宫宁颗粒调控IUD出血副反应子宫内膜剥脱/修复相关机制的临床和实验研究
|
摘要
目的:探讨宫宁颗粒调控宫内节育器(IUD)出血副反应子宫内膜剥脱/修复的相关机制。
方法:临床试验中,对IUD出血副反应患者进行宫宁颗粒和消炎痛两种药物干预,并设未放置IUD月经正常的空白对照组,在观察疗效的同时,采用宫腔镜对子宫内膜的IUD压迫区、移行区和远器区进行观察并定点取材,比较各区治疗前后及与空白对照组在显微、超微结构方面的组织形态学变化,并检测ER(雌激素受体)、PR(孕激素受体)、VEGF(血管内皮生长因子)及其受体KDR、t-PA(组织型纤溶酶原激活剂)、PAI(纤溶酶原激活剂抑制剂)的表达情况;动物实验中,对大鼠子宫行IUD造模后,分为空白对照组、假手术组、模型组、宫宁大、中、小剂量组和消炎痛组,采用改良单宁酸-Fe法观察各组大鼠药物干预后子宫血管构筑的变化。
结果:宫宁颗粒的临床疗效、中医证候改善率明显优于消炎痛组(P<0.05或P<0.01)。形态学观察表明,IUD出血副反应患者子宫内膜较之正常对照组,存在明显的显微、超微结构病理损伤和内膜发育不同步、剥脱/修复障碍的现象,且内膜损伤程度与距离IUD的远近成反比,距离越近,损伤越重;子宫内膜ER、PR、VEGF、KDR、t-PA、PAI的表达均与距离IUD远近成正比,距离越近,表达越低,较之正常对照组,VEGF、KDR、t-PA表达显著升高(P<0.05),PAI显著降低(P<0.05),且ER、VEGF、KDR、t-PA、PAI在内膜不同部位的表达均显著不同步(P<0.05或P<0.01)。IUD出血副反应患者治愈或好转后,较之治疗前,子宫内膜病理损害、发育不同步和剥脱/修复障碍的现象消失或明显减轻,VEGF、KDR、t-PA表达降低,PR、PAI表达升高,各指标在内膜不同部位变化幅度虽不一致(P<0.05或>0.05),但ER、VEGF、KDR、t-PA、PAI的表达不同步现象均消失(P>0.05);在减轻内膜病理损害和改善内膜各部分ER、VEGF、KDR、t-PA、PAI表达不同步方面,宫宁颗粒明显优于消炎痛(P<0.05)。动物实验表明,宫宁颗粒和消炎痛均能改善IUD模型大鼠子宫血构筑异常的改变,尤以宫宁大、中剂量组的改善作用显著。
结论:瘀热型IUD出血副反应患者存在明显的子宫内膜剥脱/修复障碍,宫宁颗粒通过减轻内膜显微、超微结构的形态学损伤,调控内膜ER、PR、VEGF、KDR、t-PA、PAI表达,消除子宫血管构筑的异常,纠正了子宫内膜剥脱/修复障碍,从而达到防治IUD出血副反应的效果,且宫宁颗粒的临床疗效、中医证候疗效和对内膜剥脱/修复障碍相关指标的改善作用明显优于消炎痛。
Objective: To discuss the endometria’s peeling and recovery mechanism concerning control of the side reaction of bleeding after IUD placement by Gongning granula.
Method: In the clinical experimental investigation , Gongning granula and Indometacin are used for the patients suffered by side reaction of bleeding,and it is assumed that without IUD blank group is placed;while observing herapeutic effect,uterine cavity is also adopted to observe pressure area,transition area and distant area,and sample is taken at a certain point. changes of different parts prior to and after the treatment are compared,those parts and the blank control groups are also compared in terms of conventional organization morphology and Ultrastructura,and the empress of ER、PR、VEGF、KDF、t-PA and PAI are examined;in animal test,after IUD placed in rat’s uterus,it is divided into blank group,sham operation group,model group,max-dosage group,mid-dosage group,min-dosage group and Indometacin group,and improved Tannin-Fe method is adopted to observe the changes of uterus angioarchitecture of rat in different groups after medicine effect.
Results: the clinical curative effect and the improvement rate of traditional Chinese medicine of Gongning granula obviously better than Indometacin group(P<0.05).The observation of morphology indicate that,the endometria’s of the patients that the adverse reaction of bleeding after IUD placement exist obviously patho-damagement in histological anatomy and ultrastructural organization,it’s degree of the patho-damagement inverse proported with the distance to IUD,the farther distance the slighter pain, as well it appears the obviously derangement of endometria’s and the disturbance of stripping or recovery. Compare to normal control,the empress of the endometrias VEGF,KDR and t-PA obviously heigh(tP<0.05),the empress of the PAI obviously degrade,the empress of each indicatrix for the different location at endometria’s obviously discrepancy as well,the empress of PAI obviously degrade. After the patients that the adverse reaction of bleeding after IUD placement healing well or improved,the patho-damagement of the endometria’s obviously relieved,the disturbance of stripping or recovery endometria’s vanished or lightened;although the empress of ER、PR、VEGF、t-PA and PAI appears the tendency of height or degrade,but out of synchronia vanished or improved. In the directions to the improvement endometria’s patho-damagement and the empress of ER、PR、VEGF、KDR、t-PA、PAI、Gongning granula obviously better than Indometacin(P>0.05).Animal experiment manifests that,Gongning granula and Indometacin can improve abnormal change of the uterus angioarchitecture in the rat which placed IUD,obviously at max-dosage group and mid-dosage group.
Conclusion: The patients who have IUD bleeding side reaction have an obvious hindrance of endometria exfoliating/repairing periodically,Gongning granula adjusts and recovers the delivery of endometrium ER、PR、VEGF and their receptors KDR、t-PA、PAI and the abnormal construction of uterus vessels, by relieving the impair of endometrium tectology and ultrastructure , so as to adjust peeling and recovery endometrium foul-up of IUD bleeding side reaction. Gongning granula's clinical effect、effect on traditional medical syndrome and improvement of relative indexes of endometrium exfoliating/repairing foul-up excels to Indometacin obviously.
方法:临床试验中,对IUD出血副反应患者进行宫宁颗粒和消炎痛两种药物干预,并设未放置IUD月经正常的空白对照组,在观察疗效的同时,采用宫腔镜对子宫内膜的IUD压迫区、移行区和远器区进行观察并定点取材,比较各区治疗前后及与空白对照组在显微、超微结构方面的组织形态学变化,并检测ER(雌激素受体)、PR(孕激素受体)、VEGF(血管内皮生长因子)及其受体KDR、t-PA(组织型纤溶酶原激活剂)、PAI(纤溶酶原激活剂抑制剂)的表达情况;动物实验中,对大鼠子宫行IUD造模后,分为空白对照组、假手术组、模型组、宫宁大、中、小剂量组和消炎痛组,采用改良单宁酸-Fe法观察各组大鼠药物干预后子宫血管构筑的变化。
结果:宫宁颗粒的临床疗效、中医证候改善率明显优于消炎痛组(P<0.05或P<0.01)。形态学观察表明,IUD出血副反应患者子宫内膜较之正常对照组,存在明显的显微、超微结构病理损伤和内膜发育不同步、剥脱/修复障碍的现象,且内膜损伤程度与距离IUD的远近成反比,距离越近,损伤越重;子宫内膜ER、PR、VEGF、KDR、t-PA、PAI的表达均与距离IUD远近成正比,距离越近,表达越低,较之正常对照组,VEGF、KDR、t-PA表达显著升高(P<0.05),PAI显著降低(P<0.05),且ER、VEGF、KDR、t-PA、PAI在内膜不同部位的表达均显著不同步(P<0.05或P<0.01)。IUD出血副反应患者治愈或好转后,较之治疗前,子宫内膜病理损害、发育不同步和剥脱/修复障碍的现象消失或明显减轻,VEGF、KDR、t-PA表达降低,PR、PAI表达升高,各指标在内膜不同部位变化幅度虽不一致(P<0.05或>0.05),但ER、VEGF、KDR、t-PA、PAI的表达不同步现象均消失(P>0.05);在减轻内膜病理损害和改善内膜各部分ER、VEGF、KDR、t-PA、PAI表达不同步方面,宫宁颗粒明显优于消炎痛(P<0.05)。动物实验表明,宫宁颗粒和消炎痛均能改善IUD模型大鼠子宫血构筑异常的改变,尤以宫宁大、中剂量组的改善作用显著。
结论:瘀热型IUD出血副反应患者存在明显的子宫内膜剥脱/修复障碍,宫宁颗粒通过减轻内膜显微、超微结构的形态学损伤,调控内膜ER、PR、VEGF、KDR、t-PA、PAI表达,消除子宫血管构筑的异常,纠正了子宫内膜剥脱/修复障碍,从而达到防治IUD出血副反应的效果,且宫宁颗粒的临床疗效、中医证候疗效和对内膜剥脱/修复障碍相关指标的改善作用明显优于消炎痛。
Objective: To discuss the endometria’s peeling and recovery mechanism concerning control of the side reaction of bleeding after IUD placement by Gongning granula.
