基于microRNA表达谱变化探讨“秩边透水道”针法治疗对子宫内膜异位症患者的疗效

To investigate effect of"Zhibian through Shuidao"acupuncture therapy on endometriosis patients based on microRNA expression profile changes

目的基于微小核糖核酸(microRNA,miR)表达谱变化探讨“秩边透水道”针法治疗对子宫内膜异位症(Endometriosis,EMS)患者的疗效。方法选取2019年10月至2022年10月西北妇女儿童医院收治的133例EMS患者,按随机数字表法分为对照组(n=66)与观察组(n=67),对照组给予米非司酮片治疗,观察组在米非司酮片治疗基础上应用“秩边透水道”针法治疗,两组患者均连续治疗3个月。比较两组患者临床疗效、疼痛视觉模拟量表(Visual simulation scale,VAS)评分、卵泡刺激素(Follicle-stimulating hormone,FSH)、雌二醇(Estradiol,E2)、黄体生成素(Luteinizing hormone,LH)、抗子宫内膜抗体(Anti endometrial antibody,EMAb)、癌胚抗原125(Carcinoembryonic antigen 125,CAl25)、血流动力学指标[阻力指数(Resistance index,RI)、搏动指数(Pulse index,PI)]及外周血单个核细胞中miR-141-3p、miR-17-5p、miR-145表达水平及不良反应。结果观察组临床疗效总有效率较对照组显著升高(P<0.05);与治疗前比较,治疗1、2、3个月后,两组患者VAS评分均降低(P<0.05),且观察组与对照组比较差异有统计学意义(P<0.05);与治疗前比较,治疗3个月后,两组患者FSH、E2、EMAb、CA125、PI、RI、miR-145均降低(P<0.05),LH、miR-141-3p、miR-17-5p均升高(P<0.05),且观察组与对照组比较差异有统计学意义(P<0.05);用药过程中两组患者呼吸、脉搏、体温、血压等生命体征均平稳,血、尿、便常规基本正常,均未见严重不良反应。结论“秩边透水道”针法治疗应用于子宫内膜异位症患者,可有效减缓痛经程度,调节性激素及EMAb、CA125水平,改善血流动力学状态,其疗效机制可能与上调miR-141-3p、miR-17-5p及下调miR-145表达水平有关。

Objective To explore the therapeutic effect of the"Zhibian through Shuidao"acupuncture method on patients with Endometriosis(EMS)based on the changes in microRNA(miR)expression profile.Methods A total of 133 EMS patients admitted to the hospital from October 2019 to October 2022 were randomly divided into control group(n=66)and observation group(n=67)with using a random number table method.The control group was treated with mifepristone tablets,while the observation group was treated with"Zhibian through Shuidao"acupuncture on the basis of the control group.Both groups were treated continuously for 3 months.The clinical efficacy,visual simulation scale(VAS)score,follicle stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),anti endometrial antibody(EMAb),Carcinoembryonic antigen 125(CAl25)Hemodynamic indexes[Resistance index(RI),Pulse index(PI)]and the expression levels of miR-141-3p,miR-17-5p,and miR-145 in peripheral blood mononuclear cell were analyzed for safety.Results The total effective rate of clinical efficacy in the observation group was significantly higher than that in the control group(P<0.05);Compared with before the treatment,after 1,2,and 3 months of the treatment,the VAS scores of both groups of the patients were decreased(P<0.05),and the VAS scores of the observation group were lower(P<0.05);Compared with before the treatment,after 3 months of the treatment,FSH,E2,EMAb,CA125,PI,RI,and miR-145 in both groups of the patients were decreased(P<0.05),while LH,miR-141-3p,and miR-17-5p was increased(P<0.05),and the improvement of the above indicators in the observation group was greater(P<0.05),During the medication process,vital signs such as respiration,pulse,body temperature,and blood pressure was stable in both groups,and blood,urine and stool routine tests were basically normal,with no serious adverse reactions observed.Conclusion The application of"Zhibian through Shuidao"acupuncture in patients with endometriosis can effectively alleviate dysmenorrhea,regulate the levels of sex hormones,EMAb and CA125 and improve hemodynamics.Its therapeutic mechanism may be related to the up regulation of miR-141-3p,miR-17-5p and the down regulation of miR-145 expression.