宫环止血片对置CU-IUD家兔子宫内膜TNF-a、IL-2含量及iNOS表达的影响
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:宫环止血片系我院妇科专家尤昭玲教授根据多年的临床经验总结所创,临床应用疗效显著。本课题以中医药理论为指导,采用现代科学试验研究手段,在以前的试验基础上,探讨宫环止血片对置铜宫内节育器(Cu-IUD)家兔子宫内膜局部TNF-α、IL-2含量及诱生型二氧化氮合酶(Inos)蛋白表达的影响。
     方法:将家兔随机分为7组:空白组、假手术组、模型组、吲哚美辛组、宫环止血片大剂量组、宫环止血片中剂量组和宫环止血片小剂量组。建立置Cu-IUD家兔的动物模型,用吲哚美辛作对照,采用放射免疫法对各组家兔子宫匀浆液TNF-a和IL-2的含量进行测定,对各组家兔子宫内膜进行免疫组织化学染色,应用图像分析法检测宫环止血片对置Cu-IUD家兔子宫内膜iNOS蛋白的表达水平。
     结果:模型组家兔子宫内膜iNOS蛋白表达的平均面积、平均光密度、阳性细胞数明显高于空白对照组,平均灰度值明显低于空白对照组,差异具有显著性意义(P<0.01)。说明模型组家兔子宫内膜iNOS蛋白表达较空白对照组明显增高。
     宫环止血片大、中、小剂量组与模型组比较,子宫内膜iNOS蛋白表达的平均面积、平均光密度、阳性细胞数明显低于模型组,平均灰度值明显高于模型组,差异具有显著性意义(P<0.01)。说明经宫环止血片治疗后家兔子宫内膜iNOS蛋白表达明显降低。
     模型组家兔子宫匀浆液TNF-a含量较空白对照组明显增高,IL-2含量明显降低,差异具有显著性意义(P<0.01),经宫环止血片治疗后家兔子宫匀浆液中TNF-a含量明显降低(宫环止血片大、中、小剂量组与模型组比较P<0.01)IL-2含量明显增(宫环止血片大、中、小剂量组与模型组比较P<0.01)。
     结论:上述试验结果表明:CU-IUD对子宫内膜产生局部机械压迫,引起内膜充血、坏死,表浅溃疡形成而不易愈合,iNOS被大量诱导产生,生成大量NO,可能是其导致子宫内膜异常出血的又一机制。而宫环止血片可以明显降低子宫内膜中iNOS蛋白的表达水平,调节血管的收缩功能,而使子宫异常出血减少,宫环止血片还可通过降低置Cu-IUD家兔子宫匀浆液中TNF-a含量,增高IL-2含量使免疫机能增强,提示宫环止血片能减轻置器后子宫局部坏死及无菌性炎症,有效地提高机体免疫机能,增强抗感染能力。
     本实验证实,宫环止血片可以明显降低子宫内膜中iNOS蛋白的表达水平,降低子宫匀浆液中TNF-a含量,增高IL-2含量,为防治IUD引起子宫异常出血的药理机制提供新的理论依据,也证明本方通过多重机制起作用,同时证实中药复方多途径,多靶点作用的一般规律。为中医药防治IUD引起异常出血的研究开拓新的思路和着眼点。
Objective:Gonghuanzhixue tablets has predominant therapeutic effect in clinic, which was created by You Zhaoling, the specialist of department of gynecology, according to many years' clinical experience. This topic was guided by traditional Chinese medicine and was adopted modern scientific experiments.In the former experiment bases, to explore the effect of Gonghuanzhixue tablets on the content of TNF-a,IL-2 and the express of iNOS in endometria of CU-IUD-wearing rabbits.
     Methods:The rabbits were divided into blank group, sham operation group, model group, indomethacin group, high-dose-group, middle-dose-group and low-dose group.The animal model of CU-IUD-wearing rabbits was established.Compared with indomethacin, to determine the content of TNF-a and IL-2 of homogenate by radioimmunity.The immunohistochemistry dyeing was used in the endometria of rabbits in every group. To detect the express level of Gonghuanzhixue tablets on the protein of iNOS in endometria by image analysis.
     Result:The surface density,average optical and masculine cell population expressed by iNOS in the model group were more than those of blank group, but the average gray scale was lower than these of blank group. There were significant differences between the two groups(P<0.01). They could explain that the express of iNOS in model group was higher than those in the blank group.