Method: In the clinical experimental investigation , Gongning granula and Indometacin are used for the patients suffered by side reaction of bleeding,and it is assumed that without IUD blank group is placed;while observing herapeutic effect,uterine cavity is also adopted to observe pressure area,transition area and distant area,and sample is taken at a certain point. changes of different parts prior to and after the treatment are compared,those parts and the blank control groups are also compared in terms of conventional organization morphology and Ultrastructura,and the empress of ER、PR、VEGF、KDF、t-PA and PAI are examined;in animal test,after IUD placed in rat’s uterus,it is divided into blank group,sham operation group,model group,max-dosage group,mid-dosage group,min-dosage group and Indometacin group,and improved Tannin-Fe method is adopted to observe the changes of uterus angioarchitecture of rat in different groups after medicine effect.
Results: the clinical curative effect and the improvement rate of traditional Chinese medicine of Gongning granula obviously better than Indometacin group(P<0.05).The observation of morphology indicate that,the endometria’s of the patients that the adverse reaction of bleeding after IUD placement exist obviously patho-damagement in histological anatomy and ultrastructural organization,it’s degree of the patho-damagement inverse proported with the distance to IUD,the farther distance the slighter pain, as well it appears the obviously derangement of endometria’s and the disturbance of stripping or recovery. Compare to normal control,the empress of the endometrias VEGF,KDR and t-PA obviously heigh(tP<0.05),the empress of the PAI obviously degrade,the empress of each indicatrix for the different location at endometria’s obviously discrepancy as well,the empress of PAI obviously degrade. After the patients that the adverse reaction of bleeding after IUD placement healing well or improved,the patho-damagement of the endometria’s obviously relieved,the disturbance of stripping or recovery endometria’s vanished or lightened;although the empress of ER、PR、VEGF、t-PA and PAI appears the tendency of height or degrade,but out of synchronia vanished or improved. In the directions to the improvement endometria’s patho-damagement and the empress of ER、PR、VEGF、KDR、t-PA、PAI、Gongning granula obviously better than Indometacin(P>0.05).Animal experiment manifests that,Gongning granula and Indometacin can improve abnormal change of the uterus angioarchitecture in the rat which placed IUD,obviously at max-dosage group and mid-dosage group.
Conclusion: The patients who have IUD bleeding side reaction have an obvious hindrance of endometria exfoliating/repairing periodically,Gongning granula adjusts and recovers the delivery of endometrium ER、PR、VEGF and their receptors KDR、t-PA、PAI and the abnormal construction of uterus vessels, by relieving the impair of endometrium tectology and ultrastructure , so as to adjust peeling and recovery endometrium foul-up of IUD bleeding side reaction. Gongning granula's clinical effect、effect on traditional medical syndrome and improvement of relative indexes of endometrium exfoliating/repairing foul-up excels to Indometacin obviously.
引文
[1] 乐杰.妇产科学.北京:人民卫生出版社,2000,第五版:421-423.
[2] 张玉珍.中医妇科学.北京:中国中医药出版社,2002,第一版:350-351.
[3] 王桂敏,郑淑蓉.甾体激素与子宫内膜出血.生殖与避孕,1996,16(4):248-250.
[4] Marsh MM,Buttar AR,Riley SC,et al.Immunolocalization of endothelin and neutral en dopeptidase in endometrium of users of subdermally implanted levonorgestrel. Hum Reprod, 1995, 10(10):2584.
[5] 杜天竹,李明,罗新,等.雌二醇皮贴片防治 GyneFixIUD 早期出血副反应的疗效及机理初探.中国优生与遗传杂志,2003,11(4):106.
[6] 张烨,尤昭玲,文乐兮,等.宫环Ⅱ号胶囊对宫环出血患者子宫内膜形态学的影响.中医药学刊,2004,22(7):1227.
[7] 尤昭玲,张烨 ,雷磊,等.宫环Ⅱ号胶囊对宫环出血患者血管舒缩因子的影响.中国中医药信息杂志,2004,11(4):290.
[8] 刘瑞芬,李继风,栾跃芳.宫宁颗粒剂治疗使用宫内节育器出血副反应的临床研究.中医杂志,1998,5(11):292.
[9] 庄留琪.中华妇产科杂志.宫内节育器及其使用的研究进展,1995,30(9):516-518.
[10] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2407-2408.
[11] 刘志成,陈湫波,倪秀生.放置γCuI 和 TCu220C 宫内节育器前后子宫内膜螺旋动脉形态计量学研究,1998,33(4):232.
[12] 黄丽丽,陈凌钧,陈湫波,等.放置宫内节育器后子宫内膜螺旋动脉的三维空间形态.中华妇产科杂志,1996,31(9):523-524.
[13] Schwi S E L,Toppozada M,Kamel et al.Prostaglandins and cellular reaction in uterine flushing.I.Effect of IUD insertion.Adv Contracept,1987,3:241.
[14] Shaw S T Jr,Macaulay L K,Sun N C et al.Changes of plasminogen activator in human uterine tissue induced by intrauterine contraceptive devices.Contraception,1983,27:131.
[15] Salmi A,Pakarinen P,Peltola AM,et al.The effect of intrauterine levonorgestrel useon the expressionof c-JUN,oestrogen receptor,progesterone receptors and Ki-67 in human endometrium.Mol Hum Reprod,1998,4:1110-1115.
[16] 付灵梅,尤昭玲.环血宁汤对置带铜宫内节育器家兔锌含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[17] 刘瑞芬.中医治疗宫内节育器引起异常子宫出血的研究概况.山东中医学院学报 1995,19(3):216-217.
[18] 刘爱华.对放置宫内节育器后经期延长 30 例的治疗体会.上海中医药杂志,1992,(11):19.
[19] 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.湖南中医药导报,2001,7(3)101-102.
[20] 任景芳,屈秦红,于冰,等.中药消炎止血胶囊治疗宫内节育器致出血的临床疗效及机理研究.中国中西医结合杂志,2004,24(7):605-608.
[21] 陈刚,薛红,周宜,等.柴胡止血液对置含铜节育器大鼠子宫组织基质金属蛋白酶-9 和金属蛋白酶组织抑制物-1 及内皮素和一氧化氮的影响.中国计划生育杂志,2003,11:658.
[22] 雷磊,尤昭玲.环血宁汤对置带铜宫内节育器家兔 NO 含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[23] 尤昭玲.中西医结合妇科学(全国高等中医药院校中西医结合专业系列教材).第1 版.北京:中国中医药出版社,2001.434 -436.
[24] 王永炎,王耀廷.今日中医妇科.第 1 版.北京:人民卫生出版社,2000.2-3.
[25] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2388.
[26] 刘瑞芬,李继风,栾跃芳等.环安散防治宫内节育器致月经异常的疗效观察.中国中西医结合杂志,1994,14(6):340-341.
