针药并用对子宫内膜异位症大鼠血管内皮生长因子的影响

目的观察针药配合对子宫内膜异位症(endometriosis,EMs)大鼠血管内皮生长因子(vascular endothelial growth factor,VEGF)表达的影响,探讨针药配合治疗子宫内膜异位症的作用机制。方法建立大鼠EMs模型,随机分为模型组、针灸组、中药组、针药组,并设立假手术组。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混悬液灌胃;针药组采用上述两种方法综合治疗;假手术组和模型组捆绑固定并行生理盐水灌胃。治疗30 d后,取腹腔灌洗液及血清ELISA法检测VEGF水平,测量异位囊肿最大直径,取异位组织进行组织病理学观察,免疫组化法测定组织中VEGF的蛋白水平。结果针药组异位囊肿最大直径明显小于模型组、针灸组及中药组(P0.01);模型组异位内膜生长旺盛,针药组内膜趋于萎缩,部分上皮细胞坏死;模型组腹腔灌洗液和异位组织中VEGF的表达显著高于其他各组,针药组腹腔灌洗液VEGF表达显著低于模型组、中药组、针灸组(P0.01),针药组异位组织中VEGF表达强度低于模型组(P0.01)和中药组(P0.05)。结论大鼠EMs发病与其病变局部及腹腔微环境中VEGF水平相关,针药配合能缩小EMs大鼠子宫内膜囊肿大小,下调异位组织及腹腔液中异常升高的VEGF蛋白表达。

Effect of Combined Acupuncture and Medicine on the Expression of Vascular Endothelial Growth Factor in Endometriosis Rats

Objective To investigate the effect of acupuncture combined with Jiawei Mojie Plan on the expression of vascularendothelial growth factor （VEGF） in endometriosis （EMs） rats and explore the mechanism of action of combined acupuncture andChinese herbal medicine in treating endometriosis. Method A rat model of EMs was made. The rats were were randomly allocatedto model, acupuncture, Chinese herbal medicine and acupuncture plus medicine groups. A sham operation group was set up. Theacupuncture group received electroacupuncture at Xuehai （SP10） and Sanyinjiao （SP6） and moxibustion on Guanyuan （CV4）; theChinese herbal medicine group, an oral gavage of a suspension of Jiawei Mojie Pian in normal saline; the acupuncture plus medicinegroup, a combined treatment with the above two methods. The sham operation and model groups were bound and fixed, and givenan oral gavage of normal saline. The peritoneal lavage fluid and serum were taken after 30 days of treatment. VEGF levelswere measured by ELISA. The maximum diameter of ectopic cyst was determined. The ectopic tissue was taken forhistopathological observation. The protein level of tissue VEGF was measured by immunohistochemical method. ResultThe maximum diameter of ectopic cyst was significantly shorter in the acupuncture plus medicine group than in the model,acupuncture and Chinese herbal medicine groups （P〈0.01）. Ectopic endometrium grew vigorously in the model group. Theendometrium tended to atrophy and part of the epithelial ceils became necrosis in the acupuncture plus medicine group. Theexpression of VEGF in the peritoneal lavage fluid and ectopic tissue was significantly higher in the model group than in the othergroups. The expression of VEGF in the peritoneal lavage fluid was significantly lower in the acupuncture plus medicine group thanin the model, Chinese herbal medicine and acupuncture groups （P〈0.01）. The expression of VEGF in the ectopic tissue wassignificantly lower in the acupuncture plus medicine group than in the model a