     Compared to model group, the surface density, average optical and masculine cell population expressed by iNOS was low in the high-dose-group, middle-dose-group and low-dose group but the average gray scale was high.There were significant differences between the two groups (P<0.01).They could explain that the express of iNOS in endometria depressed obviously after treatmented by Gonghuanzhixue tablets.
     Compared to control group, the content of TNF-a in homogenate was high in model group and the content of IL-2 depressed.There were significant differences between the two groups (P<0.01).After treatmented by Gonghuanzhixue tablets, the content of TNF-a in homogenate depressed obviously (the content of TNF-a in high-dose-group,middle-dose-group and low-dose group was different from those of model group, P<0.01), the content of IL-2 in homogenate increased obviously (the content of IL-2 in high-dose-group, middle-dose-group and low-dose group was different from those of model group, P<0.01).
     Conclusion:The result of the experiment indicated that:CU-IUD could form mechanical pressure for iNOS.It could cause congestion, cellular necrosis and superficial anabrosis of endometrium. The production of iNOS was induced and much NO formed.These may be another mechanism for abnormal bleeding.Gonghuanzhixue tablets could depress the express level of iNOS in endometrium, adjust the contractile function of blood vessel, so reduced the abnormal bleeding of hystera. It could also increase the content of IL-2 and enhance the immune function by decreasing the content of TNF-a of homogenate. These indicated that Gonghuanzhixue tablets could enhance the immune function and anti-infection.
     The experiment confirmed that Gonghuanzhixue tablets could decrease the express level of iNOS, the content of TNF-a in endometrium, but could increase the content of IL-2. It provided new theory base for the mechanism of preventing and curing abnormal bleeding according by IUD.It also confirmed that Gonghuanzhixue tablets reacted by multiplicitas mechanism and effected by many paths and many targets. And this would improve new methods for preventing and curing abnormal bleeding caused by IUD.
引文
[1]孟延兵,雷磊,尤昭玲.论“胞环出血”[J].湖南中医药导报.2001,7(1):4-5.
    [2]尤昭玲,付灵梅.宫环止血片对置铜宫内节育器家兔子宫匀浆中一氧化氮及一氧化氮合酶的影响[J].湖南中医学院学报.2001,21(4):12-14.
    [3]纪小龙。免疫组织化学新编[M].北京:人民军医出版社.2005:19-73.
    [4]胥桂生.缩宫止漏汤治疗上环月经不调214例[J].吉林中医药.1998,14(4):25.
    [5]戴阳娟.中医治疗宫内节育器放置后经期延长临床观察[J].浙江中西医结合杂志.2000.10(2):94-95.
    [6]雷磊,孟延兵,尤昭玲.中医药防治IUD出血副反应的思路与方法[J].湖南中医药导报.2001.7(3):101-102.
    [7]张烨。中医药治疗宫环出血概况[J].湖南中医杂志.2003.19(2):76-77.
    [8]尤昭玲.全国高等中医药院校中西医结合专业系列教材.中西医结合妇科学[M].北京:中国中医药出版社,2001:434-436。
    [9]戴德英.现代中医药应用与研究大系·第七卷·妇科[M].上海:上海中医药出版社.1995.280-295.
    [10]孟延兵,雷磊,尤昭玲.论胞环出血[J].湖南中医药导 报.2001,7(1):4-6。
    [11]翁文忠,陈永明,四物汤加味治疗放环后出血32例[J].中华现代临床医学杂志,2004.2(05B):733-734.
    [12]郭荷先,潘乐意,张菊新。桃红四物汤加减治疗宫环300例[J].国医论坛,2005.20(3):33。
    [13]邓平香.中西医结合治疗宫环出血120例疗效观察[J].中国医药卫生,2005.6(9):13-15。
    [14]马翠萍.安冲中汤治疗放环后子宫出血60例报告.甘肃中医,2003.16(3):30-31。
    [15]赵丽莎,白晓晨,樊玉亮。三地固冲汤治疗放环后子宫异常出血32例疗效观察[J].内蒙古中医药.2002.21(10):10.
    [16]张惠萍,赵红.调冲止血汤治疗放环后子宫出血的观察及护理[J].河北医药.2004.26(11):921-922.
    [17]王飞霞.贯茜止血汤治疗放环后子宫出血78例[J].四川中医.2004.22(6):61-62.
