莪棱胶囊防治卵巢子宫内膜异位囊肿术后复发及对在位、异位内膜组织MMP-9 mRNA和TIMP-1 mRNA作用的研究  

Preventive and Therapeutic Effect of E-leng Capsule on Post-operation Recurrence of Ovarian Endometriotic Cysts and Its Influence on Expression of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 in Eutopic and Ectopic Endometrium

作　　者：曹立幸[1] 司徒仪[1] 黄健玲[1] 梁雪芳[1] 向东方[1] 冉青珍 

机构地区：[1]广东省中医院,广州510120

出　　处：《中国中西医结合杂志》2008年第6期541-544,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：中国博士后基金(No.2003033408)

摘　　要：目的探讨术前应用中药莪棱胶囊防治卵巢子宫内膜异位囊肿(ovarian endometriosis,EMA)术后复发的作用和机制。方法收集2002—2004年因卵巢子宫内膜异位囊肿于广东省中医院妇科住院行手术治疗的患者60例,随机分为两组(各30例)。治疗组手术前服用中药莪棱胶囊3个月、手术后7天再服用莪棱胶囊3个月;对照组手术前不用药,手术后7天服用西药丹那唑胶囊3个月。两组均术中取在位、异位内膜组织,应用PCR方法检测基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)mRNA、基质金属蛋白酶组织抑制剂-1(tissue inbibitor of metalloproteinase-1,TIMP-1)mRNA表达,术后观察患者复发情况。结果术后12个月,治疗组复发1例(3.3%),对照组复发6例(20.0%),两组比较,差异有统计学意义(P<0.05)。在位、异位内膜TIMP-1 mRNA表达治疗组分别为1.85±0.36和0.76±0.57,对照组分别为0.71±0.33和0.56±0.39,治疗组较对照组均明显升高(P<0.01);在位、异位内膜MMP-9mRNA治疗组分别为0.36±0.40和0.35±0.35,对照组分别为0.36±0.33和0.72±0.59,治疗组异位内膜MMP-9mRNA表达较对照组降低(P<0.01)。结论中药莪棱胶囊可增加在位、异位内膜组织中TIMP-1含量,降低异位内膜MMP-9含量,可能通过调节MMP/TIMP平衡降低了内膜组织的侵袭性,从而起到防治EMA复发的作用。Objective To investigate the effect and mechanism of E-leng Capsule （ELC） in preventing and treating post-operation recurrence of ovarian endometriotic cysts （ OEC）. Methods A total of 60 patients enrolled were the inpatients, who underwent cystectomy of OEC in the Gynecological Department of Guangdong Provincial Hospital of Traditional Chinese Medicine from 2002 to 2004. They were randomly assigned to two groups, the treatment group and the control group. Patients in the treatment group were administered with ELC before operation and after operation （starting from the 7th day post-operation） , each for 3 months, while patients in the control group were untreated before operation and administered with Danazol from the 7th day post-operation for 3 months. Specimens of eutopic and ectopic endometrium in all patients of both groups were taken during the operation for detecting expressions of matrix metalloproteinase-9 （MMP-9） and tissue inhibitor of metalloproteinase-1 （TIMP-1） mRNA by polymerase chain reaction （PCR）, and the incidence of post-operation recurrence was observed 12 months later. Results The 12-month follow-up showed that recurrence presented in 1 patient in the treatment group （3.3%） , and 6 in the control group （20.0%）, showing significant difference between them （P 〈 0.05 ）. The expressions of TIMP-1 mRNA in eutopic and ectopic endometrium were 0. 85 ± 0. 36 and 0.76 ± 0. 57 in the treatment group, and 0.71 ±0.33 and 0.56 ±0.39 in the control group, while the expressions of MMP-9 mRNA were 0. 36 ±0.40 and 0. 35 ±0. 35 vs 0. 36 ± 0. 33 and 0.72 ± 0.59, respectively. The expression of endometrial TIMP-1 mRNA, either eutopic or ectopic, was significantly higher, and the expression of ectopic endometrial MMP-9 mRNA was lower in the treatment group than that in the control group （ P 〈 0. 01 ）. Conclusion ELC can reduce the invasive ability of endometrium tissue probably by regulating the balance of MMP/TIMP, namely, increase the expression of eutopic an

关 键 词：卵巢子宫内膜异位囊肿 莪棱胶囊 基质金属蛋白酶-9 基质金属蛋白酶组织抑制剂-1 

分 类 号：R271.9[医药卫生—中西医结合]