[27] 赵淑敏,孔祥玉,马泉.改良单宁酸-氯化铁法媒染子宫血管的实验研究.中国临床解剖学杂志,2003,21(6):614.
[28] 陈钢,薛红,孟宪丽,等.柴胡止血液对置含铜 IUD 家兔宫腔液 PGI2 和 TXB2含量的影响.中国计划生育学杂志,1999,(7):297-299.
[29] 赵淑敏,刘瑞荣,孔祥玉.应用单宁酸—氯化铁法观察大鼠子宫血管构筑.中国计划生育杂志,2003,89(3):154~155.
[30] Caser ML,MacDonald PC.The endothelin-parathyroid hormone-related protein vasoactive peptide system in human endometrium:modulation by transforming growth factor-β.Hum Reprod,1996,11:62~82.
[31] Strauss JF,Gurpide E.The endometrium:regulation and dysfunction.In Yen & Jaffe ed:“Reproductive Endocrinology”.3rd ed.Philadelphia:Saunders WB Co,1991,314~319.
[32] 黄丽丽,石一复.妇产科领域纤溶酶原激活剂及其抑制物的研究.国外医学·妇产科分册,1998,25,(5):261~264.
[33] Lockwood CJ,Nemerson Y,Guller S,et al.Progestational regulation of human endometrial stromal cell tissue factor expression during decidualization.J Clin Endocrinol Metab,1993,76(1):231~236.
[34] Kawano H,Motoyama T,KuglyanaK,et al.Gender difference in improvement of endothelium dependent vasodilation after restrogen supplementation.J Am Coll Cardiol,1997,30:914.
[35] Toyoski M,Jeffrey R,Horowitz BS,et al.Vascular endothelial growth faxtor/Vasculat permeability factor enhances vascular permeability via nitric oxide and prostacyclin.Circulation,1998,97:99-107.
[36] Harada SI,Nagy GA,Sullivarl KA,et al.Induction of vascular growth factor expression by prostaglandin E2 and in osteoblasts.Clin Invest,1994,93(6):2490-2496.
[37] Sheppard B L,Phil D.Endometrial morphological changes in IUD users:review.Contraception,1987,36:1.
[38] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2407-2408.
[39] 董白桦,侯桂华,张友忠,等.长期放置宫内避孕器对子宫微环境的影响及其机理的研究.中华医学杂志,2003,83(10):823.
[40] 叶联顺,计垣,李红,等.放置含铜宫形器、TCU220C 和圆形宫内节育器后人子宫内膜形态的比较.生殖医学杂志,1995,4(2):100-102.
[41] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2391.
[42] 刘昌官,李恕香,刘晓瑷,等.消炎痛宫内节育器对大鼠和兔子宫内膜影响的形态学观察.生殖医学杂志,1998,7(2):80.
[43] 潘俊峰,余玉琳,陈桂英,等.宫内节育器致异常出血子宫内膜止血反应的形态学改变.中华妇产科杂志,1995,30(9):526-527.
[44] 刘志成,陈湫波,倪秀生.放置γCuI 和 TCu220C 宫内节育器前后子宫内膜螺旋动脉形态计量学研究,1998,33(4):232.
[45] 黄晋红,张仲海.宫内节育器出血副反应机理的研究进展.医学信息,2000,13(3):139-141.
[46] Brian L.Sheppard,et al.The effect of intrauterine contraceptive devices on the ultrastructure of the endometrium in relation to bleeding conplications.Am J Obstet Gynecol,1983,146:829.
[47] 周玉玲,曹路敏,刘子龙,等.释放吲哚美辛的固定式铜宫内节育器减少子宫出血机制的研究.同济医科大学学报,2000,29(1):49.
[48] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2394-2398.
[49] Charnock-Jones DS,Sharkey AM,Rajpu-Williams J.Identification and localization of alternately spliced mRNAs for vascular endothelial growth factor in human uterus and estrogen regulation in endothelial carcinoma cell lines. Biol Reprd,1993, 48:1120～1128.
[50] Sharkey AM,Day K,Mcpherson A,et al.Vascular endothelial growth factor expression in human endometriosis is regulated by hypoxia.J Clin Endocrinol Metab,2000,85:402～409.
[51] 辛志敏,谢青贞,曹路敏.铜宫内节育器和含吲哚美辛铜宫内节育器对大鼠子宫内膜血管内皮生长因子表达的影响.生殖医学杂志,2003,12(3):150~152.
[52] Toyoaki M,Jeffrey R,Horowitz BS,et a1.Vascular endothelial growth factor/vascular permeability factor enhances vascular permeability via nitric oxide and prostacy clin.Circulation,1998,97(1):99~107.
[53] Nayak NR,Critchley HO,Slayden OD,et a1.progesterone withdrawal up regulates vascular endothelial growth factor receptor type 2 in the superficial zone stroma of the human and macaque endometrium:potential relevance to menstruation.Clin Metab,2000,85(9):3442~3452.
[54] 刘小乐,杜天竹,陈衡,等.置 Cu-IUD 有或无子宫异常出血者血管内皮生长因子的表达.广东医学院学报,2005,23(4):403-405.
[55] Polette M,Nawrocki B,Pintiaux A,Massenat C,Maquoi E,Volders L,Schaaps JP,Birenbaut P & Foidart JM:Ewpression of gelatinases A and B and their tissue inhibitor by cells of early and term human placenta and gestation endometium.Lab Invest 71:838,1994.
[56] 张嘉宁,朱正美,唐丽云,等.放置 IUD 后异常出血子宫内膜的基质金属蛋白酶酶谱分析.生殖与避孕,1998,18(5):286-289.
[57] 薛红,周宜,陈刚等.调肝止血中药对放置 Cu-IUD 大鼠外周血清及子宫组织t-PA,PAI 活性的影响.浙江中医学院学报,2003,27(6):46-48.
[58] 尤昭玲,付灵梅,雷磊,等.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.湖南中医学院学报,2001,21(4):12-14.
[59] 方晓艳等.茜草的研究进展.河南中医药学刊,2002,17(5):78~80.
[60] 王海波,王章元.蒲黄药理作用的研究进展.医药导报,2005,24(4):319.
[61] 杨志刚,陈阿琴,俞颂东.三七皂昔药理作用研究进展.中国兽药杂志,2005,39(1):33~37.
[62] Zhang HG,Li XH,Yang ZC.Effects of Panax notoginseng on myocardial Gsa mRNA expression and ATPase activity after severe cald in rats.Burns, 2003,29:541~546.
[63] 弥树勇.黄芩的药理作用研究现状.伤残医学杂志,2005,13(2):54.
[64] Kinashita JH.Mechanism of initiating cataract formation.Invest Ophthamol,1974,13:713.
[65] 焦红军.党参的药理作用及其临床应用.临床医学,2005,25(4):92.
[66] 周强,果占国.白芍总昔的药理作用及其在自身免疫性疾病中的应用.中国新药与临床杂志, 2003,22(11):687.
[67] 陈文静,沈继云,周洁玲,等.串铜 394 和 TCu 2 2 0C 宫内节育器对子宫内膜形态学影响的初步观察.同济医科大学学报,1997,26(5):396.
[68] 韩向阳,吴振铎.TCu220C 宫内节育器放置 10 年以上子宫内膜形态学研究 哈尔滨医科大学学报,1995,29(4):300.
[69] 韩向阳,孙敬.带铜宫内节育器子宫内膜电子显微镜观察.中国实用妇科与产科杂志,1995,1(4):194.
[70] 陈志龙译.子宫内膜组织病理学.第 1 版.上海:上海科学技术出版社,1984.245.
[71] LaIl TM,Afandi B,Rogers PA.The efects of levonorgestrel implants on vascular endothelial growth factor expression in the endometrium.MolHum Reprod,1999,5(1):57~63.
