【作者】 杨丽娜；

【导师】 刘瑞芬；

【作者基本信息】 山东中医药大学 ， 中医妇科学， 2010， 硕士

【摘要】 目的：通过观察盆腔炎颗粒治疗血瘀兼肾虚型慢性盆腔炎的临床疗效及对模型大鼠血清、子宫组织中炎症细胞因子及核因子的变化,探讨盆腔炎颗粒治疗慢性盆腔炎(CPID)的抗炎的免疫调节机制,为临床应用提供依据。方法：将60例慢性盆腔炎患者随机分为治疗组(服用盆腔炎颗粒)、对照组(服用盆炎净颗粒),观察治疗前后临床症状、体征的改善情况。以Wistar雌性大鼠为实验对象,采用混合细菌加机械损伤方法,制备慢性盆腔炎动物模型。将65只大鼠随机分为7组,药物干预后,检测各组大鼠血清的炎症细胞因子白介素-8(IL-8)、白介素-10(IL-10)；大鼠子宫形态学观察后,检测各组大鼠子宫组织核因子κB(NF-κB)及核因子抑制蛋白(IκB)的表达。结果：临床观察结果显示,治疗组与对照组综合临床疗效的愈显率、总有效率比较有极显著性差异(P<0.01),治疗组疗效优于对照组；两组的中医证候疗效的愈显率、总有效率比较,均有极显著性差异(P<0.01),治疗组疗效优于对照组。治疗后两组患者的综合积分、中医症状积分、局部体征积分比较均有显著性差异(P<0.05),治疗组明显优于对照组。动物实验研究显示慢性盆腔炎模型大鼠血清前炎症细胞因子IL-8水平较正常组大鼠升高,抗炎症细胞因子IL-10水平较正常组大鼠降低,子宫组织中的相关免疫分子NF-κB、IκB表达水平均较正常组升高,有极显著性差异(P<0.01)。药物干预后,各治疗组大鼠血清前炎症细胞因子水平下降,抗炎症细胞因子水平升高；各治疗组大鼠子宫组织中NF-κB、IκB的表达均较模型组降低(P<0.05或P<0.01)。结论：盆腔炎颗粒治疗血瘀兼肾虚型慢性盆腔炎有较好的临床疗效,通过对大鼠血清、子宫组织的炎症细胞因子和核因子表达的调节,恢复机体免疫平衡,有效抑制盆腔炎模型大鼠炎症。盆腔炎颗粒调节机体免疫平衡的可能机制是通过调节炎症细胞因子水平和调节核因子的活化从而缓解或消除慢性炎症反应。更多还原

【Abstract】 Objective:To explore the immunoregulation mechanism of the treatment of PenQiangyan Granule on the rats with chronic pelvic inflammatory disease(CPID) by observing the clinic study of Granule on treating chronic pelvic inflammatory Disease (CPID)of blood stagnate and deficiency of the kidney and the changes of inflammatory cytokines and neuclear factor expression in serum or uterine tissue of CPID model rats,and provide evidences for its clinical application.Method:60 cases of chronic pelvic inflammatory disease were divided into two groups randomly:Pen Qiangyan Granule treatment group and Pen Yanjing Granule control group, each group of 30 examples. Female Wistar rats were used and the CPID model was established with mixed bacteria injection combined with mechanic injury. Sixty-five rats were randomly divided into seven groups. After the histomorphological changes of the rats’ uteri were observed,we assayed the concentration of pro-inflammatory cytokines IL-8 and anti-inflammatory cytokines IL-10 in serum of rats in each group and detected the expression of the following indices in rats’ uterine tissue:neuclear factor-kappaB(NF-κB) and inhibitor of nuclear factor-kappaB(IκB).Result:The total effective rate and the recovery rate of the clinical curative effect and traditional Chinese medicine symptom curative effect of the treatment group and the control group are significantly different(P<0.01), stating that the treat group’s curative effect is superior to contrasting group.After treatment by Pen Qiangyan Granule, two groups of medicines can imporve patinet’s comprehensive points,traditional Chinese medicine symptom points and some body to solicit points, there are a significant difference(P<0.05), state that the treat group’s curative effect is superior to contrasting group.The serous levels of pro-inflammatory cytokines (IL-8) level in model group are significantly higher than those in normal group(P<0.01);the serous levels of anti-inflammatory cytokines (IL-10) in model group are significantly lower than those in normal group. The expression of NF-κB and IκB are all significantly increased than those in normal group. After treatment, the pro-inflammatory cytokine levels are decreased while the anti-inflammatory cytokine levels are elevated. The expression of neuclear factor-kappaB(NF-κB) and inhibitor of nuclear factor-kappaB(IκB) in the uterine tissue of model group is significantly decreased(P<0.01).Conclusions:Pen Qiangyan Granule has effective clinical result in the treatment of Chronic Pelvic Inflammatory Disease with blood stasis asthenia of kidney. Pen Qiangyan Granule could adjust levels of the inflammatory cytokines and neuclear factor expression, thus restore the immune balance effectively so as to inhibit inflammation. The mechanism might be that Pen Qiangyan Granule could regulate the levels of inflammatory cytokines and the activation of NF-κB,and relief Inflammatory reaction.更多还原