目的:研究桂枝茯苓丸联合促性腺激素释放激素类似物(GnRH-a)对子宫内膜异位病灶内细胞增殖、侵袭及MEK/ERK通路的影响。方法:选择在本院诊断为子宫内膜异位症的患者作为研究对象并随机分为两组,观察组术前接受桂枝茯苓丸联合GnRH类似物治疗,对照组术前接受GnRH类似物单药治疗。手术切除后收集子宫内膜异位病灶,测定增殖及侵袭相关基因的mRNA表达量以及MEK/ERK通路分子的蛋白表达量。结果:观察组子宫内膜异位病灶内Id-1、Sema3A、c-IAP1、OPN、uPA的mRNA表达量以及p-MEK、p-EKR1/2、MMP2的蛋白表达量显著低于对照组,Bak、Smac、PAI-1、TIMP1、TIMP2的mRNA表达量以及caspase-3的蛋白表达量显著高于对照组。结论:桂枝茯苓丸联合GnRH类似物能够抑制子宫内膜异位病灶内细胞的增殖、侵袭及MEK/ERK通路的激活。

Objective: To study the effect of Guizhi Fuling Pill combined with gonadotropin-releasing hormone analog (GnRH-a) on cell proliferation and invasion as well as MEK/ERK pathway in endometriosis lesions. Methods: Patients who were diagnosed with endometriosis in Bazhong Hospital of Traditional Chinese Medicine between November 2014 and March 2017 were selected as the research subjects and randomly divided into two groups, observation group received preoperative Guizhi Fuling Pill combined with GnRH analog therapy, and control group received preoperative GnRH analog monotherapy. After surgical resection, the endometriosis lesion was collected to determine the mRNA expression of proliferation and invasion-related genes as well as the protein expression of MEK/ERK pathway molecules. Results:Id-1, Sema3A, c-IAP1, OPN and uPA mRNA expression as well as p-MEK, p-EKR1/2, caspase-3 and MMP2 protein expression in endometriosis lesion of observation group were significantly lower than those of control group while Bak, Smac, PAI-1, TIMP1 and TIMP2 mRNA expression as well as caspase-3 protein expression were significantly higher than those of control group. Conclusion: Guizhi Fuling Pill combined with GnRH analog can inhibit the cell proliferation and invasion as well as the MEK/ERK pathway activation in endometriosis lesions.

R711.71

巴中市科技成果立项课题(2013004)