[72] Greb RR,Heikinheimo,Williams RF,et a1.Vascular end0thelial growth factor in primate endometrium is regulated by oestrogen-receptorand progesterone—receptor ligands in vivo.Hum Reprod,1997,12(6):1289~1297.
[73] 张华,孙海梅,周齐.ER、PR、VEGF 及其受体在宫内节育器引起子宫异常出血中作用的研究.解剖学报,2004,35(4):431-434.
[74] 范秀华,陈素琴.血管内皮生长因子和碱性成纤维细胞生长因子置上环出血子宫内膜中的表达及意义.中国计划生育学杂志,2004,25(1):19.
[75] 尹玖.置宫内节育器子宫异常出血与血管内皮生长因子表达的关系.华中医学杂志,2004,28(1):41.
[76] 杨安峰,王平.大鼠的解剖和组织.北京:科学出版社,1985,101~102.
[77] Wynn RM.周苏文译.子宫生物学.北京:人民卫生出版社,1982,31~34.
[78] Kazumasa T,Hitoshi O,Hidharu K,et al.Scanning electron microscopy study on corrosion cast of rat uterus vasculature during the first half or pregnancy.J Anat,1984,138:163~172.
[1] 乐杰.妇产科学.第 5 版.北京:人民卫生出版社,2000.421-423.
[2] 张玉珍.中医妇科学.第 1 版.北京:中国中医药出版社,2002.350-351.
[3] 刘瑞芬.中医治疗宫内节育器引起异常子宫出血的研究概况.山东中医学院学报1995,19(3):216-217.
[4] 陈钢,李青,薛红等.柴胡止血液治疗宫内节育器所致子宫出血的临床研究.成都中医药大学学报.1999,22(4):8-9.
[5] 刘爱华.对放置宫内节育器后经期延长 30 例的治疗体会.上海中医药杂志,1992,(11):19.
[6] 尤昭玲,王若光.宫内节育器引起异常子宫出血中医治疗评述.湖南中医药导报,1998,4(3):10.
[7] 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.湖南中医药导报,2001,7(3)101-102.
[8] 刘瑞芬.中医治疗宫内节育器引起异常子宫出血近况.山东中医杂志,1995,19(3):215-216.
[9] 李秀霞.中医辨证分型治疗宫内放置节育器后并发症 54 例.现代中西医结合杂志,2003,12(20):2187-2188.
[10] 李莉.清热化瘀宁坤汤治放环后月经异常 100 例.河南中医,2002,22(4):42.
[11] 汤艳秋.龟鹿固冲汤治疗宫内节育器放置后月经失调 200 例.黑龙江中医药,2002,(1):32.
[12] 朱颖,李军.安环止血汤治疗宫内节育器致异常出血.中国中医急症,2002,11(1):23.
[13] 李萍,郑秋萍.清肝止淋汤治疗放环后经期延长 56 例.实用中医药杂志,2003,19(3):133.
[14] 任景芳,屈秦红,于冰,等.中药消炎止血胶囊治疗宫内节育器致出血的临床疗效及机理研究.中国中西医结合杂志,2004,24(7):605-608.
[15] 张烨,尤昭玲,文乐兮,等.宫环Ⅱ号胶囊对宫环出血患者子宫内膜形态学的影响.中医药学刊,2004,22(7):1227.
[16] 刘瑞芬,李继风,栾跃芳等.环安散防治宫内节育器致月经异常的疗效观察.中国中西医结合杂志,1994,14(6):340-341.
[17] 尤昭玲 ,张 烨 ,雷 磊 ,等.宫环Ⅱ号胶囊对宫环出血患者血管舒缩因子的影响.中国中医药信息杂志,2004,11(4):290.
[18] 尤昭玲,左诗慧,徐祥英等.葆妇欣治疗带铜 IUD 出血副反应的临床观察.中国计划生育学杂志,1998,39(7):325-326.
[19] 陈钢,李青,薛红等.柴胡止血液治疗宫内节育器所致子宫出血的临床研究.成都中医药大学学报,1999,22(4):6-8.
[20] 黄学惠,李武,董文漪等.宫血宁防治宫内节育器所致子宫出血.现代中西医结合杂志,2002,11(6)3:485-486.
[21] 王英芳.耳穴贴压治疗妇女上环后月经过多 60 例.中国针灸,1996,(9):44.
[22] 李文华,宋菊先,闫金凤等.针刺孔最穴治疗放置宫内节育器出血 26 例.中国针灸,1997,(8):478.
[23] 吴兆利.针刺对置 IUD 导致子宫出血者血浆 PG 的影响.辽宁中医杂志,2001,28(3):173.
[24] 赵智,尹红梅,刘海防.针灸治疗放置 IUD 子宫异常出血 60 例疗效观察.齐齐哈尔医学院学报,2003,24(1):41.
[25] 赵玉芬,薛海霞.中西医结合防治放置 IUD 后异常出血的临床研究.河南中医药学刊,2000,15(6):41-42.
[26] 李红霞.中西医结合治疗宫内节育器致阴道淋漓出血的体会.中医药研究,2001,17(6):29.
[27] 林芳芬.中西医结合治疗放置宫内节育器后子宫异常出血.中国乡村医药杂志,2002,9(5):15.
[28] 陈钢,薛红,孟宪丽,等.柴胡止血液对置含铜 IUD 家兔宫腔液 PGI2 和 TXB2含量的影响.中国计划生育学杂志,1999,(7):297-299.
[29] 尤昭玲,余定国,徐祥英,等.葆妇欣对带铜 IUD 副反应的治疗机理研究.中国计划生育学杂志,1999,(2):70-72.
[30] 薛红,周宜,陈刚等.调肝止血中药对放置 Cu-IUD 大鼠外周血清及子宫组织t-PA,PAI 活性的影响.浙江中医学院学报,2003,27(6):46-48.
[31] 尤昭玲,付灵梅,雷磊,等.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.湖南中医学院学报,2001,21(4):12-14.
[32] 陈刚,薛红,周宜,等.柴胡止血液对置含铜节育器大鼠子宫组织基质金属蛋白酶-9 和金属蛋白酶组织抑制物-1 及内皮素和一氧化氮的影响.中国计划生育杂志,2003,11:658.
[33] 付灵梅,尤昭玲.环血宁汤对置带铜宫内节育器家兔锌含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[34] 文乐兮,雷磊,尤昭玲,等.宫环止血片对置铜宫内节育器家兔子宫内膜形态学的影响.湖南中医学院学报,2002,22(1):17-19.
[1] 庄留琪.中华妇产科杂志.宫内节育器及其使用的研究进展,1995,30(9):516-518.
[2] 张玉珍.中医妇科学.第 1 版.北京:中国中医药出版社,2002.350-351.
[3] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2407-2408.
[4] Sheppard B L,Phil D.Endometrial morphological changes in IUD users:review.Contraception,1987,36:1.
[5] 董白桦,侯桂华,张友忠,等.长期放置宫内避孕器对子宫微环境的影响及其机理的研究.中华医学杂志,2003,83(10):823.
[6] 叶联顺,计垣,李红,等.放置含铜宫形器、TCU220C 和圆形宫内节育器后人子宫内膜形态的比较.生殖医学杂志,1995,4(2):100-102.
[7] 陈文静,沈继云,周洁玲,等.观察串铜 394 和 Tcu220cIUD 对人子宫内膜形态学影响的初步观察.同济医科大学学报,1997,26(5):394-396.
[8] 刘昌官,李恕香,刘晓瑷,等.消炎痛宫内节育器对大鼠和兔子宫内膜影响的形态学观察.生殖医学杂志,1998,7(2):80.
[9] 潘俊峰,余玉琳,陈桂英,等.宫内节育器致异常出血子宫内膜止血反应的形态学改变.中华妇产科杂志,1995,30(9):526-527.
[10] 刘志成,陈湫波,倪秀生.放置γCuI 和 TCu220C 宫内节育器前后子宫内膜螺旋动脉形态计量学研究,1998,33(4):232.
