桂枝茯苓丸对子宫内膜异位症患者MEK-2、p-ERK和VEGF表达影响

Effects of Guizhi Fuling Pill on MEK-2,p-ERK and VEGF Expression in Patients with Endometriosis

目的:探讨桂枝茯苓丸对子宫内膜异位症患者MEK-2、p-ERK和VEGF表达的影响效果。方法:选取我院妇科收治的子宫内膜异位症患者60例,随机分为两组,其中对照组30例,予常规醋酸戈舍瑞林缓释植入剂10.8 mg,月1次皮下注射,1个月为1疗程,治疗2个疗程。实验组30例,予桂枝茯苓丸,12 g日2次口服,1月为1疗程,治疗2个疗程。正常组30例,选取健康女性,不予任何治疗手段。治疗结束后,对比各组患者MEK-2、ERK-5、p-ERK及VEGF、T-cad、VE-cad水平变化,并通过PCR逆转录聚合酶链反应检测各组MEK-2、p-ERK、VEGF蛋白基因表达水平。试验结束后应用宫腔内窥镜进行组织活检,通过染色方法进行镜下观察。结果:(1)试验后各组MEK-2、ERK-5及p-ERK水平均有不同程度变化,与对照组比较,实验组MEK-2(4.05±0.75)μg/m L、ERK-5(10.81±3.29)μg/m L、p-ERK(0.99±0.17)μg/m L较对照组MEK-2(5.77±10.69)μg/m L、ERK-5(13.34±2.16)μg/m L、p-ERK(1.59±0.47)μg/m L明显降低,差异有统计学意义(P<0.05)。(2)试验后各组VEGF、T-cad及VE-cad水平均有不同程度变化,与对照组比较,实验组VEGF(5.90±1.82)ng/m L、T-cad(0.11±0.01)U/m L、VE-cad(0.19±0.17)U/m L较对照组VEGF(22.77±5.32)ng/m L、T-cad(0.27±0.11)U/m L、VEcad(0.69±0.07)U/m L明显降低,差异有统计学意义(P<0.05)。(3)试验后,实验组与对照组细胞活化及生长因子基因电泳结果均不同程度表达,实验组PCR(301 bp)、MEK-2基因(0.20±0.17)、p-ERK基因(0.13±0.09)、VEGF基因(0.15±0.07)较对照组PCR(521 bp)、MEK-2基因(0.60±0.16)、p-ERK基因(0.62±0.04)、VEGF基因(0.66±4.19)明显改善。结论:桂枝茯苓丸能够明显抑制子宫内膜异位症的细胞增殖与分化,通过抑制MEK及ERK蛋白活性,阻断细胞间信号传导通路,从而抑制子宫内膜异常增殖及细胞分裂周期的进行,并能有效抑制肿瘤的生长与分化,对临床具有指导意义,值得临床推广。

Objective：To investigate the effects of Guizhi Fuling Pill on MEK-2,p-ERK and VEGF expression in patients with endometriosis. Methods：60 patients with endometriosis who were treated in our hospital department of gynaecology were selected and randomly divided into two groups,30 cases in the control group were treated with conventional goserelin acetate sustained-release implant 10.8 mg,subcutaneous injection one time,a month,1 month is 1 course of treatment,two courses of treatment. 30 cases in the experiment group were treated with Guizhi Fuling Pill,12 g two times a day oral,1 month is 1 course of treatment,two courses of treatment. the normal group,chose healthy women,without any treatment. After treatment,the MEK-2,ERK-5,p-ERK and VEGF,T-cad,VEcad levels changed were compared of every groups,reversed transcription polymerase chain reaction and by PCR detected the MEK-2,p-ERK,VEGF protein gene expression levels of every group. After the test application of uterine cavity endoscope for tissue biopsy,under the microscope observation through the dyeing method. Results：（1）After test,the MEK-2,ERK-5 and p-ERK levels of every group all had different degree changed,compared with the control group,the MEK-2（4.05±0.75）μg/m L,ERK-5（10.81±3.29）μg/m L,p-ERK（0.99±0.17）μg/m L of the experiment group compared with the MEK-2（5.77±10.69）μg/m L,ERK-5（13.34±2.16）μg/m L,p-ERK（1.59±0.47）μg/m L of the control group were decreased obviously,with statistically significant（P〈0.05）.（2）After test,the VEGF,T-cad and VE-cad levels of every group all had different degree changed,compared with the control group,the VEGF（5.90±1.82）ng/m L,T-cad（0.11±0.01）U/m L,VE-cad（0.19±0.17） U/m L of the experiment group compared with the VEGF（22.77±5.32）ng/m L,T-cad（0.27±0.11）U/m L,VE-cad（0.69±0.07）U/m L of the control group were decreased obviously,with statistically significant（P〈0.05）.（3）After test,the cells activation and growth factor gene electrophoresis results of the experiment group and control group all had different degree expressions,the PCR（301 bp）,MEK-2 gene（0.20±0.17）,p-ERK gene（0.13±0.09） and VEGF（0.15 ＋ 0.07）of the experiment group compared with the PCR（521 bp）,MEK-2 gene（0.60±0.16）,p-ERK gene（0.62±0.04）and VEGF（0.66±4.19）of the control group were improved significantly. Conclusion：Guizhi Fuling Pill can significantly inhibit cell proliferation and differentiation of endometriosis,by inhibiting the MEK and ERK protein activity,blocking the cell signaling pathways,thus inhibiting abnormal endometrial proliferation and cell division cycle,and can effectively inhibit tumor growth and differentiation,to give a guidance in clinical,be worth clinical promotion.