摘要
目的探讨益气化瘀方对产后子宫内膜炎模型大鼠肿瘤坏死因子-α(TNF-α)、白介素-1(IL-1)、6-酮-前列腺素F1α(6-K-PGF1α)、血栓素B2 (TXB2)表达的影响及其促进产后子宫复旧的作用机理。
方法将72只妊娠大鼠随机分为空白组、模型组、产复康颗粒对照组及益气化瘀方低、中、高剂量组。除空白组外,其余各组均造成产后子宫内膜炎模型,并于造模后第3～10天分别灌胃给药。采用酶联免疫吸附法(ELISA)测定TNF-α值；采用免疫组化法检测IL-1含量；采用放免药盒测试法测定6-K-PGF1α和TXB2的含量。
结果1.以益气化瘀为法的益气化瘀方能改变产后子宫内膜炎模型大鼠子宫的病理学形态,减轻炎症反应。
2.益气化瘀方能减弱产后子宫内膜炎模型大鼠TNF-α的表达强度。模型组大鼠TNF-α值较空白组升高,差异有显著统计学意义(P<0.01)。产复康颗粒对照组,益气化瘀方中、高剂量组与模型组相比,TNF-α值降低有统计学意义(P<0.05)；益气化瘀方中、高剂量组与产复康颗粒对照组相比及益气化瘀方中、高剂量组之间相比,差异无统计学意义(P>0.05)
3.益气化瘀方能减弱产后子宫内膜炎模型大鼠IL-1的表达的强度。模型组大鼠平均灰度、面密度值与空白组相比,有显著统计学意义(P<0.01)。产复康颗粒对照组,益气化瘀方中、高剂量组与模型组相比,平均灰度值升高、面密度值降低有统计学意义(P<0.05)；其中产复康颗粒对照组、益气化瘀方高剂量组面密度值的降低有显著统计学意义(P<0.01)。益气化瘀方中、高剂量组与产复康颗粒对照组相比及益气化瘀方中、高剂量组间相比差异无统计学意义(P>0.05)
4.益气化瘀方能减弱6-K-PGF1α表达、增强TXB2表达。模型组大鼠6-K-PGF1α、TXB2值与空白组相比,差异有统计学意义(P<0.05、P<0.01)。产复康颗粒对照组TXB2值较模型组升高,差异有显著统计学意义(P<0.01)。益气化瘀方高剂量组与模型组比较,6-K-PGF1α值降低、TXB2值升高有统计学意义(P<0.05),其中TXB2值升高有显著统计学意义(P<0.01)。益气化瘀方高剂量组与产复康颗粒对照组相比,其增强TXB2表达的作用无统计学差异(P>0.05)。
结论益气化瘀方能改变产后子宫内膜炎模型大鼠子宫组织病理学形态；能减弱炎症因子IL-1、TNF-α的表达强度,抗炎作用明显；能降低6-K-PGF1α值、升高TXB2值,调节PGI2/TXA2比例关系促进PGI2/TXA2之间的动态平衡,使血止而不留瘀；通过以上调节机制有效治疗产后子宫内膜炎,从而发挥促进产后子宫复旧之功效。中、高剂量的益气化瘀方疗效肯定,而高剂量的益气化瘀方疗效更显著。
Objective To explore the effect of formulae that can tonify Qi and dissolve stasis ontumor necrosis factor-alpha (TNF-α), interleukin-1(IL-1), 6-keto-prostaglandin F1alpha(6-K-PGF1α), thromboxane B2(TXB2) of rats model of postpartum endometritis and the action mechanism of promoting postpartum involution of uterus.
Methods Seventy-two SD pregnant rats were randomly divided into 6 groups:blank group,model group, the comparing group with Chanfu Kang grain used and small, middle, large dose of formulae tonifying Qi and dissolving stasis group. The model of subinvolution of uterus was established on rats in groups beside the blank one. All rats in each group were administered by intragastric infusion with corresponding drugs during day 3～10 after the model established. The content of IL-1, TNF-α, 6-K-PGF1αand TXB2 were respectively detected by the method of Immunohistochemistry(IHC), Enzyme-Linked Immunosorbnent Assay (ELISA) and Radioimmunoassay(RIA).
Result
1.The formulae that can tonify Qi and dissolve stasis, based on the "Tonifying Qi and Dissolving Stasis Method"can change the pathological image of the uterus of the rats with postpartum endometritis caused by postpartum inflammation, and alleviate the inflammatory reaction.
2.The formulae that can tonify Qi and dissolve stasis can alleviate the TNF-a value in rats with postpartum endometritis.TNF-a value in rats in modeling group has obvious growth, compared with the blank group (P<0.01). As to the comparing group with Fuchan Kang grain used, the high dose group with formulae tonifying Qi and dissolving stasis, compared with the modeling group, has a decreasing value of TNF-a value, which is of significance (P<0.05). There's no significance in the high dose group with formulae tonifying Qi and dissolving stasis used and comparing group with Chanfu Kang grain used(P>0.05). Also there's no significance between and among all figures in the high dose group with formulae tonifying Qi and dissolving stasis used(P>0.05).
3. The formulae with functions of tonifying Qi and dissolving stasis can weaken the IL-1 value in rats with the postpartum endometritis. Rats in modeling group embark significant differences in the average grey level and areal density level, compared with the blank group (P<0.01). As to the comparing group where Chanfu Kang grain is in use, in the formulae that tonifying Qi and dissolving stasis, high volume group, comparing with the modeling group, the average grey level increased, and the areal density level decreased, both with statistical significance (P<0.05); the comparing group with Chanfu Kang grain used and the high dose group with formulae tonifying Qi and dissolving stasis, shared the decline in areal density level (P<0.01). There's no significance in the high dose group with formulae tonifying Qi and dissolving stasis used and comparing group with Chanfu Kang grain used(P>0.05). Also there's no significance between and among all figures in the high dose group with formulae tonifying Qi and dissolving stasis used(P>0.05).
4. The formulae that can tonify Qi and dissolve stasis can decrease the value of 6-K-PGF1a and increase the value of TXB2.The modeling group, compared with the blank group,has significant difference in 6-K-PGF1a value and TXB2 value (P<0.05,P<0.01).Comparing group with Chanfu Kang grain used has a significant increasing value in TXB2 when compared with the modeling group (P<0.01).The high dose group with formulae tonifying Qi and dissolving stasis used, compared with the modeling group, has a decreasing value of 6-K-PGF1a and increasing value of TXB2, which is of great significance (P<0.05), and TXB2 value has tremendous increase (P<0.01).There's no significance in the high dose group with formulae tonifying Qi and dissolving stasis used and comparing group with Chanfu Kang grain used in TXB2 value (P>0.05).
Conclusion The formulae that can tonify Qi and dissolve stasis can change the pathological image of the uterus of the rats with postpartum endometritis caused by after birth inflammation;also it can weaken the value of inflammatory factor IL-1,TNF-a, with significant anti-inflammatory action;it also can decrease the value of 6-K-PGF1a, increase the TXB2 value and adjust the proportional relation PGI2/TXA2, promoting the dynamic balance of PGI2/TXA2, enabling smooth blood circulation and vanishing the stasis. Through all these adjustive functions, the formulae that can tonify Qi and dissolve stasis can effectively cure postpartum endometritis, thus stimulating involution of uterus after delivery. The effect of middle, high dose group with formulae tonifying Qi and dissolving stasis used were apparent, especially the high one.
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