[11] 黄丽丽,陈凌钧,陈湫波,等.放置宫内节育器后子宫内膜螺旋动脉的三维空间形态.中华妇产科杂志,1996,31(9):523-524.
[12] Schwi S E L,Toppozada M,Kamel et al.Prostaglandins and cellular reaction in uterine flushing.I.Effect of IUD insertion.Adv Contracept,1987,3:241.
[13] Shaw S T Jr,Macaulay L K,Sun N C et al.Changes of plasminogen activator in human uterine tissue induced by intrauterine contraceptive devices.Contraception,1983,27:131.
[14] 曹路敏,黄秀兰,刘子龙,等.药铜宫内节育器的恒河猴实验研究.生殖医学杂志,1996,5:85-88.
[15] 黄晋红,张仲海.宫内节育器出血副反应机理的研究进展.医学信息,2000,13(3):139-141.
[16] Brian L.Sheppard,et al.The effect of intrauterine contraceptive devices on the ultrastructure of the endometrium in relation to bleeding conplications.Am J Obstet Gynecol,1983,146:829.
[17] 周玉玲,曹路敏,刘子龙,等.释放吲哚美辛的固定式铜宫内节育器减少子宫出血机制的研究.同济医科大学学报,2000,29(1):49.
[18] 国家计生委.计划生育“六五”期间科技攻关成果论文摘要汇编.北京:国家计划生育委员会,1985,46.
[19] 郑雪琴,陆埼，冯惠忠，等．放置不同材料 IUD 后兔子宫内膜水解酶组织化学的观察.生殖与避孕,1987,7(2):25～29.
[20] Marbaix E,Kokrine I,Henriet P,Donnez J,Courtoy P J& Eeckhout Y:The expression of interstitial collagenase in human endometrium is controlled by progesterone andby eestradiol and in related to menstruation.Biochen J305:1027,1995.
[21] Polette M,Nawrocki B,Pintiaux A,Massenat C,Maquoi E,Volders L,Schaaps JP,Birenbaut P & Foidart JM:Ewpression of gelatinases A and B and their tissue inhibitor by cells of early and term human placenta and gestation endometium.Lab Invest 71:838,1994.
[22] 李玮,曹路敏,杜庆玲,等.固定式 Cu-IUD 和固定式含吲哚美辛 Cu-IUD 对兔宫腔冲洗液及子宫内膜基质金属蛋白酶影响的初步研究.生殖与避孕,2000,20(5):297-301.
[23] 张嘉宁,朱正美,唐丽云,等.放置 IUD 后异常出血子宫内膜的基质金属蛋白酶酶谱分析.生殖与避孕,1998,18(5):286-289.
[24] Zhu P D,Luo Hz,Gu Z,et al.The effects of lenonorlgestrel-releasing intrauterine device(20mg/day)(LNG-IUD-20)on the endometreal FⅧ activity in the women before and after insertion of LNG-IUD-20 digital image analysis.Contraception,1995,52(1):63-68.
[25] 朱蓬第,刘晓群,罗宏志,等.左旋 18 甲基炔诺酮 T 型宫内节育器对子宫内膜血管内皮细胞因子Ⅷ活性的影响.生殖与避孕,1994,14(6),416-421.
[26] 王桂敏,郑淑蓉.内皮素和一氧化氮对子宫血流的调节.生殖与避孕,1999,19(1):3-6.
[27] 陈刚,薛红,周宜,等.柴胡止血液对置含铜节育器大鼠子宫组织基质金属蛋白酶-9 和金属蛋白酶组织抑制物-1 及内皮素和一氧化氮的影响.中国计划生育杂志,2003,11:658.
[28] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2394-2398.
[29] Salmi A,Pakarinen P,Peltola AM,et al.The effect of intrauterine levonorgestrel use on the expressionof c-JUN,oestrogen receptor,progesterone receptors and Ki-67 in human endometrium.Mol Hum Reprod,1998,4:1110-1115.
[30] 王海燕,陈贵安.血管内皮生长因子在子宫内膜的表达及调控.生殖医学杂志,2002,11(6):357-359.
[31] 辛志敏,谢青贞.血管内皮生长因子与子宫内膜.国外医学计划生育分册,2002,21(3):163-166.
[32] Toyoski M,Jeffrey R,Horowitz BS,et al.Vascular endothelial growth faxtor/Vasculat permeability factor enhances vascular permeability via nitric oxide andprostacyclin.Circulation,1998,97:99-107.
[33] Harada SI,Nagy GA,Sullivarl KA,et al.Induction of vascular growth factor expression by prostaglandin E2 and in osteoblasts.Clin Invest,1994,93(6):2490-2496.
[34] Pepper MS,Ferrara N,Orci L,et al.Vascular endothelial growth factor(VEGF)induces plasm inogen activators and plasm inogen activator . Inhibitor-1 in microvascular endothelial cell.Biochem Biophys Res Commun,1991,181(2):902-906.
[35] Nayak NR,Critchley HO,Slayden OD,et al.Progesterone withdrawal up-regulates vascular growth factor receptor type2 in the superficial zone stroma of the human and macaque endometrium:potential relevance to menstruation.J Clin Metab,2000,85:3442-3452.
[36] 杜天竹,李明,罗新,等.雌二醇皮贴片防治 GyneFixIUD 早期出血副反应的疗效及机理初探.中国优生与遗传杂志,2003,11(4):106.
[37] 刘小乐,杜天竹,陈衡,等.置 Cu-IUD 有或无子宫异常出血者血管内皮生长因子的表达.广东医学院学报,2005,23(4):403-405.
[38] 范秀华,陈素琴,王惠兰,等.血管内皮生长因子和碱性成纤维细胞生长因子在放置 IUD 出血子宫内膜中的表达及意义.中国计划生育学杂志,2004,99(1):99-101.
[39] 付灵梅,尤昭玲.环血宁汤对置带铜宫内节育器家兔锌含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[40] 欧阳普友,徐春华.放置 IUD 致子宫异常出血的药物治疗.西北国防医学杂志,2000,21(4):262.
[2] 张玉珍.中医妇科学.北京:中国中医药出版社,2002,第一版:350-351.
[3] 王桂敏,郑淑蓉.甾体激素与子宫内膜出血.生殖与避孕,1996,16(4):248-250.
[4] Marsh MM,Buttar AR,Riley SC,et al.Immunolocalization of endothelin and neutral en dopeptidase in endometrium of users of subdermally implanted levonorgestrel. Hum Reprod, 1995, 10(10):2584.
[5] 杜天竹,李明,罗新,等.雌二醇皮贴片防治 GyneFixIUD 早期出血副反应的疗效及机理初探.中国优生与遗传杂志,2003,11(4):106.
[6] 张烨,尤昭玲,文乐兮,等.宫环Ⅱ号胶囊对宫环出血患者子宫内膜形态学的影响.中医药学刊,2004,22(7):1227.
[7] 尤昭玲,张烨 ,雷磊,等.宫环Ⅱ号胶囊对宫环出血患者血管舒缩因子的影响.中国中医药信息杂志,2004,11(4):290.
[8] 刘瑞芬,李继风,栾跃芳.宫宁颗粒剂治疗使用宫内节育器出血副反应的临床研究.中医杂志,1998,5(11):292.
[9] 庄留琪.中华妇产科杂志.宫内节育器及其使用的研究进展,1995,30(9):516-518.
[10] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2407-2408.
[11] 刘志成,陈湫波,倪秀生.放置γCuI 和 TCu220C 宫内节育器前后子宫内膜螺旋动脉形态计量学研究,1998,33(4):232.
[12] 黄丽丽,陈凌钧,陈湫波,等.放置宫内节育器后子宫内膜螺旋动脉的三维空间形态.中华妇产科杂志,1996,31(9):523-524.
[13] Schwi S E L,Toppozada M,Kamel et al.Prostaglandins and cellular reaction in uterine flushing.I.Effect of IUD insertion.Adv Contracept,1987,3:241.
