桂枝茯苓丸联合达那唑、孕三烯酮胶囊对EMs患者TLR4/MyD88/NF-κB信号通路的影响

Effects of Guizhifuling pill combined with danazol and gestrinone capsules on TLR4/MyD88/NF-κB signal pathway in treatment of endometriosis

目的研究桂枝茯苓丸联合达那唑、孕三烯酮胶囊对子宫内膜异位症(EMs)患者TLR4/MyD88/NF-κB信号通路的影响。方法行腹腔镜手术的EMs患者110例,随机分为对照组和治疗组,每组55例,对照组术后给予达那唑、孕三烯酮胶囊口服,治疗组在对照组基础上给予桂枝茯苓丸口服。疗程均为12周。观察2组异位子宫内膜组织TLR4信号通路分子(TLR4、MyD88、NF-κB)、增殖相关基因(LC3、Smac、Bak、cFLIP、Nanog、eIF4E)、侵袭相关基因(TIMP-1、TIMP-2、E-cadherin、Twist1、Twist2、MMP-1)mRNA和蛋白表达变化。结果治疗前2组异位子宫内膜组织TLR4、MyD88、NF-κB、LC3、Smac、Bak、cFLIP、Nanog、eIF4E、TIMP-1、TIMP-2、E-cadherin、Twist1、Twist2、MMP-1 mRNA和蛋白表达比较差异无统计学意义(P>0.05)。治疗后2组异位子宫内膜组织TLR4、MyD88、NF-κB、cFLIP、Nanog、eIF4E、Twist1、Twist2、MMP-1 mRNA和蛋白表达均显著低于治疗前,LC3、Smac、Bak、TIMP-1、TIMP-2、E-cadherin mRNA和蛋白表达均显著高于治疗前,差异均有统计学意义(P<0.05),且治疗组改善程度优于对照组(P<0.05)。结论桂枝茯苓丸联合达那唑、孕三烯酮胶囊治疗EMs能够通过抑制TLR4/MyD88/NF-κB信号通路降低病灶细胞的增殖和侵袭。

Objective To investigate the effects of Guizhifuling pill combined with danazol and gestrinone capsules on TLR4/MyD88/NF-κB signal pathway in treatment of endometriosis (EMs). Methods A total of 110 patients with EMs,who were treated by laparoscopic operation,were randomly divided into control group and treatment group,with 55 cases in each group. The patients in control group were treated by oral danazol and gestrinone capsules after operation,however,the patients in treatment group,on the basis of control group, were treated by Guizhifuling pill,with a treatment course of 12 weeks for both groups. After treatment,the expression levels of TLR4,MyD88,NF-κB,LC3, Smac, Bak,cFLIP,Nanog,eIF4E,TIMP-1,TIMP-2,E-cadherin,Twist1,Twist2 and MMP-1 mRNA and proteins were observed and comapred between the two groups. Results Before treatment there were no significant differences in the expression levels of TLR4, MyD88, NF-κB,cFLIP,Nanog,eIF4E,Twist1,Twist2,MMP-1 mRNA and proteins in endometriosis tissues between the two groups ( P >0.05). After treatment the expression levels of TLR4,MyD88,NF-κB,cFLIP,Nanog,eIF4E,Twist1,Twist2,MMP-1 mRNA and proteins in endometriosis tissues in both groups were significantly decreased,however, the expression levels of LC3,Smac,Bak,TIMP-1,TIMP-2,E-cadherin mRNA and protein in endometriosis tissues in both groups were significantly increased ( P <0.05),moreover the improvement degree in treatment group was superior to that in control group ( P <0.05). Conclusion Guizhifuling pill combined with danazol and gestrinone capsules in treatment of EMs can significantly inhibit the cell proliferation and invasion by inhibiting the activation of TLR4/MyD88/NF-κB signal pathway in endometriosis lesions.