清热化瘀法对子宫内膜异位症患者血管生成机制的影响  

The Effects of Heat-clearing Stasis-eliminating Method on the Mechanism of Angiogenesis of Endometriosis Patients

作　　者：徐群群[1] 卢敏[1] 曹阳[1] 张婷婷[1] 谭蕾[1] 戴德英[2] 束兰娣[2] 孙兆贵[3] 季培英[1] 王唯迪[1] 庄梦斐[1] 夏馨 XU Qunqun;LU Min;CAO Yang;ZHANG Tingting;TAN Lei;DAI Deying;SHU Landi;SUN Zhaogui;JI Peiying;WANG Weidi;ZHUANG Mengfei;XIA Xin(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai Universityof Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Shuguang Hospital Affiliatedwith Shanghai University of TCM;hanghai Institute of Planned Parenthood Research)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学附属曙光医院 [3]上海市计划生育科学研究所

出　　处：《西部中医药》2019年第2期1-5,共5页Western Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(编号81373684);上海卫计委中医药三年行动计划课题(编号ZY3-CCCX-3-3019);H上海市科委"科技创新行动计划"项目(编号1840197);上海市进一步加快中医药事业发展三年行动计划项目[编号ZY(2018-2020)-CCCX-1015]

摘　　要：目的:比较以清热化瘀法为主的中药与西药醋酸曲普瑞林(注射用GnRHa)治疗腹腔镜术后子宫内膜异位症(EMs)患者的临床疗效差异,探讨外周血中血管内皮生长因子(VEGF)、血管内皮生长因子-受体1(VEGF-R_1)、血管内皮生长因子-受体2(VEGF-R_2)、前列腺素E2(PGE_2)和环氧化酶2(COX_2)与EMs发病的相关性,为本病的中医药防治提供依据。方法:选择90例EMs患者及输卵管炎性疾病患者,分为中药组、西药组和对照组,每组30例。中药组术后口服清热化瘀中药汤剂,连续治疗3个月经周期;西药组于术后第1次月经来潮第1～5天内皮下注射醋酸曲普瑞林(GnRHa),每4周1次,连用3月;对照组为输卵管炎性疾病患者,术后不使用药物。ELISA法测定患者外周静脉血中VEGF、VEGF-R_1、VEGF-R_2、PGE2和COX_2的浓度,探讨EMs的发病机理。结果:外周静脉血中VEGF、VEGF-R_1、VEGF-R_2浓度中药组、西药组均高于对照组,差异有统计学意义(P<0.05);PGE_2和COX_2浓度中药组、西药组与对照组比较,差异无统计学意义(P>0.05);外周静脉血中VEGF、VEGF-R_1、VEGF-R_2、PGE_2、COX_2浓度治疗前后3组组内比较差异有统计学意义(P<0.05);治疗后中药组、西药组与对照组比较,差异也有统计学意义(P<0.05);治疗后中药组与西药组比较,差异无统计学意义(P>0.05)。结论:外周静脉血中VEGF、VEGF-R_1和VEGF-R_2的含量在一定程度上能够反映EMs的发生及发展进程,清热化瘀法可能是通过降低血管内皮生长因子及其受体的含量,达到治疗内异症的目的。Objective:To compare clinical effects of herbs of heat-clearing stasis-eliminating and Western medicine triptorelin acetate injection(GnRHa for injection)in treating endometriosis(EMs)after laparoscopic surgery,and survey the correlation between the incidence of EMs and VEGF,VEGF-R1,VEGF-R2,PGE2 and COX2 in peripheral blood,to provide the reference for TCM prevention and treatment of EMs.Methods:Ninety patients with EMs and salpingitis disease were screened and assigned to herbal group,Western medicine group and the control group,30 cases each group.The herbal group took the decoction of heat-clearing stasis-eliminating orally after the operation for three menstrual cycles consecutively;the group of Western medicine accepted hypodermic injection of GnRHa from the first day to the fifth day of the first period after the surgery,once each four weeks,for three months consecutively;the patients with salpingitis disease in the control group didn忆t use the medicine after the surgery.The pathogenesis of EMs was discussed,and the concentrations of VEGF,VEGF-R1,VEGF-R2,PGE2 and COX2 in peripheral blood were detected using ELISA method.Results:The herbal group and Western medicine group were higher than the control group in the concentrations of VEGF,VEGF-R1 and VEGF-R2 in peripheral blood,and the difference had statistical meaning(P<0.05);the difference had no statistical meaning when the herbal group and Western medicine group were compared with the control group in the concentrations of PGE2 and COX2(P>0.05);the difference had statistical meaning in the comparisons of the concentrations of VEGF,VEGF-R1,VEGF-R2,PGE2 and COX2 in peripheral blood before and after treating within three groups before and after treating(P<0.05);the difference had statistical meaning when the herbal group and Western medicine group were compared with the control group after treating(P<0.05);the difference had no statistical meaning when the herbal group was compared with Western medicine group after treating(P>0.05).Conclusion:The contents o

关 键 词：子宫内膜异位症 清热化瘀法 血管内皮生长因子 

分 类 号：R711.32[医药卫生—妇产科学]