[14] Shaw S T Jr,Macaulay L K,Sun N C et al.Changes of plasminogen activator in human uterine tissue induced by intrauterine contraceptive devices.Contraception,1983,27:131.
[15] Salmi A,Pakarinen P,Peltola AM,et al.The effect of intrauterine levonorgestrel useon the expressionof c-JUN,oestrogen receptor,progesterone receptors and Ki-67 in human endometrium.Mol Hum Reprod,1998,4:1110-1115.
[16] 付灵梅,尤昭玲.环血宁汤对置带铜宫内节育器家兔锌含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[17] 刘瑞芬.中医治疗宫内节育器引起异常子宫出血的研究概况.山东中医学院学报 1995,19(3):216-217.
[18] 刘爱华.对放置宫内节育器后经期延长 30 例的治疗体会.上海中医药杂志,1992,(11):19.
[19] 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.湖南中医药导报,2001,7(3)101-102.
[20] 任景芳,屈秦红,于冰,等.中药消炎止血胶囊治疗宫内节育器致出血的临床疗效及机理研究.中国中西医结合杂志,2004,24(7):605-608.
[21] 陈刚,薛红,周宜,等.柴胡止血液对置含铜节育器大鼠子宫组织基质金属蛋白酶-9 和金属蛋白酶组织抑制物-1 及内皮素和一氧化氮的影响.中国计划生育杂志,2003,11:658.
[22] 雷磊,尤昭玲.环血宁汤对置带铜宫内节育器家兔 NO 含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[23] 尤昭玲.中西医结合妇科学(全国高等中医药院校中西医结合专业系列教材).第1 版.北京:中国中医药出版社,2001.434 -436.
[24] 王永炎,王耀廷.今日中医妇科.第 1 版.北京:人民卫生出版社,2000.2-3.
[25] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2388.
[26] 刘瑞芬,李继风,栾跃芳等.环安散防治宫内节育器致月经异常的疗效观察.中国中西医结合杂志,1994,14(6):340-341.
[27] 赵淑敏,孔祥玉,马泉.改良单宁酸-氯化铁法媒染子宫血管的实验研究.中国临床解剖学杂志,2003,21(6):614.
[28] 陈钢,薛红,孟宪丽,等.柴胡止血液对置含铜 IUD 家兔宫腔液 PGI2 和 TXB2含量的影响.中国计划生育学杂志,1999,(7):297-299.
[29] 赵淑敏,刘瑞荣,孔祥玉.应用单宁酸—氯化铁法观察大鼠子宫血管构筑.中国计划生育杂志,2003,89(3):154~155.
[30] Caser ML,MacDonald PC.The endothelin-parathyroid hormone-related protein vasoactive peptide system in human endometrium:modulation by transforming growth factor-β.Hum Reprod,1996,11:62~82.
[31] Strauss JF,Gurpide E.The endometrium:regulation and dysfunction.In Yen & Jaffe ed:“Reproductive Endocrinology”.3rd ed.Philadelphia:Saunders WB Co,1991,314~319.
[32] 黄丽丽,石一复.妇产科领域纤溶酶原激活剂及其抑制物的研究.国外医学·妇产科分册,1998,25,(5):261~264.
[33] Lockwood CJ,Nemerson Y,Guller S,et al.Progestational regulation of human endometrial stromal cell tissue factor expression during decidualization.J Clin Endocrinol Metab,1993,76(1):231~236.
[34] Kawano H,Motoyama T,KuglyanaK,et al.Gender difference in improvement of endothelium dependent vasodilation after restrogen supplementation.J Am Coll Cardiol,1997,30:914.
[35] Toyoski M,Jeffrey R,Horowitz BS,et al.Vascular endothelial growth faxtor/Vasculat permeability factor enhances vascular permeability via nitric oxide and prostacyclin.Circulation,1998,97:99-107.
[36] Harada SI,Nagy GA,Sullivarl KA,et al.Induction of vascular growth factor expression by prostaglandin E2 and in osteoblasts.Clin Invest,1994,93(6):2490-2496.
[37] Sheppard B L,Phil D.Endometrial morphological changes in IUD users:review.Contraception,1987,36:1.
[38] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2407-2408.
[39] 董白桦,侯桂华,张友忠,等.长期放置宫内避孕器对子宫微环境的影响及其机理的研究.中华医学杂志,2003,83(10):823.
[40] 叶联顺,计垣,李红,等.放置含铜宫形器、TCU220C 和圆形宫内节育器后人子宫内膜形态的比较.生殖医学杂志,1995,4(2):100-102.
[41] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2391.
[42] 刘昌官,李恕香,刘晓瑷,等.消炎痛宫内节育器对大鼠和兔子宫内膜影响的形态学观察.生殖医学杂志,1998,7(2):80.
[43] 潘俊峰,余玉琳,陈桂英,等.宫内节育器致异常出血子宫内膜止血反应的形态学改变.中华妇产科杂志,1995,30(9):526-527.
[44] 刘志成,陈湫波,倪秀生.放置γCuI 和 TCu220C 宫内节育器前后子宫内膜螺旋动脉形态计量学研究,1998,33(4):232.
[45] 黄晋红,张仲海.宫内节育器出血副反应机理的研究进展.医学信息,2000,13(3):139-141.
[46] Brian L.Sheppard,et al.The effect of intrauterine contraceptive devices on the ultrastructure of the endometrium in relation to bleeding conplications.Am J Obstet Gynecol,1983,146:829.
[47] 周玉玲,曹路敏,刘子龙,等.释放吲哚美辛的固定式铜宫内节育器减少子宫出血机制的研究.同济医科大学学报,2000,29(1):49.
[48] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2394-2398.
[49] Charnock-Jones DS,Sharkey AM,Rajpu-Williams J.Identification and localization of alternately spliced mRNAs for vascular endothelial growth factor in human uterus and estrogen regulation in endothelial carcinoma cell lines. Biol Reprd,1993, 48:1120～1128.
[50] Sharkey AM,Day K,Mcpherson A,et al.Vascular endothelial growth factor expression in human endometriosis is regulated by hypoxia.J Clin Endocrinol Metab,2000,85:402～409.
[51] 辛志敏,谢青贞,曹路敏.铜宫内节育器和含吲哚美辛铜宫内节育器对大鼠子宫内膜血管内皮生长因子表达的影响.生殖医学杂志,2003,12(3):150~152.
[52] Toyoaki M,Jeffrey R,Horowitz BS,et a1.Vascular endothelial growth factor/vascular permeability factor enhances vascular permeability via nitric oxide and prostacy clin.Circulation,1998,97(1):99~107.
[53] Nayak NR,Critchley HO,Slayden OD,et a1.progesterone withdrawal up regulates vascular endothelial growth factor receptor type 2 in the superficial zone stroma of the human and macaque endometrium:potential relevance to menstruation.Clin Metab,2000,85(9):3442~3452.
[54] 刘小乐,杜天竹,陈衡,等.置 Cu-IUD 有或无子宫异常出血者血管内皮生长因子的表达.广东医学院学报,2005,23(4):403-405.
[55] Polette M,Nawrocki B,Pintiaux A,Massenat C,Maquoi E,Volders L,Schaaps JP,Birenbaut P & Foidart JM:Ewpression of gelatinases A and B and their tissue inhibitor by cells of early and term human placenta and gestation endometium.Lab Invest 71:838,1994.
[56] 张嘉宁,朱正美,唐丽云,等.放置 IUD 后异常出血子宫内膜的基质金属蛋白酶酶谱分析.生殖与避孕,1998,18(5):286-289.
[57] 薛红,周宜,陈刚等.调肝止血中药对放置 Cu-IUD 大鼠外周血清及子宫组织t-PA,PAI 活性的影响.浙江中医学院学报,2003,27(6):46-48.
[58] 尤昭玲,付灵梅,雷磊,等.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.湖南中医学院学报,2001,21(4):12-14.
[59] 方晓艳等.茜草的研究进展.河南中医药学刊,2002,17(5):78~80.
