| Objective: 1.To observe the clinical effect of Tongmai Huazheng Decoction on adenomyosis;2.to observe the mechanism of promoting apoptosis of endometrium cells in rats with adenomyosis model under the effect of the core prescription Gui-Lou drug pair of Tongmai Huazheng Decoction.Methods: 1.In the clinical research,volunteers who are suffering the adenomyopathy were informed the research project and signed the consent form.They were allocated randomly into an observation group and a control group.The patients in the observation group was treated with Tongmai Huazheng Decoction based on individuals’ condition,while the treatment for patients in the control group was taking Chinese patent medicine called Sanjie Zhentong capsule.The evaluation of clinical effect during the three months research period was based on the syndrome score of the patients in both groups.2.In the animal experiment,Wistar female rats were selected to model by noninvasive pituitary allotransplantation.The effect of the model was evaluated three months later.The models were randomly divided into five groups: Blank group,Model group,Blank Intrauterine Sustained Release System group(BISRS group),Gui-Lou drug pair Gastric Lavage group(GLGL group)and Gui-Lou drug pair Intrauterine Sustained Release System group(GLISRS group).The blank group and model group do not have special treatments.GLGL group was given Gui-Lou drug pair suspension;BISRS group and GLISRS group established Intrauterine passage by non-invasive method,and the blank intrauterine release system and Gui-Lou drug pair sustained-release system were placed respectively.The expression levels of CA125,E2,PRL,and BAX,caspace-3,MMP-2,MMP-9 and Bcl-2 of Focus tissue of adenomyosis were observed in serum of rats.Results: 1.In the clinical section,there were no significant difference of dysmenorrhea and menstruation score and TCM syndrome integral between the two experiment groups before treatment(P > 0.05).After treatment,the control group was better than the experimental group in improving subcutaneous ecchymosis(P < 0.05),and the experimental group was better than the control group in improving menstrual cycle(P < 0.05).There was no significant difference in dysmenorrhea VAS score,menstruation score,lost blood clot score,comprehensive menstruation score and TCM syndrome integral between the two groups(P > 0.05).Comparing the intragroup data before and after treatment,significant changes(P< 0.05)have been observed compared with the results before the experiment that the experimental group had no statistical significance in terms of skin nail error and subcutaneous ecchymosis(P > 0.05),and the control group had no statistical significance in terms of skin nail error(P > 0.05)had significant changes(P < 0.05).The other aspects and the total score of TCM symptoms of the two groups had significant changes(P< 0.05).2.In animal experiment section,pathological staining observation showed that glands invaded deep intima and muscle layer,and fibrosis lesions were seen in model group,BISRS group,GLGL group and GLISRS group;ELISA results showed that E2 in each group had no statistical significance,CA125,PRL and Bcl-2 in Model group and BISRS group were higher than those in Blank group,and Bax was lower than those in Blank group;CA125,PRL and Bcl-2 in the other two groups were higher than those in Blank group,and Bax increased(P < 0.05).Compared with the Blank group,MMP-9 and MMP-2 increased significantly and BAX decreased significantly in the Model group compared with the Blank group.The MMP-9 and MMP-2 in the GLGL group and the GLISRS group were significantly lower than those in the Model group and the BISRS group,and BAX increased significantly(P<0.05).Compared with the blank group and model group,the changes of Bax and Caspase-3 in the model group and blank sustained-release rod group were not significant(P > 0.05),and there were significant differences between the gastric lavage group and guilou sustained-release rod group and the model group and blank sustained-release rod group(P < 0.05).Conclusion: 1.In the clinical observation,Tongmai Huazheng Decoction can significantly improve the VAS score,menstrual cycle,blood loss and other clinical symptoms and TCM syndrome integral of patients with adenomyosis,which is an effective method for the treatment of adenomyosis and worthy of clinical promotion.Sanjie Zhentong capsule is superior to Tongmai Huazheng Decoction in improving subcutaneous ecchymosis,which needs further experimental observation.2.In the part of animal experiment,Gui-Lou drug pair can significantly promote the expression of Bax and Caspase-3,reduce the production of Bcl-2,improve the ability of apoptosis and inhibit the proliferation of endometrial cells in rats with adenomyosis;at the same time,Gui-Lou drug pair can reduce MMP-2 and MMP-9 to inhibit the invasion of endometrial cells. |
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