宫清颗粒预防和治疗米非司酮-米索前列醇药物流产后出血的机制

Preventing and curing mechanism of Gongqing granum on lochiorrhea after administrated with mifepristone and misoprostol

目的探讨宫清颗粒诱导米非司酮-米索前列醇药流后人早孕绒毛膜、蜕膜组织细胞凋亡的作用机制。方法将240例受试者随机分为宫清药流组(A组)、茜芷药流组(B组)、单纯药流组(C组)及人工流产组(D组),各60例。收集各组绒毛膜和蜕膜组织,缺口原位末端标记技术(TUNEL)检测细胞凋亡率(AR),免疫组化法检测Fas、FasL、Caspase-8及Caspase-3蛋白表达。结果A组绒毛膜与蜕膜组织细胞AR、Fas、FasL、Caspase-8及Caspase-3蛋白表达明显升高,与其他3组比较差异有统计学意义(P<0.05或P<0.01)。结论宫清颗粒能促进Fas/FasL介导的凋亡信号转导,激活Caspase级联反应,诱导人早孕绒毛膜、蜕膜组织细胞凋亡,促进绒毛膜与蜕膜组织完全排出,进而防治药流后出血。

AIM To investigate the mechanism of Gongqing granum, a traditional Chinese medicine, on lochiorrhea after administrated with mifepristone and misoprostol in human early pregnancy. METHODS The selected 240 subjects were randomly divided into group A, B, C, and D. In group A, subjects took mifepristone, misoprostol, and Gongqing granum. In group B, subjects took RU-486, misoprostol and Qianzhi granum. In group C, subjects took mifepristone and misoprostol only. In group D, subjects received artificial abortion operation. The specimen of the 4 groups were collected, the change of apoptosis rate （AR） was observed by the method of TUNEL, and the expressions of Fas, FasL, Caspase-8, and Caspase-3 were observed by the method of immunohistochemistry. RESULTS Compared to the other 3 groups, AR and the expressions of Fas, FasL, Caspase-8 and Caspase-3 of group A were obviously higher （P 〈 0.05 or P 〈 0.01）. CONCLUSION Gongqing granum can promote the signal transduction of Fas and FasL, activate the cascade reaction of easpase, consequently induce the cell apoptosis of ehorionic and deeidua in human early pregnancy, so as to prevent and cure lochiorrhea after drug abortion by mifepristone and misoprostol.