膈下逐瘀汤加减方对气滞血瘀型输卵管炎性不孕模型大鼠DA、NE表达的影响

目的:通过观察膈下逐瘀汤加减方(GD)对模型大鼠中医证候评分、血流变、去甲肾上腺素(Norepinephrine, NE)和多巴胺(Dopamine, DA)的表达水平、输卵管病理表现及输卵管组织形态,来探讨GD治疗气滞血瘀型输卵管炎性不孕症的作用机制。方法:将100只SD大鼠随机分为空白组(K)、病证结合组(B)、膈下逐瘀汤高剂量组(H)、膈下逐瘀汤中剂量组(M)、膈下逐瘀汤低剂量组(L),每组20只。除K组外,余雌性大鼠,先于输卵管接种金黄色葡萄球菌制备成输卵管炎症模型,后进行声、光、电+夹尾复合刺激。气滞血瘀型慢性输卵管炎大鼠模型制备成功后,从实验第29天开始,H、M、L三组分别给予相应浓度的GD液灌胃,B组用等体积蒸馏水代替,持续给药28 d。于末次给药后的第二天,每组随机选取12只大鼠行腹主动脉取血,测定血流变学指标,Elisa法检测大鼠血清中DA、NE的含量;取模型大鼠双侧输卵管组织,行HE染色制备病理切片及进行电镜观察输卵管组织形态。结果:与K组相比,B组的中医证候积分、血液流变学指标以及血清DA、NE的表达均有极为显著的变化(P<0.01)。与B组相比较,经过高、中剂量GD治疗的大鼠血液流变学指标及DA、NE的表达有显著性差异,具有统计学意义(P<0.05)。病理结果显示:B组模型大鼠输卵管病理表现最为严重,治疗后的H、M、L组病理表现均减轻,其中H组最优。电镜下观察输卵管组织形态显示:B组模型大鼠输卵管的病态组织形态最重,表明模型制备成功,经治疗后,H、M、L组输卵管组织形态均有不同程度的改善作用。结论:GD可以明显改善模型大鼠中医证候积分、血液流变学指标、DA、NE的表水达平、病理表现及输卵管组织形态,对气滞血瘀型输卵管炎不孕症起到积极的治疗作用。

Effect of Gexia Zhuyu Decoction on the Expressions of DA and NE in Infertile Rats with Fallopian Tube Inflammatory of Qi Stagnation and Blood Stasis Pattern

Objective:To observe the effect of Gexia Zhuyu Decoction(GD)on TCM syndrome scores,hemorheology,expressions of DA and NE,pathological manifestation of fallopian tube and morphology of fallopian tube tissue in the model rats,thus to explore the mechanism of GD in the treatment of salpingitis infertile of Qi stagnation and blood stasis.Methods:100 SD rats were randomly divided into the blank group(K),disease-syndrome combined group(B),Gexia Zhuyu Decoction of high-dose group(H),Gexia Zhuyu Decoction of middle-dose group(M)and Gexia Zhuyu Decoction of low-dose group(L),with 20 rats in each group.In addition to group K,the model of tubal inflammation was established by inoculating Staphylococcus aureus in fallopian tube,and then stimulated by sound,light and electric tail clamping.After the rat model of chronic salpingitis of Qi stagnation and blood stasis was successfully established,the experimental procedure were as follows:at the beginning of 29 days,the three groups of H,M and L were respectively given the corresponding concentration of GD Decoction,and the group B was replaced with equal volume of distilled water,and the administration was continued for 28 d.The second day after last administration,12 rats were randomly selected from each group to take blood from abdominal aorta,to determine the hemorheological index,and to detect the serum content of DA and NE by Elisa method.The pathological sections were prepared by HE staining and the morphology of the oviduct was observed by electron microscope.Results:There were statistical differences in the scores of TCM syndromes,hemorheological indexes and the serum expressions of DA and NE between the group B and the group K(P<0.01).Compared to those in the group B,the hemorheological indexes and the expressions of DA and NE were significantly improved after the intervention with high-dose and medium-dose of GD(P<0.05).The pathological results showed that the pathological manifestations of fallopian tubes in the group B were the most serious.After the treatment,the pathological manifestations of the group H,the group M and the group L were alleviated,and the group H was the best.The observation of fallopian tube tissue morphology under electron microscope showed that the morbid tissue morphology of fallopian tube in the group B was the most serious,indicating that the model was successfully made.After the interventions of GD,the morphology of fallopian tube tissue had different degrees of improvements in the group H,the group M and the group L.Conclusion:GD can obviously improve the integral of TCM syndrome,hemorheology,and the expressions of DA and NE in the model rats,and has a positive therapeutic effect on the infertility due to Qi stagnation and blood stasis.