化瘀散结法对子宫内膜息肉患者Bcl-2表达的影响  

Effects of Huayu Sanjie TCM therapy on expression of Bcl-2 in patients with endometrial polyps

作　　者：张蔚苓 赵珊琼 张宜群 

机构地区：[1]宁波市中医院妇科,浙江宁波315010

出　　处：《中华全科医学》2017年第6期989-992,共4页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2015ZB101);宁波市中医重点学科中西医结合妇科学(2016-Z03)

摘　　要：目的通过观察治疗前后子宫内膜中Bcl-2的变化,探讨化瘀散结法防治子宫内膜息肉术后复发的作用机制。方法选取2015年6月—2016年6月147例子宫内膜息肉术后患者,按随机单盲法分为中药组、西药组和对照组,每组49例。中药组用中药化瘀散结法口服加外敷分期治疗,西药组用妈富隆周期治疗,对照组不予任何药物治疗。用药3个月后观察3组患者中医证候的改善情况、超声下子宫内膜的变化以及免疫组化法检测子宫内膜中Bcl-2的表达改变。结果治疗后3组中医证候积分、超声下子宫内膜情况均较治疗前明显改善(P<0.01),组间比较,中药组优于西药组及对照组(P<0.05),西药组与对照组比较差异无统计学意义(P>0.05)。治疗后中药组和西药组子宫内膜中Bcl-2表达均明显降低(中药组Z=-5.690,P<0.01;西药组Z=-5.477,P<0.01),对照组治疗前后比较差异无统计学意义(Z=-1.732,P=0.083),治疗后3组比较差异有统计学意义(χ~2=31.143,P<0.01),中药组对子宫内膜Bcl-2表达的下调作用优于西药组及对照组,西药组优于对照组(P<0.05)。结论化瘀散结法能明显改善子宫内膜息肉患者的临床症状,有效预防子宫内膜息肉术后复发,其机制可能与通过抑制Bcl-2的过度表达有关。Objective To observe the changes of Bcl-2 in the endometrium before and after the therapy,and to explore the mechanism of Huayu Sanjie TCM therapy on prevention of the recurrence of endometrial polyps（ EP）. Methods Total147 postoperative patients caused by endometrial polyps were selected from June,2015 to June,2016,they were randomly divided into the Chinese herbal group,the western medicine group and the control group,with 49 cases of each group by single-blind method. The Chinese herbal group received Huayu Sanjie TCM staging therapy by internal and external use;the western medicine group was treated with Marvelon cycle therapy; the control group was not given any drugs. After three months,the improvement of the TCM Syndromes,the changes of endometrium under ultrasound,and the expression of Bcl-2 in endometrium was detected by immunohistochemical assay. Results After the treatment,the TCM syndrome integral and the endometrial condition were all significantly improved than before in each groups（ P〈0. 01）. The Chinese herbal group were better than the other two groups（ P〈0. 05）,there were no significant difference between the western medicine group and the control group（ P〈0. 05）. After the treatment,the expression of Bcl-2 in endometrium were all significantly improved than before in the Chinese herbal group（ group Z =-5. 690,P〈0. 01） and the western medicine group（ Z =-5. 477,P〈0. 01）,and there was no significant difference in the control group（ Z =-1. 732,P = 0. 083）. There was a significant difference among the three groups（ χ~2= 31. 143,P〈0. 01）,the Chinese herbal group were better than the other two groups（ P〈0. 05）,and the western medicine group were better than the control group（ P〈0. 05）. Conclusion The Huayu Sanjie TCM therapy can obviously improve the clinical symptoms of endometrial polyps,and effectively prevent the recurrence of endometrial polyps. The mechanism might be related to the inhibition of excessive expression of Bcl-2.

关 键 词：化瘀散结 子宫内膜息肉 BCL-2 

分 类 号：R711.74[医药卫生—妇产科学]