[60] 王海波,王章元.蒲黄药理作用的研究进展.医药导报,2005,24(4):319.
[61] 杨志刚,陈阿琴,俞颂东.三七皂昔药理作用研究进展.中国兽药杂志,2005,39(1):33~37.
[62] Zhang HG,Li XH,Yang ZC.Effects of Panax notoginseng on myocardial Gsa mRNA expression and ATPase activity after severe cald in rats.Burns, 2003,29:541~546.
[63] 弥树勇.黄芩的药理作用研究现状.伤残医学杂志,2005,13(2):54.
[64] Kinashita JH.Mechanism of initiating cataract formation.Invest Ophthamol,1974,13:713.
[65] 焦红军.党参的药理作用及其临床应用.临床医学,2005,25(4):92.
[66] 周强,果占国.白芍总昔的药理作用及其在自身免疫性疾病中的应用.中国新药与临床杂志, 2003,22(11):687.
[67] 陈文静,沈继云,周洁玲,等.串铜 394 和 TCu 2 2 0C 宫内节育器对子宫内膜形态学影响的初步观察.同济医科大学学报,1997,26(5):396.
[68] 韩向阳,吴振铎.TCu220C 宫内节育器放置 10 年以上子宫内膜形态学研究 哈尔滨医科大学学报,1995,29(4):300.
[69] 韩向阳,孙敬.带铜宫内节育器子宫内膜电子显微镜观察.中国实用妇科与产科杂志,1995,1(4):194.
[70] 陈志龙译.子宫内膜组织病理学.第 1 版.上海:上海科学技术出版社,1984.245.
[71] LaIl TM,Afandi B,Rogers PA.The efects of levonorgestrel implants on vascular endothelial growth factor expression in the endometrium.MolHum Reprod,1999,5(1):57~63.
[72] Greb RR,Heikinheimo,Williams RF,et a1.Vascular end0thelial growth factor in primate endometrium is regulated by oestrogen-receptorand progesterone—receptor ligands in vivo.Hum Reprod,1997,12(6):1289~1297.
[73] 张华,孙海梅,周齐.ER、PR、VEGF 及其受体在宫内节育器引起子宫异常出血中作用的研究.解剖学报,2004,35(4):431-434.
[74] 范秀华,陈素琴.血管内皮生长因子和碱性成纤维细胞生长因子置上环出血子宫内膜中的表达及意义.中国计划生育学杂志,2004,25(1):19.
[75] 尹玖.置宫内节育器子宫异常出血与血管内皮生长因子表达的关系.华中医学杂志,2004,28(1):41.
[76] 杨安峰,王平.大鼠的解剖和组织.北京:科学出版社,1985,101~102.
[77] Wynn RM.周苏文译.子宫生物学.北京:人民卫生出版社,1982,31~34.
[78] Kazumasa T,Hitoshi O,Hidharu K,et al.Scanning electron microscopy study on corrosion cast of rat uterus vasculature during the first half or pregnancy.J Anat,1984,138:163~172.
[1] 乐杰.妇产科学.第 5 版.北京:人民卫生出版社,2000.421-423.
[2] 张玉珍.中医妇科学.第 1 版.北京:中国中医药出版社,2002.350-351.
[3] 刘瑞芬.中医治疗宫内节育器引起异常子宫出血的研究概况.山东中医学院学报1995,19(3):216-217.
[4] 陈钢,李青,薛红等.柴胡止血液治疗宫内节育器所致子宫出血的临床研究.成都中医药大学学报.1999,22(4):8-9.
[5] 刘爱华.对放置宫内节育器后经期延长 30 例的治疗体会.上海中医药杂志,1992,(11):19.
[6] 尤昭玲,王若光.宫内节育器引起异常子宫出血中医治疗评述.湖南中医药导报,1998,4(3):10.
[7] 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.湖南中医药导报,2001,7(3)101-102.
[8] 刘瑞芬.中医治疗宫内节育器引起异常子宫出血近况.山东中医杂志,1995,19(3):215-216.
[9] 李秀霞.中医辨证分型治疗宫内放置节育器后并发症 54 例.现代中西医结合杂志,2003,12(20):2187-2188.
[10] 李莉.清热化瘀宁坤汤治放环后月经异常 100 例.河南中医,2002,22(4):42.
[11] 汤艳秋.龟鹿固冲汤治疗宫内节育器放置后月经失调 200 例.黑龙江中医药,2002,(1):32.
[12] 朱颖,李军.安环止血汤治疗宫内节育器致异常出血.中国中医急症,2002,11(1):23.
[13] 李萍,郑秋萍.清肝止淋汤治疗放环后经期延长 56 例.实用中医药杂志,2003,19(3):133.
[14] 任景芳,屈秦红,于冰,等.中药消炎止血胶囊治疗宫内节育器致出血的临床疗效及机理研究.中国中西医结合杂志,2004,24(7):605-608.
[15] 张烨,尤昭玲,文乐兮,等.宫环Ⅱ号胶囊对宫环出血患者子宫内膜形态学的影响.中医药学刊,2004,22(7):1227.
[16] 刘瑞芬,李继风,栾跃芳等.环安散防治宫内节育器致月经异常的疗效观察.中国中西医结合杂志,1994,14(6):340-341.
[17] 尤昭玲 ,张 烨 ,雷 磊 ,等.宫环Ⅱ号胶囊对宫环出血患者血管舒缩因子的影响.中国中医药信息杂志,2004,11(4):290.
[18] 尤昭玲,左诗慧,徐祥英等.葆妇欣治疗带铜 IUD 出血副反应的临床观察.中国计划生育学杂志,1998,39(7):325-326.
[19] 陈钢,李青,薛红等.柴胡止血液治疗宫内节育器所致子宫出血的临床研究.成都中医药大学学报,1999,22(4):6-8.
[20] 黄学惠,李武,董文漪等.宫血宁防治宫内节育器所致子宫出血.现代中西医结合杂志,2002,11(6)3:485-486.
[21] 王英芳.耳穴贴压治疗妇女上环后月经过多 60 例.中国针灸,1996,(9):44.
[22] 李文华,宋菊先,闫金凤等.针刺孔最穴治疗放置宫内节育器出血 26 例.中国针灸,1997,(8):478.
[23] 吴兆利.针刺对置 IUD 导致子宫出血者血浆 PG 的影响.辽宁中医杂志,2001,28(3):173.
[24] 赵智,尹红梅,刘海防.针灸治疗放置 IUD 子宫异常出血 60 例疗效观察.齐齐哈尔医学院学报,2003,24(1):41.
[25] 赵玉芬,薛海霞.中西医结合防治放置 IUD 后异常出血的临床研究.河南中医药学刊,2000,15(6):41-42.
[26] 李红霞.中西医结合治疗宫内节育器致阴道淋漓出血的体会.中医药研究,2001,17(6):29.
[27] 林芳芬.中西医结合治疗放置宫内节育器后子宫异常出血.中国乡村医药杂志,2002,9(5):15.
[28] 陈钢,薛红,孟宪丽,等.柴胡止血液对置含铜 IUD 家兔宫腔液 PGI2 和 TXB2含量的影响.中国计划生育学杂志,1999,(7):297-299.
[29] 尤昭玲,余定国,徐祥英,等.葆妇欣对带铜 IUD 副反应的治疗机理研究.中国计划生育学杂志,1999,(2):70-72.
[30] 薛红,周宜,陈刚等.调肝止血中药对放置 Cu-IUD 大鼠外周血清及子宫组织t-PA,PAI 活性的影响.浙江中医学院学报,2003,27(6):46-48.
[31] 尤昭玲,付灵梅,雷磊,等.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.湖南中医学院学报,2001,21(4):12-14.
[32] 陈刚,薛红,周宜,等.柴胡止血液对置含铜节育器大鼠子宫组织基质金属蛋白酶-9 和金属蛋白酶组织抑制物-1 及内皮素和一氧化氮的影响.中国计划生育杂志,2003,11:658.
