国际妇产科学杂志

国际妇产科学杂志 ›› 2015, Vol. 42 ›› Issue (2): 197-200.

• 论著 • 上一篇    下一篇

葛根在盆底功能障碍性疾病治疗中的作用及其机制

严斌，马骏，刘大庆，杨蓉，马庆良，王育   

  1. 200127 上海市交通大学医学院附属仁济医院（严斌，马骏，马庆良，王育）；上海市第七人民医院（刘大庆，杨蓉）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-04-15 发布日期:2015-04-15
  • 通讯作者: 马庆良

Effect and Mechanism of Pueraria in Women with Pelvic Floor Dysfunction

YAN Bin，MA Jun，LIU Da-qing，YANG Rong，MA Qing-liang，WANG Yu   

  1. Shanghai Jiao Tong University School of Medicine，Renji Hospital，Shanghai 200127，China（YAN Bin，MA Jun，MA Qing-liang，WANG Yu）；Shanghai Seventh People′s Hospital，Shanghai 200137，China（LIU Da-qing，YANG Rong）
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-04-15 Online:2015-04-15
  • Contact: MA Qing-liang

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摘要： 目的：研究葛根在盆底韧带组织中对Ⅰ型、Ⅲ型胶原蛋白及弹性蛋白表达的影响，探讨其在盆底功能障碍性疾病（pelvic floor dysfunction，PFD）治疗中的作用及可能机制。方法：选择2010年12月—2012年11月绝经后行阴式全子宫切除术的PFD患者60例。根据盆腔器官脱垂定量分度法（POP-Q）评分，Ⅰ~Ⅱ度患者为轻度者（30例），Ⅲ~Ⅳ度患者为重度者（30例）。将轻度者和重度者随机分配，术前给予葛根治疗60 d者为用药组（30例），其中Ⅰ~Ⅱ度15例，Ⅲ~Ⅳ度15例；未使用任何外源性雌激素患者为对照组（30例），其中Ⅰ~Ⅱ度15例，Ⅲ~Ⅳ度15例。术中取宫骶韧带组织，行苏木素-伊红（HE）染色及Weigert染色在光镜下观察比较胶原蛋白及弹性蛋白的形态，再采用免疫组化二步法和图像分析检测Ⅰ型、Ⅲ型胶原蛋白及弹性蛋白的表达情况。结果：①韧带组织在光镜下HE染色及Weigert染色可见胶原蛋白及弹性蛋白表达，且用药组比对照组两者染色均更深、更均匀，数量更丰富，分布更密集。②对照组中轻度者的韧带组织中Ⅰ型、Ⅲ型胶原蛋白及弹性蛋白的表达率均高于重度者（P＜0.01）。③用药组中轻度者和重度者的韧带组织中Ⅰ型、Ⅲ型胶原蛋白及弹性蛋白的表达率均高于对照组（P＜0.01）。结论：葛根可通过增加盆底组织细胞外基质中作为主要成分的胶原蛋白和弹性蛋白的含量，增强盆底结缔组织的强度，从而能改善PFD的症状，为葛根作为治疗PFD的有效药物提供了可能的理论依据。

关键词: 葛根素, 骨盆底, 生殖器疾病, 女（雌）性, 胶原, 弹性蛋白, 治疗, 盆底功能障碍性疾病

Abstract: Objective： By detecting collagenⅠ，collagenⅢ and elastin′s expression in pelvic ligament tissue，we can investigate the effect and possible mechanism of pueraria in women with pelvic floor dysfunction（PFD）. Methods：Select 60 menopause patients with PFD who had underwent vaginal hysterectomy from December 2010 to November 2012. Based on POP-Q score，30 patients in Ⅰ-Ⅱ degrees defined as mild group，30 patients in Ⅲ-Ⅳ degrees defined as severe group. 30 patients in the treatment group took pueraria in 60 days before the surgery including the 15 patients in Ⅰ-Ⅱ degrees and the rest in Ⅲ-Ⅳ degrees. The control group including 30 patients，15 cases in Ⅰ-Ⅱ degrees and 15 cases in Ⅲ-Ⅳ degrees，did not take any exogenous estrogen. We use HE staining to observe the form of collagen and Weigert staining to observe those of elastin. Then we use the immunohistochemical two-step method and image analysis to investigate the expression of collagen Ⅰ，collagen Ⅲ and elastin in uterosacral ligament tissue. Results：①Collagen and elastin are both widely expressed in uterosacral ligament tissue through HE and Weigert staining from light microscopy，and their staining expression in the treatment group are deeper and more even，the number are richer, and more intensive distribution than in the control group. ②In the control group，the expression of collagen Ⅰ，collagen Ⅲ and elastin in mild group ligament tissue are higher than those in the severe group（P＜0.01）. ③In the treatment group，the expression of collagen Ⅰ，collagen Ⅲ and elastin in mild or severe group ligament tissue are higher than those in the control group（P＜0.01）. Conclusions： The pueraria can increase the expression of collagen Ⅰ，collagen Ⅲ and elastin in the pelvic tissue，thereby enhancing the supportive effect of pelvic floor tissue which can relieve the symptoms of PFD. Puerarin as an effective drug for the treatment of PFD provides a possible theoretical basis.

Key words: Pueraria, Pelvic floor, Genital diseases, female, Collagen, Elastin, Pelvic floor dysfunction