补肾活血方调节COX-2、PGE2改善不明原因复发性流产患者分泌晚期蜕膜化水平的研究  

Bushen Huoxue Formula Regulating COX-2 and PGE2 to Improve Late Decidualization in URSA Patients

作　　者：冯晓玲[1] 朱慧[2] 常卓 张扬[1] 蒋莎 谷玥儒 贾紫千 吴仪 FENG Xiaoling;ZHU Hui;CHANG Zhuo;ZHANG Yang;JIANG Sha;GU Yueru;JIA Ziqian;WU Yi(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中医药学报》2020年第12期41-46,共6页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金资助项目(81973894);黑龙江中医药大学校科研基金资助项目(2019MS34)。

摘　　要：目的:探索不明原因复发性流产(URSA)患者分泌晚期蜕膜COX-2、PGE2水平变化与蜕膜化水平的关系,通过研究补肾活血方对分泌晚期COX-2、PGE2及蜕膜化水平的影响,从分子层面揭示中药补肾活血方治疗URSA疾病的作用机制。方法:收集肾虚血瘀证URSA者(试验组1)与正常者(对组照1)流产蜕膜,利用RT-PCR法检测两组蜕膜中COX-2、PGE2、PRL、IGFBP-1的mRNA水平;收集符合纳排标准的正常未孕女性(空白组)与URSA未孕女性,URSA者随机分为两组,分别予以中药补肾活血方(试验组2)与阿司匹林(对照组2)进行为期4周的体内干预治疗,于治疗前后月经周期第26天留取三组受试者静脉血,应用ELISA法检测血清中COX-2、PGE2、PRL、IGFBP-1水平。结果:(1)试验组1蜕膜中COX-2、PGE2、PRL、IGFBP-1的mRNA水平显著低于对照组1(P<0.05)。(2)治疗前试验组2血清中COX-2、PGE2、PRL、IGFBP-1水平显著低于空白组(P<0.05);治疗后试验组2血清COX-2、PGE2、PRL、IGFBP-1水平显著高于治疗前水平(P<0.05),略高于对照组2且与空白组水平相近。结论:URSA的低蜕膜化水平可能与COX-2、PGE2的低表达相关,补肾活血方可通过提高URSA者分泌晚期COX-2、PGE2水平进而改善蜕膜化,这可能是该方药对URSA疾病发挥显著疗效的分子机制。Objective:To explore the relationship beween the level changes of COX-2 and PGE2 in late decidual secretion and the level of decidualization in patients with unexplained recurrent spontaneous abortion(URSA),and to discover the action mechanism of Bushen Huoxue Formula in treating URSA by studying its effect on COX-2,PGE2 and decidualization levels.Methods:The decidua of URSA patients with Kidney deficiency and blood stasis syndrome(the experimental group 1)and normal patients(the control group 1)were collected,and the mRNA levels of COX-2,PGE2,PRL and IGFBP-1 in decidua of the two groups were detected by RT-PCR;the normal non pregnant women(the blank group)and URSA non pregnant women were randomly divided into the experimental group 2(Bushen Huoxue Formula)and the control group 2(Aspirin).The intervention duration was four weeks.The venous blood was collected on the 26 th day of menstrual cycle before and after the treatment.The serum levels of COX-2,PGE2,PRL and IGFBP-1 were detected by ELISA.Results:The mRNA levels of COX-2,PGE2,PRL and IGFBP-1 in decidua of the experimental group 1 were significantly lower than those of the control group 1(P<0.05).The serum levels of COX-2,PGE2,PRL and IGFBP-1 of the experimental group 2 were significantly lower than those in the blank group before the treatment(P<0.05);the serum levels of COX-2,PGE2,PRL and IGFBP-1 of the experimental group 2 were significantly higher after the treatment than those before the treatment(P<0.05),which were slightly higher than those in the control group 2 and similar to those in the blank group.Conclusion:The low decidualization level of URSA may be related to the low expressions of COX-2 and PGE2,Bushen Huoxue Formula can improve the decidualization by increasing the levels of COX-2 and PGE2 in the late secretion stage of URSA,which may be the molecular mechanism of its significant effect on URSA.

关 键 词：不明原因复发性流产 补肾活血方 环氧化酶2 前列腺素E2 

分 类 号：R271.4[医药卫生—中医妇科学]