    [18]孙珊,姚康德.宫内节育器的九十年[J]。生殖与避孕.1992.12(6):7.
    [19]Zhu PD, Luo HZ, Xu Rh el al.The effect of intrauterine devices,the stainless spteeling, the copper T200,and releasing levonoregestrel,on the bleeding profile and the morphological structure of the human human endometrium A comparative of(three IUDS.Contraception,1989,40(4):425
    [20]黄晋红.宫内节育器出血副反应机理的研究进展[J].医学信息,2000,13(3):139-140
    [21]周玉玲.宫内节育器影响子宫出血机理的研究现状[J].中国计划生育学杂志.1999.(9):379-381.
    [22]田文萍,王沅华.消炎痛及6-氨基己酸治疗宫内节育器致月经过多62倒临床分析[J].贵州医药.1996.20(4):234.
    [23]赵月华.消炎痛及安络血治疗宫内节育器致月经过多44倒临床分析.中国医院药学杂志.1993.(3):172.
    [24]吴学浙.茜草双脂治疗IUD引起异常子宫出血(附225倒分析)[J].生殖与避孕.1992.12(3):33.
    [25]杨秀娟.中西医结合治疗放环后出血124例[J].右江医学.2002.30(5)426-427.
    [26]蒋小燕,马洪波,闫文莲.中西医结合治疗放环后子宫出血56例临床分析[J].中华临床医药与护理.2005.3(1):52-53。
    [27]林松,中西医联合治疗放环后子宫出血的临床观察[J].云南医药。2003.24(5):405-406.
    [28]陈敦金.孕产妇围产期一氧化氮的测定及其临床意义[J].国外医学妇产科学分册.1996.23(1):11-13
    [29]Snyder SH,et al Nitric oxide,a kind of important message substance.SciAm,1992,5:68-77
    [30]陈钢,薛红,孟宪丽,等。柴胡止血液对含铜IUD家兔宫腔液PGI2和TXB2含量的影响.中国计划生育.1999(7):297-299.
    [31]许爱菊,方进芬,赵士超.带铜T型宫内节育器致月经过多妇女经血NO含量测定[J].中国卫生检验杂志.1999,9(4):封二.
    [32]尤昭玲,付灵梅,雷磊,等.宫环止血片对带铜宫内节育器家兔子宫匀浆中一氧化氮及一氧化氮合酶的影响[J].湖南中医学院学报.2001.21(4):12-14.
    [33]周玉玲.宫内节育器影响子宫出血机理的研究现状[J].中国计划生育学杂志.1999(9):379-381.
    [34]吴嵩龄,仉斌,杨大,等.带铜IUD对宫颈粘液中丙二醛含量的研究[J].中国计划生育杂志.1996(2):89-92.
    [35]周玉玲。宫内节育器影响子宫出血机理的研究现状[J].中国计划生育学杂志.1999(9):379-381.
    [36]董白桦,侯桂华,张友忠.长期放置宫内避孕器对子宫微环境的影响及共机理的研究[J].中华医学杂志,2003,83(10):823-824.
    [37]陶占怀,王小华,剡海字,等。严重多发伤患者地塞米松治疗LI-8ACTH含量的变化[J].第四军医大学学报.2003.23(6):566.
    [38]陶占怀,王嘉军,闫保华.创伤性休克早期患者血浆TNF-α和IL-2含量测定及其机制分析[J]。中国>台金工业医学杂志,2006,23(2):133-134.
    [39]王晓军.太极拳对老年人白细胞介素2的影响[J].山东体育学院学报.2003.19(2):48-49.
    [1]Snyder SH,et al Nitric oxide.a kind of important message substance.Sci Am,1992,5:68-77.
    [2]陈敦金.孕产妇围产期一氧化氮的测定及其临床意义[J].国外医学妇产科学分册,1996,23(1):11-13.
    [3]Van Buren GA,Yong DS,Clark KE,et al.Estrogen induced uterine vasodilation is antagonized by L-nitroginine methyl ester:An inhibitor of Nos.Am J Obster Gyheeol,1992,167:82-83.
    [4]Teller JF,Wormen FL,Cameron ZT,et al.Identification of nitric oxide aynthesis in human uterus.Hum Reprod,1995,10-12.
    [5]王桂敏,郑淑蓉.甾体激素与子宫内膜出血[J].生殖与避孕,1996,16(2):248-253.
