针药结合调控子宫内膜异位症大鼠内膜组织ERα、ERβ的作用

Effect of acupuncture and moxibustion with traditional Chinese medicine in regulating endometrial tissue ERα/ERβin rats with endometriosis

目的研究针药结合调控子宫内膜异位症(内异症)雌激素受体的作用。方法50只SD大鼠按体质量随机分为假手术组、模型组、针灸组、中药组和针药组,每组10只;建立大鼠内异症模型;针灸组针刺“血海”“三阴交”,艾灸“关元”,中药组给予加味没竭片0.9%NaCl溶液混悬液灌胃,针药组给予上述2种方法综合治疗,假手术组、模型组进行固定针灸并给予等量0.9%NaCl溶液灌胃。治疗30 d后,测量各组大鼠异位囊肿直径;取正常子宫内膜、在位及异位内膜组织进行免疫组织化学检测,比较不同组织中雌激素受体α(ERα)、雌激素受体β(ERβ)的表达。结果与模型组比较,针灸组、中药组和针药组异位囊肿直径显著缩小(P<0.05),针药组异位囊肿直径显著小于针灸组和中药组(P<0.05)。针灸组和针药组在位及异位内膜ERα表达显著高于模型组(P<0.01)和中药组(P<0.01),针药组在位内膜ERα表达高于针灸组(P<0.05)。针灸组、中药组、针药组在位及异位内膜ERβ表达均显著低于模型组(P<0.01),针药组在位及异位内膜ERβ表达均低于中药组(P<0.01)。内异症大鼠在位及异位内膜组织ERα/ERβ比率均较低,其中针药组大鼠在位及异位内膜组织中ERα/ERβ比率高于其余各组。结论针药结合可能通过上调在位及异位内膜组织中ERα表达、下调在位及异位内膜组织中ERβ表达,使其趋于正常子宫内膜水平,进而达到治疗大鼠内异症的效应。

Objective To research the effect of acupuncture and moxibustion with Chinese medicine in regulating the estrogen receptor in endometriosis.Methods Fifty SD rats were randomly divided into sham operation group,model group,acupuncture and moxibustion group,Chinese medicine group,acupuncture and moxibustion with Chinese medicine group(AC group in brief),10 rats in each group.Endometriosis rat models were established in advance.The acupuncture and moxibustion group received acupuncture at Xuehai(SP10)and Sanyinjiao(SP6)and moxibustion at Guanyuan(CV4);the Chinese medicine group was treated with 0.9%NaCl suspension of Jiawei Mojie tablet by oral gavage;the AC group was treated by the above two methods simultaneously.The sham operation group and the model group were fixed and given of the same dosage of 0.9%NaCl by oral gavage.After 30 days of treatment,the diameters of ectopic cysts in five groups were measured.Normal endometrial,eutopic and ectopic endometrial tissues were taken for immunohistochemical detection and the expressions of estrogen receptorα(ERα)and estrogen receptorβ(ERβ)in different tissues were compared.Results The diameter of ectopic cyst in acupuncture and moxibustion group,Chinese medicine group,and AC group was significantly smaller than that in model group(P<0.05).The diameter of ectopic cyst in AC group was significantly smaller than that both in acupuncture and moxibustion group and Chinese medicine group(P<0.05).The ERαexpression in ectopic and eutopic endometrium of acupuncture and moxibustion group and AC group was significantly higher than that of model group(P<0.01)and Chinese medicine group(P<0.01).The ERαexpression in eutopic endometrium of AC group was higher than that of acupuncture and moxibustion group(P<0.05).The ERβexpression in ectopic and eutopic endometrium of acupuncture and moxibustion group,Chinese medicine group and AC group was lower than that of model group(P<0.01).The ERβexpression in ectopic and eutopic endometrium of AC group was significantly lower than that of Chinese medicine group(P<0.01).ERα/ERβratio was lower in the ectopic and eutopic endometrium of EMS rats.ERα/ERβratio in the ectopic and eutopic endometrium of AC group was the highest among all the groups.Conclusion The combination of acupuncture and moxibustion with Chinese medicine may achieve the treatment effect of rats’endometriosis through up-regulating the expression of ERαprotein and down-regulating the expression of ERβprotein in eutopic and ectopic endometrium to the normal level.