补肾活血方对重度宫腔粘连子宫内膜容受性、Wnt/β-catenin信号通路及对子宫内膜干细胞标志物的影响  

Effects of Bushen Huoxue Formula on endometrial receptivity,Wnt/β-catenin signaling pathway and endometrial stem cell markers in severe intrauterine adhesions

作　　者：范龙龙 肖盈盈[1] 马本玲[1] 周文垚 李洁 谭枚秀 FAN Longlong;XIAO Yingying;MA Benling;ZHOU Wenyao;LI Jie;TAN Meixiu(The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410005,China;Shenzhen Futian District Maternal&Child Healthcare Hospital,Shenzhen 518045,China;Liuzhou Traditional Chinese Medical Hospital,Liuzhou 545026,China)

机构地区：[1]湖南中医药大学第二附属医院,长沙410005 [2]深圳市福田区妇幼保健院,深圳518045 [3]柳州市中医医院,柳州545026

出　　处：《中华中医药杂志》2024年第7期3827-3832,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：湖南省科技厅自然科学基金-科卫联合重点项目(No.2021JJ70031)。

摘　　要：目的:探讨补肾活血方对重度宫腔粘连(IUA)分离术后患者子宫内膜容受性、Wnt/β-连环蛋白(Wnt/β-catenin)信号通路以及对子宫内膜干细胞标志物的影响。方法:选取2021年7月至12月期间湖南中医药大学第二附属医院妇科住院部符合标准的70例重度IUA分离术后患者,采用随机数表法随机分为对照组、治疗组,每组35例。对照组采用口服戊酸雌二醇治疗,于月经周期(或撤退性出血)第5天开始口服,连服21d;治疗组在对照组基础上加用补肾活血方,与西药同时服药及停药,服用21d,共治疗3个月经周期。两组患者均在治疗3个月经周期后复查宫腔镜,阴道四维超声测量子宫腔容积,HE及Masson染色观察子宫内膜厚度、间质、腺体和炎症及纤维化情况,Leica qwinplus图像处理软件测量子宫内膜厚度,免疫组织化学法检测CD34/CD117、β-catenin蛋白表达,RT-PCR法检测Oct-4mRNA表达,WesternBlot检测ABCG2蛋白表达。结果:对照组子宫内膜结构完整,大部分腺上皮及腔上皮细胞呈立方状,腺体及血管数量基本正常,淋巴细胞浸润及间质纤维较少;治疗组子宫内膜结构完整,连续,呈波浪形,腺上皮和腔上皮细胞完整,呈单层立方状,排列整齐,腺体及毛细血管数量正常,淋巴细胞浸润及间质纤维少。治疗组子宫内膜厚度及子宫腔容积较对照组显著改善(P<0.05);两组CD34、CD117、ABCG2蛋白、Oct-4mRNA在子宫内膜组织中均呈阳性表达。治疗组CD34、CD117、β-catenin、ABCG2蛋白表达较对照组显著升高(P<0.05);治疗组Oct-4mRNA相对表达量较对照组显著升高(P<0.05);且治疗组不良反应率较对照组显著降低(P<0.05)。结论:补肾活血方可增加IUA患者子宫内膜容受性,促进子宫内膜及间质生长,抑制炎症反应及纤维化,正向促进了Wnt/β-catenin信号通路的激活,增加了子宫内膜干细胞CD34、CD117、Oct-4mRNA及ABCG2蛋白的表达。Objective:To explore the effect of Bushen Huoxue Formula on endometrial receptivity,Wnt/β-catenin signaling pathway and endometrial stem cell markers in patients with severe intrauterine adhesions(IUA)after separation.Methods:From July 2021 to December 2021,70 patients with severe IUA were randomly divided into control group and treatment group,35 patients in each group.The control group was treated with oral estradiol valerate,which started on the fifth day of menstrual cycle(or withdrawal bleeding)and continued for 21 days.The treatment group was treated with Bushen Huoxue Formula on the basis of the control group's treatment measures,and took drugs and stopped taking drugs at the same time as western medicine.After three menstrual cycles of treatment,hysteroscopy was reexamined in both groups.Uterine cavity volume was measured by four-dimensional ultrasound,endometrial thickness,stroma,glands,infiammation and fibrosis were observed by HE and Masson staining,endometrial thickness was measured by Leica qwin plus image processing software,the expression of CD34/CD117 andβ-catenin protein were detected by immunohistochemistry,Oct-4 mRNA was detected by RT-PCR,and the expression of ABCG2 protein was detected by Western Blot.Results:In the control group,the endometrial structure was complete,most glandular epithelial and luminal epithelial cells were cubic,the number of glands and blood vessels was basically normal,and lymphocyte infltration and interstitial fibers were less.In the treatment group,the endometrial structure was complete,continuous and wavy,the glandular epithelium and luminal epithelial cells were complete,single-layer cubic and orderly arranged,the number of glands and capillaries was normal,and lymphocyte infiltration and interstitial fibers were few.The endometrial thickness and uterine cavity volume in the treatment group were significantly improved compared with those in the control group(P<0.05).The expression of CD34,CD117,ABCG2 protein and Oct-4 mRNA in endometrial tissue was positive in bo

关 键 词：补肾活血方 宫腔粘连 Wnt/β-连环蛋白信号通路 干细胞标志物 内膜容受性 

分 类 号：R271.9[医药卫生—中西医结合]