宫清颗粒诱导药物流产人早孕绒毛、蜕膜细胞凋亡基因调控的探究.pdfVIP

提 要 目的：探讨宫清颗粒对米非司酮药物流产者人早孕绒毛及蜕膜细胞凋亡及凋亡基 因表达的影响，从而从细胞凋亡基因调控角度探讨该方防治药物流产后出血的作用机 制。 方法：将 180 例药流对象随机分为治疗组（药流同时加服宫清颗粒）、对照组（药 流同时加服茜芷胶囊）、空白组（仅服药流药），观察药物流产临床疗效，收集绒毛及 蜕膜组织，并与 60 例人工流产者相对照，透射电镜分别对绒毛及蜕膜组织进行细胞 凋亡的形态学定性观察，Annexin Ⅴ联合 PI 染色法进行细胞凋亡的定量检测，并用 原位杂交和免疫组化法检测人早孕绒毛及蜕膜细胞凋亡的相关基因：bcl-2/bax 基因、 wtP53 基因、c -myc 基因表达。 结果：治疗组在孕囊排出时间、药流后阴道流血量等方面优于对照组和空白组， 透射电镜及 Annexin Ⅴ联合PI 染色法检测绒毛及蜕膜细胞凋亡发现治疗组凋亡现象 更明显（P0.05 ）。与对照组、空白组及人流组比较，治疗组绒毛和蜕膜凋亡基因： bax 、baxmRNA 、wtP53 、c-myc 表达明显增强（P0.05 ），bcl-2 、bcl-2mRNA 表达明 显减弱（P0.05 ）。 结论：宫清颗粒可通过提高药物流产者绒毛及蜕膜凋亡基因bax 基因、wtP53 基 因、c-myc 基因的表达，抑制抑凋亡基因 bcl-2 的表达，提高绒毛及蜕膜细胞凋亡率， 减少药流后出血率，提高药流成功率。 关键词 宫清颗粒；药物流产；细胞凋亡；基因调控 Study on the Inducement Mechanism of Gongqing Granula Concerning gene regulation in Cell Apoptosis of Human Villi and Decidua in Medical Abortion Speciality: Family Planning Complication ，Gynecology of TCM Author: Zhang Lijuan Tutor: Prof. Liu Rui-Fen Abstract Objective: To investigate the effect of Gongqing Granula combined with Mifepristone on the human chorionic villi and decidual cells’ apoptosis, as well as the expression of apoptotic gene in early pregnancy .To explore the mechanism of this prescription in preventing and treating bleeding after medical abortion. Methods: 180 early pregnancy women who wanted to terminate voluntarily their pregnancy were divided randomly into 3 groups: the test group (Gongqing granula combined with Mifepristone) ，the control group( Qianzhi capsule combined with Mifepristone), the empty group(Mifepristone) ,compared to artificial abortion group. The clinical effect of medical abortion were observed and chorionic villis and decidual tissues were collected. Transmission microscope was used to give the chorion