补肾活血方对大鼠子宫内膜细胞病理形态学及凋亡的影响

目的：探讨补肾活血方治疗子宫内膜异位症的细胞凋亡机制。方法：以雌性8～12周龄Wistar大鼠建立大鼠子宫内膜异位症模型,随机分为模型组、中药低剂量组、中药高剂量组及西药组,每组6只,共干预4周。采用光镜、电镜、TUNEL法检测药物干预前后模型大鼠异位及在位子宫内膜的病理形态学及凋亡细胞的阳性率。结果：①与模型组比较,各治疗组均有不同程度抑制异位内膜生长的作用,并可观察到异位内膜组织中典型的细胞凋亡形态学变化：细胞核固缩,染色质凝集,核破裂及凋亡小体形成等,其中以中药高剂量组及西药组的改变最明显,其次为中药低剂量组。②对在位子宫内膜进行镜下观察发现：中药组与正常的子宫内膜结构基本相同,表现为腺体及间质生长良好,腺上皮及黏膜上皮呈高柱状,间质密集,而西药组呈萎缩性改变,腺上皮萎缩,黏膜上皮呈扁平状,间质减少。③与模型组和中药低剂量组比较,中药高剂量组、西药组大鼠异位子宫内膜细胞平均凋亡指数升高,差异有统计学意义（P〈0.01）。与西药组比较,中药高剂量组异位子宫内膜细胞平均凋亡指数升高,差异有统计学意义（P〈0.05）。西药组大鼠在位子宫内膜细胞平均凋亡指数较模型组、中药低剂量及中药高剂量组明显升高,差异有统计学意义（P〈0.01）。结论：子宫内膜异位症的发生与细胞凋亡能力的下降有关;补肾活血方能促进异位内膜细胞发生凋亡,使异位病灶萎缩、消退,而对在位子宫内膜无不良影响。

Effect of "Reinforcing Kidney and Activating Blood Recipe" on Pathomorphology and Apoptosis of Endometrial cell in Rats

Objective： To investigate the cell apoptosis mechanism of ＂Reinforcing Kidney and Activating Blood Recipe＂ in treating eudometriosis. Methods： The female Wistar rats aged 8 ~ 12 weeks were randomly divided into four groups： the model group, the low dose Chinese medicine group, the high dose Chinese medicine group and the western medicine group, with six rats in each group. The endometriosis model was established, and all the rats were intervened for four weeks. The pathomorphology and the positive rate of apoptosis cell of endometrium were detected by optical microscope, electron microscope and TUNEL method. Results： （1）Compared with the model group, the growth of endometrial cell was restrained with different degrees in all the treatment groups, and the representative morphology changes of endometrial cell apoptosis were observed as follows： karyopyknosis, agglutination of chromatin, caryoclasis, and the fmanation of apoptosis body, etc. The improvement of high dose Chinese medicine group and western medicine group was the most obviously, and secondly was the low dose Chinese medicine group. （2）The eutopic endometrium were observed under the microscope. The endometrial structure of the Chinese medicine groups was same with the normal and showed that the body of gland and mesenchyme grew well and the glandular epithelium and mucous epithelium cells were columnar with intensive mesenchyme. While the endometrial structure of the western medicine group showed that the glandular epithelium was atrophic and the mucous epithelium was flat, with less mesenchyme. （~）Compared with the model group and low dose Chinese medicine group, the endometrial apoptosis index of the high dose Chinese medicine group and western medicine group was obviously increased （P 〈 0.01 ） ; compared with the western medicine group, the endometrial apoptosis index of the high dose Chinese medicine group was increased （P 〈0.05） ; compared with the model group, low dose Chinese medicine group and high dose Chinese medicine group, the entopic endometrial apoptosis index of the western medicine group was increased （ P 〈0.01 ）. Conclusion ： The occurrence of endometriosis has relationship with the decline of cell apoptosis ability ; ＂Reinforcing Kidney and Activating Blood Recipe＂ can promote the apoptosis of ectopic endometrial cell and make the ectopic focus shrink, without influence on eutopic endometrium.