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

目的 观察中药消炎止血胶囊(简称中药)治疗宫内节育器(IUD)所致子宫异常出血的疗效，并探讨其作用机制。方法 将IUD致月经前后淋沥出血的患者随机分为两组，分别服用中药及安络血，并从治疗组21例患者取其服药前后子宫内膜组织，观察其光镜及电镜下形态学变化。动物实验观察中药对炎症的消除程度，并作有关指标的检测。结果 临床疗效：(1)总有效率治疗组为90．3％，对照组为43．5％，两组比较差异有显著性(P<0．01)；(2)子宫内膜组织形态：治疗组炎症程度减轻，螺旋动脉收缩功能增强。实验部分：(1)中药组小鼠耳廓炎症抑肿率(40．5％)与氢化可的松(46、9％)相当；(2)与空白组比较，中药组血浆6-Keto-PGF1α水平显著降低(P<0．01)，而TXB2／6-keto-PGFl。比值则明显升高(P<0．05或P<0．01)；血浆D-二聚体水平降低(P<0．05)；中药大剂量组血浆ET含量升高(P<0．05)；(3)中药可增加在体大鼠子宫平滑肌收缩幅度及在体大鼠子宫活动力。结论 中药有明显的消炎、止血作用，其机制可能为：调整前列腺素的合成：对抗IUD所致纤溶亢进；促进ET的合成；增加子宫平滑肌收缩幅度和活动力。

Study on Clinical Efficacy and Mechanism of Xiaoyan Zhixue Capsule in Treating Menorrhagia Caused by Intrauterine Device

OBJECTIVE: To observe the efficacy of Xiaoyan Zhixue Capsule (XYZXC) in treating uterus abnormal menorrhagia caused by intrauterine device (IUD) and to study its mechanism. METHODS: IUD users with menorrhagia were randomly divided into two groups, the XYZXC treated group and adrenosoem (AC-17) control group. Endometrial tissue of XYZXC treated group before and after treatment were taken out to observe its morphologic change with optic and electronic microscope. Animal experiment was done to observe the effect of XYZXC in eliminating inflammation of patierts, and the relevant parameters were monitored. RESULTS: Clinical efficacy: (1) Total effective rate of the treated group was 90.3%, that of control group was 43.5%, comparison between them showed significant difference (P<0.01). (2) Morphological examination of endometrial tissue showed the inflammation in the treated group abated after treatment with the contractible function of helicine artery strengthened. Experimental study showed: (1) The auricular swelling of mice was inhibited by 40.5% in the treated group, the effect was equivalent to that of hydrocortisone (46.9%). (2) Compared with the control group, the plasma 6-keto-PGF1alpha and D-Dimer level in the treated group were markedly lower, and TXB2/6-keto-PGF1alpha ratio and plasma endothelin level were markedly higher (P<0.05 or P<0.01). ET contents in large dosage TCM group was significantly raised (P<0.05). (3) XYZXC could increase amplitude of contraction of the uterus smooth muscle as well as the uterus activity in rats in vivo. CONCLUSION: XYZXC has obvious anti-inflammatory and hemostatic effects, it has marked effect in treating IUD caused pre- and post-menstruation menorrhagia, the possible mechanism may be: (1) Modulating the synthesis of prostaglandin; (2) Antagonizing the IUD caused fibrinolytic hyperfunction; (3) Promoting the synthesis of ET; (4) Increasing the contractility and activity of uterus smooth muscle.