宫宁颗粒对置宫内节育器出血不良反应者子宫内膜不同区域ER、PR、VEGF表达的影响

Effect of Gongning Granule on Expressions of ER,PR and VEGF in different areas of Endometrium in Patients with Bleeding after IUD Placement

目的：观察宫宁颗粒对置宫内节育器（IUD）出血不良反应者子宫内膜不同区域雌激素受体（ER）、孕激素受体（PR）、血管内皮生长因子（VEGF）表达的影响,探讨其对子宫内膜修复的作用机制。方法：依标准纳入IUD出血不良反应患者,宫宁颗粒和消炎痛进行干预,宫腔镜下观察并定点获取IUD压迫区、移行区、远器区子宫内膜,免疫组化检测ER、PR、VEGF的表达情况。结果：宫宁颗粒临床疗效优于消炎痛组（P〈0.05）;内膜损伤程度与距离IUD远近成反比,治疗前ER、PR、VEGF在不同区域表达不同步（P〈0.05或P〈0.01）;与空白对照组比较,VEGF在IUD出血不良反应患者中表达显著升高（P〈0.05）,ER表达在压迫区降低远器区升高,治愈或好转后,较之治疗前,VEGF表达降低,PR表达升高,且表达趋于同步。结论：内膜周期性修复障碍是IUD出血不良反应患者的病理基础,宫宁颗粒防治IUD出血不良反应（瘀热型）的作用机制可能与调控ER、PR、VEGF同步表达,促进子宫内膜修复有关。

Objective：To observe the effect of Gongning Granule on the expressions of ER,PR and VEGF in different areas of endometrium in patients with beeding after IUD placement and its possible mechanism. Methods：In accordance with the standand,Gongning Granule and Indometacin were used while observing the effect. Uterine cavity is also adopted to observe pressure area. And the expressions of ER,PE and VEGF were examined. Results： The clinical curative effects of Gongning Granule was better than that of the Indometacin group（ P 〈 0. 05）. The damagement degree of endometrium between an IUD was inversely proportional to the distance. Compared to the normal control,the expression of endometrium VEGF was obviously higher（ P 〈 0. 05）. The expression of ER was higher in distant area and degraded in pressure area. After cured or improved,compared with before treatment,the expression of VEGF reduced,PR expression higher and expressions tended to be synchronized. Conclusion：Patients who have IUD bleeding have an obvious hindrance of endometria exfoliating/repairing periodically. Gongning Granule adjusts and recovers the delivery of endometrium ER,PR and VEGF so as to adjust peeling and recovery endometrium foul-up of IUD bleeding.