针药结合对子宫内膜异位症大鼠基质金属蛋白酶-2的影响

目的:探讨治疗子宫内膜异位症(endometriosis,EMs)的有效方法及作用机制。方法:采用清洁级雌性成熟未交配SD大鼠50只,建立大鼠EMs模型,随机分为模型组、针灸组、中药组、针药结合组,并设立正常组。针灸组电针"血海""三阴交",艾灸"关元";中药组采用加味没竭片生理盐水溶液灌胃;针药结合组采用上述2种方法综合治疗;正常组和模型组捆绑固定并行生理盐水灌胃。治疗35 d后,测量各大鼠异位组织最大直径,取异位组织进行组织病理学观察,并测定组织中基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)的表达。结果:针药结合组异位组织最大直径(2.300±1.252)mm、组织中MMP-2表达为1.000±0.667,均明显低于模型组(5.300±1.337)mm,3.300±0.823]和中药组(3.700±1.160)mm,1.900±0.738](P<0.05),异位内膜趋于萎缩,部分上皮细胞坏死。结论:针药结合对子宫内膜异位症疗效更佳,其作用机制可能通过下调异常升高的MMP-2水平,从而抑制异位组织对局部基质的侵袭,达到缩小异位组织面积、治疗EMs的作用。

Effects of acupuncture combined with medicine on expression of matrix metailoproteinase-2 in the ratof endometriosis

Objective To probe into an effective method for treatment of endometriosis(EMs) and the mechanism.Methods Rat EMs model was established and they were randomly divided into a model group,an acup-moxibustion group,a TCM group,an acupuncture and medicine group,with a control group set.The acup-moxibustion group were treated with electroacupuncture at "Xuehai(SP 10)","Sanyinjiao(SP 6)" and moxibustion at "Guanyuan(CV 4)";the TCM group were treated with stomach perfusion of modified Mojie Tablet in normal saline;the acupuncture and medicine group were treated with the above two methods;both the control group and the model group were bound and treated with stomach perfusion of saline.After treatment of 35 days,the greatest dia-meter of the ectopic tissue was measured in the rats,pathological observation of the ectopic tissue was made and matrix metalloproteinase-2(MMP-2) expression in the ectopic tissue was determined.Results The greatest diameter of ectopic tissue and MMP-2 expression in the ectopic tissue in the acupuncture and medicine group were significantly lower than those in the model group,the acup-moxibustion group and the TCM group(P<0.05);and the ectopic endometrium trended to atrophy,and with necrosis of some epithelial cells.Conclusion Combination of acupuncture with medicine has a better therapeutic effect on endometriosis and down-regulates the abnormal increase of MMP-2 level to inhibit the invasion of ectopic tissue to extracellular matrix,so as to reduce the ectopic tissue,hence cure of endometriosis.