【摘要】 目的 探讨补肾调和气血方对血瘀流产孕鼠早孕期子宫螺旋动脉重铸的影响及其机制。方法 将妊娠SD大鼠随机分为正常组、模型组、阿司匹林组和补肾调和气血方低、中、高剂量组，每组10只。正常组和模型组自妊娠第1天起给予蒸馏水灌胃，阿司匹林组给予6.75 mg/kg阿司匹林灌胃，补肾调和气血方低、中、高剂量组分别给予6.525 g/kg、13.05 g/kg、26.10 g/kg补肾调和气血方灌胃，均1次/d,连续11 d;在此过程中，模型组、阿司匹林组和补肾调和气血方各剂量组孕鼠每日皮下注射盐酸肾上腺素，于妊娠第8天给予米非司酮灌胃。实验结束后，检测各组孕鼠子宫动脉血流搏动指数(PI)、阻力指数(RI)、收缩峰与舒张期末期血流速比(S/D),计算各组孕鼠流产率，检测血清血管内皮生长因子(VEGF)和可溶性类fms酪氨酸激酶-1(sFlt-1)水平。结果模型组孕鼠子宫动脉PI、RI、S/D和流产率、血清sFlt-1水平均明显高于正常组(P均<0.05),血清VEGF水平明显低于正常组(P<0.05);补肾调和气血方组孕鼠子宫动脉PI、RI、S/D和流产率、血清sFlt-1水平均明显低于模型组(P均<0.05),血清VEGF水平均明显高于模型组(P均<0.05);阿司匹林组孕鼠子宫动脉PI、RI、S/D明显低于模型组(P均<0.05)。结论 补肾调和气血方可能通过提高VEGF水平、降低sFlt-1水平促进子宫血管重铸，从而降低子宫动脉血流阻力，改善宫腔血流灌注而对早孕期血瘀流产大鼠发挥保胎作用。更多还原

【Abstract】 Objective It is to explore the effect and mechanism of decoction for tonifying kidney and harmonizing qi and blood on uterine spiral artery recasting of abortion rats caused by blood stasis in early pregnancy. Methods The pregnant SD rats were randomly divided into normal group, model group, aspirin group, low dose, medium dose and the high dose groups of decoction for tonifying kidney and harmonizing qi and blood, with 10 rats in each group. Each group was treated respectively for 11 days from the 1st day of pregnancy: the normal group and the model group were given distilled water by gavage, the aspirin group was given aspirin solution 6.75 mg/kg by gavage, the low, medium and high dose group of decoction for tonifying kidney and harmonizing qi and blood were given decoction for tonifying kidney and harmonizing qi and blood 6.525 g/kg, 13.05 g/kg and 26.1 g/kg, respectively, all once per day, continuously treated for 11 days. Meanwhile, all the pregnant rats in the model group, aspirin group, and groups of decoction for tonifying kidney and harmonizing qi and blood were injected with epinephrine hydrochloride subcutaneously once a day from the 1st day of pregnancy until the 11 th day, and given mifepristone solution by gavage on the 8th day of pregnancy. At the end of the experiment, the uterine artery pulsatility index(PI), resistance index(RI), systolic phase/diastolic phase(S/D) of the rats in each group were detected, the abortion rate was calculated, and the levels of serum vascular endothelial growth factor(VEGF) and soluble fms-like tyrosine kinase-1(sFlt-1) were measured. Results The uterine artery PI, RI, S/D, abortion rate, and the level of serum sFlt-1 in the model group were significantly higher than those in the normal group(all P<0.05), while the level of serum VEGF was significantly lower than that in the normal group(P<0.05). The uterine artery PI, RI, S/D, abortion rate, and the level of serum sFlt-1 in every group of decoction for tonifying kidney and harmonizing qi and blood were significantly lower than those in the model group(all P<0.05), while the levels of serum VEGF were significantly higher than those in the model group(all P<0.05); only PI, RI, S/D, and abortion rate in the aspirin group were significantly lower than those in the model group(all P<0.05). Conclusion Decoction for tonifying kidney and harmonizing qi and blood may promote uterine vascular recasting by increasing the level of VEGF and reducing the level of sFlt-1, therefore reduces the resistance of uterine artery blood flow and improves the uterine blood perfusion, and ultimately increases the success rate of pregnancy in abortion rats caused by blood stasis in early pregnancy.更多还原