补肾育宫冲剂治疗子宫发育不良的机理研究

Study on Mechanism of Bushen Yugong Granule in Treating Uterine Dysgenesia

目的 :探讨补肾育宫冲剂治疗子宫发育不良性不孕症的作用机理。方法 :(1 )以子宫发育不良和发育正常的育龄妇女为观察组和对照组 ,于卵泡期测血清性激素和子宫内膜雌、孕激素受体(ER、PR)含量 ,并作观察组治疗前后比较。 (2 )用大鼠作动物实验 ,设对照组及补肾育宫冲剂 3个剂量组 ,于服药前后测血清雌二醇 (E2 ) ,对服药后大鼠的垂体、卵巢、子宫作病理检验并测ER、PR含量。对切除卵巢的幼龄大鼠作本冲剂的雌激素活性实验。结果 :(1 )临床观察组与对照组的血清性激素水平无明显差异(P >0 0 5 ) ;前者子宫内膜ER含量在 + +以上者占 46 9% (1 5 / 3 2例 )比较 ,明显低于对照组的 72 4% (2 1 / 2 9例 ,P<0 0 5 ) ;观察组 2 6例经冲剂治疗后 ,ER含量在 + +以上由3 4 6% (9/ 2 6例)上升至 65 4% (1 7/ 2 6)例 ,治疗前后比较差异显著 (P <0 0 5 )。(2 )本冲剂显著增加大鼠卵巢内生长卵泡数和子宫重量 ,提高血清E2 水平 ,对照组子宫内膜ER含量为 2 9 2 5±1 7 0 3 % ,而冲剂组为 67 75±2 4 5 6%～83 0 0± 9 87% ,两组比较 ,有显著性差异(P <0 0 0 5 )。结论 :补肾育宫冲剂具有雌激素样活性 ,能提高子宫内膜ER含量 ,增加雌激素对子宫的效应 ,起到发育子宫的作用 ,从而提高受孕率。

Objective: To explore the effective mechanism of Bushen Yugong Granule (BSYGG, a Chinese medicine preparation) in treating infertility due to uterine dysgeneia. Methods: (1)Clinical study: Serum level of sex hormone and endometrial content of estradial receptor (ER) and progesterone receptor (PR) in follicle period of 60 patients (the tested group) were measured and compared before and after treatmet, and the data were also compared with those of 70 normal women (the control group). (2)Experimental study: Rats were divided into the control group and 3 tested groups fed with different dose of BSYGG. Pathologic examination of pituitary, ovary and uterus of rats after BSYGG treatment, and serum levels of ER, PR were measured. Also, an estrogen activity experiment was adopted in some young oophorectomized rats. Results: (1)Clinical study, the difference of serum sex hormone levels between the tested and the control group was insignificant. The percentage of patients in tested group with endometrial ER content over ++ was lower than that in the control group (46.9% vs 72.4%)significantly (P<0 05), after treatment, it arised to 65.4% in test group, the change after treatment was significant (P<0 05). (2) Experimental study: The number of follicle, weight of uterus and serum E 2 level increased significantly after BSYGG treatment. The endometrial content of ER in the control group was 29.25±17.03%, while in the tested group, it was 67.75±24.56%～83.00±9.87% after treatment, the difference between the two groups was significant (P<0 005). Conclusion: BSYGG has an estrogen like activity, it could increase the endometrial content of ER, enhance the effect of estrogen on uterus and promote the uterine development, so as to elevate the fertilization rate.