[33] 付灵梅,尤昭玲.环血宁汤对置带铜宫内节育器家兔锌含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[34] 文乐兮,雷磊,尤昭玲,等.宫环止血片对置铜宫内节育器家兔子宫内膜形态学的影响.湖南中医学院学报,2002,22(1):17-19.
[1] 庄留琪.中华妇产科杂志.宫内节育器及其使用的研究进展,1995,30(9):516-518.
[2] 张玉珍.中医妇科学.第 1 版.北京:中国中医药出版社,2002.350-351.
[3] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2407-2408.
[4] Sheppard B L,Phil D.Endometrial morphological changes in IUD users:review.Contraception,1987,36:1.
[5] 董白桦,侯桂华,张友忠,等.长期放置宫内避孕器对子宫微环境的影响及其机理的研究.中华医学杂志,2003,83(10):823.
[6] 叶联顺,计垣,李红,等.放置含铜宫形器、TCU220C 和圆形宫内节育器后人子宫内膜形态的比较.生殖医学杂志,1995,4(2):100-102.
[7] 陈文静,沈继云,周洁玲,等.观察串铜 394 和 Tcu220cIUD 对人子宫内膜形态学影响的初步观察.同济医科大学学报,1997,26(5):394-396.
[8] 刘昌官,李恕香,刘晓瑷,等.消炎痛宫内节育器对大鼠和兔子宫内膜影响的形态学观察.生殖医学杂志,1998,7(2):80.
[9] 潘俊峰,余玉琳,陈桂英,等.宫内节育器致异常出血子宫内膜止血反应的形态学改变.中华妇产科杂志,1995,30(9):526-527.
[10] 刘志成,陈湫波,倪秀生.放置γCuI 和 TCu220C 宫内节育器前后子宫内膜螺旋动脉形态计量学研究,1998,33(4):232.
[11] 黄丽丽,陈凌钧,陈湫波,等.放置宫内节育器后子宫内膜螺旋动脉的三维空间形态.中华妇产科杂志,1996,31(9):523-524.
[12] Schwi S E L,Toppozada M,Kamel et al.Prostaglandins and cellular reaction in uterine flushing.I.Effect of IUD insertion.Adv Contracept,1987,3:241.
[13] Shaw S T Jr,Macaulay L K,Sun N C et al.Changes of plasminogen activator in human uterine tissue induced by intrauterine contraceptive devices.Contraception,1983,27:131.
[14] 曹路敏,黄秀兰,刘子龙,等.药铜宫内节育器的恒河猴实验研究.生殖医学杂志,1996,5:85-88.
[15] 黄晋红,张仲海.宫内节育器出血副反应机理的研究进展.医学信息,2000,13(3):139-141.
[16] Brian L.Sheppard,et al.The effect of intrauterine contraceptive devices on the ultrastructure of the endometrium in relation to bleeding conplications.Am J Obstet Gynecol,1983,146:829.
[17] 周玉玲,曹路敏,刘子龙,等.释放吲哚美辛的固定式铜宫内节育器减少子宫出血机制的研究.同济医科大学学报,2000,29(1):49.
[18] 国家计生委.计划生育“六五”期间科技攻关成果论文摘要汇编.北京:国家计划生育委员会,1985,46.
[19] 郑雪琴,陆埼，冯惠忠，等．放置不同材料 IUD 后兔子宫内膜水解酶组织化学的观察.生殖与避孕,1987,7(2):25～29.
[20] Marbaix E,Kokrine I,Henriet P,Donnez J,Courtoy P J& Eeckhout Y:The expression of interstitial collagenase in human endometrium is controlled by progesterone andby eestradiol and in related to menstruation.Biochen J305:1027,1995.
[21] Polette M,Nawrocki B,Pintiaux A,Massenat C,Maquoi E,Volders L,Schaaps JP,Birenbaut P & Foidart JM:Ewpression of gelatinases A and B and their tissue inhibitor by cells of early and term human placenta and gestation endometium.Lab Invest 71:838,1994.
[22] 李玮,曹路敏,杜庆玲,等.固定式 Cu-IUD 和固定式含吲哚美辛 Cu-IUD 对兔宫腔冲洗液及子宫内膜基质金属蛋白酶影响的初步研究.生殖与避孕,2000,20(5):297-301.
[23] 张嘉宁,朱正美,唐丽云,等.放置 IUD 后异常出血子宫内膜的基质金属蛋白酶酶谱分析.生殖与避孕,1998,18(5):286-289.
[24] Zhu P D,Luo Hz,Gu Z,et al.The effects of lenonorlgestrel-releasing intrauterine device(20mg/day)(LNG-IUD-20)on the endometreal FⅧ activity in the women before and after insertion of LNG-IUD-20 digital image analysis.Contraception,1995,52(1):63-68.
[25] 朱蓬第,刘晓群,罗宏志,等.左旋 18 甲基炔诺酮 T 型宫内节育器对子宫内膜血管内皮细胞因子Ⅷ活性的影响.生殖与避孕,1994,14(6),416-421.
[26] 王桂敏,郑淑蓉.内皮素和一氧化氮对子宫血流的调节.生殖与避孕,1999,19(1):3-6.
[27] 陈刚,薛红,周宜,等.柴胡止血液对置含铜节育器大鼠子宫组织基质金属蛋白酶-9 和金属蛋白酶组织抑制物-1 及内皮素和一氧化氮的影响.中国计划生育杂志,2003,11:658.
[28] 曹泽毅.中华妇产科学.第 1 版.北京:人民卫生出版社,2000.2394-2398.
[29] Salmi A,Pakarinen P,Peltola AM,et al.The effect of intrauterine levonorgestrel use on the expressionof c-JUN,oestrogen receptor,progesterone receptors and Ki-67 in human endometrium.Mol Hum Reprod,1998,4:1110-1115.
[30] 王海燕,陈贵安.血管内皮生长因子在子宫内膜的表达及调控.生殖医学杂志,2002,11(6):357-359.
[31] 辛志敏,谢青贞.血管内皮生长因子与子宫内膜.国外医学计划生育分册,2002,21(3):163-166.
[32] Toyoski M,Jeffrey R,Horowitz BS,et al.Vascular endothelial growth faxtor/Vasculat permeability factor enhances vascular permeability via nitric oxide andprostacyclin.Circulation,1998,97:99-107.
[33] Harada SI,Nagy GA,Sullivarl KA,et al.Induction of vascular growth factor expression by prostaglandin E2 and in osteoblasts.Clin Invest,1994,93(6):2490-2496.
[34] Pepper MS,Ferrara N,Orci L,et al.Vascular endothelial growth factor(VEGF)induces plasm inogen activators and plasm inogen activator . Inhibitor-1 in microvascular endothelial cell.Biochem Biophys Res Commun,1991,181(2):902-906.
[35] Nayak NR,Critchley HO,Slayden OD,et al.Progesterone withdrawal up-regulates vascular growth factor receptor type2 in the superficial zone stroma of the human and macaque endometrium:potential relevance to menstruation.J Clin Metab,2000,85:3442-3452.
[36] 杜天竹,李明,罗新,等.雌二醇皮贴片防治 GyneFixIUD 早期出血副反应的疗效及机理初探.中国优生与遗传杂志,2003,11(4):106.
[37] 刘小乐,杜天竹,陈衡,等.置 Cu-IUD 有或无子宫异常出血者血管内皮生长因子的表达.广东医学院学报,2005,23(4):403-405.
[38] 范秀华,陈素琴,王惠兰,等.血管内皮生长因子和碱性成纤维细胞生长因子在放置 IUD 出血子宫内膜中的表达及意义.中国计划生育学杂志,2004,99(1):99-101.
[39] 付灵梅,尤昭玲.环血宁汤对置带铜宫内节育器家兔锌含量影响的实验研究.湖南中医学院学报,2001,21(3):11-13.
[40] 欧阳普友,徐春华.放置 IUD 致子宫异常出血的药物治疗.西北国防医学杂志,2000,21(4):262.