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目的:探讨琥珀散治疗子宫内膜异位症(EMs)的作用机理。方法:采用夹尾刺激加自体子宫内膜移植法建立病证结合的气滞血瘀型EMs大鼠模型。随机分为模型组、治疗组(琥珀散高剂量组、琥珀散中剂量组、琥珀散低剂量组)和孕三烯酮组,分别灌胃给药,4周后处死。比色法检测血清一氧化氮(NO)含量和一氧化氮合酶(NOS)活性,酶联免疫法检测血浆前列腺素2α(PGF2α)水平,光镜下观察子宫内膜形态学变化。结果:①琥珀散高、中剂量组可降低模型鼠血清NO含量、NOS活性和血浆PGF2α水平,与模型组比较,差异均有统计学意义(P<0.01);与孕三烯酮组相比,差异均无统计学意义(P>0.05);琥珀散低剂量组可降低模型鼠NO含量,与模型组比较,差异有统计学意义(P<0.05)。②模型组大鼠在位内膜腺体数量多,腺腔完整,异位内膜出现类似于在位子宫内膜的结构。治疗组大鼠在位内膜变化不明显,异位内膜体积偏小,腺体减少,腺上皮呈不同程度的萎缩。孕三烯酮组大鼠在位、异位内膜均见腺体数目少,腺腔缩小,腺上皮细胞萎缩。结论:琥珀散可以降低EMs大鼠血清NO、NOS及血浆PGF2α水平,这可能是琥珀散有效抑制异位病灶种植、生长,缓解盆腔疼痛的作用机理之一。
Objective: To investigate the mechanism of action of amber powder in treating endometriosis (EMs). Methods: A rat model of qi stagnation and blood stasis was established by tailgating stimulation and autologous endometrial transplantation. The rats were randomly divided into model group, treatment group (high dose of amber powder, middle dose of amber powder, low dose of amber powder) and gestrinone group. Serum nitric oxide (NO) content and nitric oxide synthase (NOS) activity were measured by colorimetric method. Plasma prostaglandin 2α (PGF2α) level was detected by enzyme-linked immunosorbent assay. Morphological changes of endometrium were observed under light microscope. Results: ① Aspartame high and medium dose groups could reduce NO content, NOS activity and PGF2α level in plasma in model rats, which were significantly different from those in model group (P <0.01); Compared with gestrinone (P> 0.05). Compared with the model group, the difference was statistically significant (P <0.05). ② In the model group, the number of endomembrane glands in eutopic endometrium was large, the glandular cavity was intact, and the ectopic endometrium appeared similar to the structure of eutopic endometrium. In the treatment group, there was no significant change in the eutopic endometrium, the ectopic endometrium was smaller, the gland was reduced, and the glandular epithelium showed varying degrees of atrophy. Gestrinone group rats in ectopic endometrium were seen in the small number of glands, glands narrowing, glandular epithelial cells shrink. CONCLUSION: Amber powder can reduce serum NO, NOS and plasma PGF2α level in EMs rats, which may be one of the mechanisms that Amber Powder can effectively inhibit the growth, edema and alleviate pelvic pain in ectopic lesions.