【作者】 徐薇；

【导师】 陈钢；

【作者基本信息】 成都中医药大学 ， 中医基础理论， 2010， 博士

【摘要】 目的：研究调肝止血法治疗宫内节育器所致子宫异常出血症的作用机制,为临床治疗出血性疾病提供新思路和新方法,也为进一步研究中医肝藏血理论提供实验依据。方法：以机械法培养人子宫内膜组织,观察根据调肝止血法组方的柴胡止血液含药血清对培养的人子宫内膜组织中ERK1/2和PI3K磷酸化水平的影响；采用ELISA方法测定p-ERK的含量；采用western blot法检测ERK1/2和PI3K的磷酸化水平；培养人子宫内膜螺旋动脉内皮细胞,采用ELISA方法测定柴胡止血液含药血清对其ET-1含量的影响；采用硝酸还原酶法测定柴胡止血液含药血清对其NO含量的影响。结果：①1、3、5号为经间期异常阴道出血、辨证为肝不藏血证的患者,1号病例检测结果显示,柴胡止血液含药血清有提高子宫内膜组织ERK1/2磷酸化水平的趋势,归脾汤含药血清有提高子宫内膜组织PI3K磷酸化水平的趋势；3号病例检测结果显示,柴胡止血液含药血清有提高子宫内膜组织ERK1/2磷酸化水平的趋势；5号病例检测结果显示,柴胡止血液含药血清有提高子宫内膜组织ERK1/2和PI3K磷酸化水平的趋势。②4、8、9号为经间期阴道异常出血者,出血量偏少,辨证为脾虚证的患者,其检测实验结果显示,归脾汤含药血清有提高子宫内膜组织ERK1/2和PI3K磷酸化水平的趋势。③2、7号为经间期出血、辨证为肝郁脾虚的患者,其检测结果显示,归脾汤含药血清有提高子宫内膜组织ERK1/2磷酸化水平的趋势,丹栀逍遥散含药血清有提高子宫内膜组织PI3K磷酸化水平的趋势；6号患者无经间期出血症状,辨证为肝郁脾虚,其检测结果显示,丹栀逍遥散含药血清组有提高子宫内膜组织ERK1/2磷酸化水平的趋势。④柴胡止血液含药血清中剂量组较其他组对人流组1、2号宫内膜螺旋动脉内皮细胞NO/ET比值影响较小。结论：柴胡止血液可能通过调节子宫内膜组织ERK1/2磷酸化水平,促进血管收缩、修复,促进血小板的聚集和激活凝血机制；通过调节PI3K的磷酸化水平,促进组织细胞的抗炎作用和增殖作用,从而达到治疗肝不藏血置宫内节育器所致子宫异常出血症的目的。更多还原

【Abstract】 Purpose:Investigate the mechanisms of adjusting liver to stop bleeding to cure the uterus abnormal bleeding side-effect with IUD, in order to provide new thought and method to cure haemorrhagia, and to provide experimental foundation for further investigation of the basic theory of TCM that liver storing blood.Method:Primary culture the Endometrial tissue, then treat them with Drug-containing serum, use western blot and ELISA method to check the leve of Phosphorylation of ERK1/2 and PI3 K signal pathway; Acquire endothelial cell of human spiral arteries by homogenization and enzyme digestion. Then observe the effect of the serum containing Chaihu Zhixueye by testing NO、ET that the endothial cell excrete.Results:①The patients of No.1、3、5 belong to liver can not store blood pattern, they have abnormal uterine bleeding, for No.l, Chaihu zhixueye-containing serum have a tendency of increasing the level of phosphorylation of ERK1/2, Guipitang-containing serum have a tendency of increasing the level of phosphorylation of PI3K; for No.3, Chaihu zhixueye-containing serum have a tendency of increasing The level of phosphorylation of ERK1/2; for No.5, Chaihu zhixueye-containing serum have a tendency of increasing the level of phosphorylation of ERK1/2 and PI3K.②The patients of No.4、8、9 belong to spleen deficiency pattern, they have little amount of abnormal uterine bleeding, Guipitang-containing serum have a tendency of increasing the level of phosphorylation of ERK1/2 and PI3K.③The patients of No.2、7 belong to both liver depression and spleen deficiency pattern, Guipitang-containing serum have a tendency of increasing the level of phosphorylation of ERKl/2, and Danzhixiaoyaosan-containing serum have a tendency of increasing the level of phosphorylation of PI3K; The patient of No.6 belongs to both liver depression and spleen deficiency pattern, she does not have abnormal uterine bleeding, Danzhixiaoyaosan-containing serum have a tendency of increasing the level of phosphorylation of ERKl/2.④For the 2 patients in induced abortion group, compare to orther serum, serum of middle dosage of Chaihu Zhixueye can maintain the the ratio of NO/ET.Conclusion:In order to treat Abnormal uterine bleeding after using IUD, Chaihuzhixueye may have the mechanism of regulating the level of phosphorylation of ERK1/2 to advance vasoconstriction and vascular repair, platelet aggregation, activate coagulation of uterine tissue of liver excessive patients, and also may regulating the level of phosphorylation of PI3K to advance the effect of cell proliferation and inflammatory. Chaihu Zhixueye can adjust the activity that endothelial cell excrete ET and NO. So that endothelial cell can accelerate repair of uterus spiral arteries vessels then stop the abnormal bleeding.更多还原