and coloretur of positive protein particle of integrin turned lighter in all the therapeutic groups, especially in the combined group.Detection of integrinαvmRNA and integrinβ3mRNA in the ectopic endometrium of EMS rats shows that there is much less expression in both the combined and kidney nourishing group than that in the model group.Conclusion:This clinical study shows that dysmenorrhea and pelvic pain are significantly relieved in EMS patients,while the pregnancy rate of infertile patients does not show significance.The EMS model is successfully derived from the rats of endometrial autotransplantation,and the Sequential therapy by nourishing kidney combined with stasis softening and resolving therapy can significantly improve the local pathological changes.The detection of proteinum and genetic level shows that the expression of integrinαv and integrinβ3 of endometrium is lower in normal group,while higher in model group,which indicates integrinαv and integrinβ3 are close related to the occurrence of EMS,and the adhesion of ectopic endometrium to peritoneum is due to the high expression of integrin.Both formula of stasis softening and resolving and formula of sequential therapy by nourishing kidney treating rats of EMS can reduce the expression of integrinαvβ3,especially when they are used together.The research reveals that the treatmeant for EMS should focus on both temporary and permanent solutions,not only stasis softening and resolving therapy. The sequential therapy by nourishing kidney according to sex cycle can obtain better effect.The research provides the theoretical and experimental basis for the clinical application of the method of sequential therapy by nourishing kidney combined with stasis softening and resolving therapy.