    [6]许爱菊,方进芬,赵士超.带铜T型宫内节育器致月经过多妇女经血NO含量测定[J].中国卫生检验杂志,1999,9(4):封二.
    [7]尤昭玲,付灵梅,雷磊等.宫环止血片对带铜宫内节育器家兔子宫匀浆中一氧化氮及一氧化氮合酶的影响[J].湖南中医学院学报,2001,21(4):12-14.
    [8]周玉玲.宫内节育器影响子宫出血机理的研究现状[J].中国计划生育学杂志,1999.(9):379-381.
    [9]许爱菊.宫内节育器致月经过多妇女经血一氧化氮含量分析.中国卫生检验杂志,2004,14(4):506.
    [10]周宜,陈钢,沈映君,等.柴胡止血液对人工性周期大鼠置器后子宫内膜内皮素和一氧化氮动态变化的影响,2005,28(3):1-5.
    [11]林其德.妊娠高血压综合征病因学研究的现状[J].中华妇产科杂志,2001,36(4):197-198.
    [12]董文岳,张方红,王正平.正常孕妇及妊高征患者血清一氧化氮变化及意义[J].浙江预肺医学,2000,12(12):9-10.
    [13]牟瑞丽,马玉燕,吴美琳.妊娠高血压综合征孕妇血清一氧化氮与雌三醇水平的相关性研究[J].现代妇产科进展,2002,6(11):439-441。
    [14]王若光,尤昭玲,刘小丽,等.黄芪丹参复方成分对妊高征大鼠胎盘滋养细胞渗透型一氧化氮合酶mRNA表达的影响.中国中医药科技,2005,12(5):305-306.
    [15]Costoya A.et al Morphological Study of placental terminal villi in intrahepatic cholestasts of pregnancy:histochemistry.light and electronmicros copy Placenta,1980,1:361-368.
    [16]刘伯宁,沈宁,陶雯琪.妊娠期肝内胆汁淤积症眙盘的组织计量谢定[J].中华妇产科杂志,1998,23(3):9-12.
    [17]张珂,阮玲娣,王正平.超声脐动脉血流分析在妊振肝内胆汁淤积症孕妇中的应用[J].实用妇产科杂志,1999,15(6):303-304.
    [18]陈杰,陈沿东,应小燕.妊娠肝内胆汁淤积症孕妇血及脐血中一氧化氮水平与胎儿脐血流的关系[J].宁夏医学杂志,2001,23(9):521-522.
    [19]赵文娟.孕妇和葡萄胎患者血浆ET,NO和NOS检测的临床意义[J].放射免疫学杂志,2002,15(1):32-33.
    [20]叶元华,张少静.雌激素替代疗法对绝经后妇女血浆一氧化氮的影响[J].中华妇产科杂志,1998,33(6):340-342.
    [21]区文超,杨光钦.雌激素替代治疗对妇女冠心病患者血浆一氧化氮和内皮素的影响[J].临床心血管病杂志,2000,16(7):300-302.
    [22]赖爱鸾,张建生,丁磊,等.绝经妇女血浆一氧化氮、内皮素的水平及补充性激素后的变化[J].中华妇产科杂志.2000,35(4):222.
    [23]彭幼玲,陈党生,李玲玲.激素替代疗法对绝经后妇女血浆一氧化氮水平的影响[J].广东医学,2001,22(12);1147-1148.
    [24]邢爱棣,邢均萍,李明莉.维尼安对绝经妇女血一氧化氮及内皮素的影响[J].中国全科医学,2002,5(7):528-530.
    [25]杨丁友,段学忠,张蕴慧,等.青娥丸加减治疗绝经后妇女冠心病心绞痛患者临床研究.中国自然医学杂志,2001,3(1):14-16.
    [26]金镇,王景华,李守柔.正常妊娠和妊高征孕妇血浆一氧化氮的变化[J].中华妇产科杂志.1996,31(10):594-596.
    [27]yaliam Palli C,et al Nitric oxide.Endothellum derived relaxing factor.Am J Obstet Gyncvol.1993,169:1316-1320.
    [28]徐开红,董曼岳,周坚红。胎儿宫内生长迟缓孕妇静脉血及其新生儿脐血一氧化氮水平测定的临床意义[J].中华妇产科杂志,2000,35(12);715-716.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700