【作者】 刘文娥；

【导师】 尤昭玲；

【作者基本信息】 湖南中医学院 ， 中医妇科学， 2004， 硕士

【摘要】 目的：了解炎症所致异常出血Rhesus猴的子宫内膜形态学的改变，以及三七复方成分对炎症子宫内膜形态学的影响，从而阐释三七化瘀止血的作用机制，为临床治疗炎症所致异常子宫出血提供实验依据。 方法：将Rhesus猴随机分为3组，对照组、治疗组及空白组，将大肠埃希菌、金黄色葡萄球菌及消化链球菌以1∶1∶3的比例混合后在Rhesus猴的月经期后期注入治疗组、对照组子宫腔内，5天后取宫腔冲洗液证实宫内有接种细菌生长，继而观察月经期量的改变，确定月经改变后，治疗组以复方三七成分灌胃治疗，对照组给予等量生理盐水，3个疗程后，在预测下一次月经来潮前一天切取三组猴的子宫内膜，固定后分别置电镜及光镜下观察。 结果：电镜下空白组见子宫内膜间质细胞结构正常，螺旋动脉平滑肌细胞排列规则，内皮细胞结构完整。对照组间质内可见大量中性粒细胞浸润，腺上皮基底部胞浆水肿，螺旋动脉扩张，内皮细胞线粒体广泛空泡样变，管腔内见淤滞的红细胞。治疗组间质细胞有少量中性粒细胞，螺旋动脉部分内皮细胞线粒体有空泡样变。 光镜下：对照组为慢性子宫内膜炎的改变，表现为内膜上皮坏死，间质炎性细胞增多明显，以中性粒细胞为主，间质出血严重，表浅微血管、静脉窦扩张明显，螺旋动脉扩张较明显，特别是在扩张的，大量炎性分泌物的腺体周围，其内皮细胞和平滑肌细胞变性严重，结构模糊，界限不清，平滑月ILi田胞排列紊乱。空白组为正常行经前期图像，螺旋动脉强烈收缩，内皮细胞无变性。治疗组间质少量炎性细胞浸润， I有少量出血，螺旋动脉较对照组管径要小，但较空白组管径要大，螺旋动脉平滑肌细胞排歹l}规则。结论:上述实验结果表明，炎症导致子宫内膜螺旋动脉发生损伤从而引起异常出血，而复方三七成分可以促进螺旋动脉的修复和收缩从而达到止血的作用。更多还原

【Abstract】 Objective: By studying the changes of rhesus monkey’s endomitrial histomorphology with abnormal uterine bleeding caused by endomitritis and the therapy effect of compound utility components of sanchi, discuss the mechanism of action in Huayuzhixue of sanchi, and give help for clinical therapy of inflammatory menorrhagia.Methods: 9 cases of female rhesus monkey with normal menses were divided into three groups, including Chinese medicine group(3 cases), model group(3 cases) and normal control group(3 cases). Injected the mixed bacteria to the two group(mcluding Chinese medicine group and the model group) rhesus monkey’s uterus to induce endomitritis. The mixed bacteria was colibacillus, staphylococcus aureus and streptobacillus. It’s proportion was 1:1:3. Five day’s later, bacteria cultured to indicate there was bacteria growing in the uterus. Then observed the menstruation change. Bred with compound utility components of sanchi to the Chinese medicine group two days before the next menstrual cycle for seven days. After three menstrual cycles’ therapy, cut all rhesus monkeys’ uterus within 24 hours prior to their fourth menstrual cycle. Observed the changes of uterine histomorphology under light and electron microscope.Result: (1) Contrasted with normal control group, model group was menorrhagia and the menstrual period was long, Chinese medicine group was better than the model group. (2)Under electron microscope model group’s endomitrium was found not only in flammatory cells infiltrate and endothelial cells degenerate and edema, but glandular epithelium cytoplasm edema was well as endothelial spiral uterioles cell of edema and vacuolate, Chinese medicine group’s endomitrium was found only few inflammatory cells infiltrate and few endothelial cells degenerate and edema.(3)Under light microscope, model group’s endomitrium was found not only inflammatory cells infiltrate and bleeding in the stroma, endometrium epithelium necrosis superficial micrangium and venous sinus dilatation, but spiral arteriolar lumen was obvious dilatation especially around the gland dilatated and filled with inflammatory exudates. the Chinese medicine group’s endomitrium was found few inflammatory cell infiltrate and hyporrhe in the stroma, spiral arteriolar luman was subdilatation.Conclusions: All above suggested that inflammation cause the spiral arteriolar lumen deletation and degenerate which result in endomitrium bleeding. Compound components of sanchi can decompress in flammation, relieve degenerate and enhance the spiral arteriolar lumens’ contraction to hemostasis.更多还原