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ObjectiveTo explore the possible mechanisms of Shoutai Wan (寿胎丸) in treating recurrent miscarriage (RSA) from the perspective of immune tolerance under the acidic microenvironment at the maternal-fetal interface. MethodsFemale CBA/J mice were randomly divided into normal group, model group, progesterone group, and Shoutai Wan group, with 15 mice in each group. The mice in the normal group and model group were given 0.2 ml distilled water by gavage each day, the Shoutai Wan group given Shoutai Wan decoction 0.15 g/(10 g·d) by gavage, the progesterone group given progesterone tablets 0.44 mg/(10 g·d) by gavage. After gavage for 14 days, the mice were cohabited. Female CBA/J mice in the normal group were mated with male BALB/c mice at a ratio of 2∶1, and female CBA/J mice in the other groups were mated with male DBA/2 mice at a ratio of 2∶1 to establish the RSA mouse model. Vaginal smears were taken from the female mice the next morning, and the appearance of a large number of spermatozoa and the presence of a vaginal plug were considered as the first day of pregnancy. After the appearance of the plug, the mice were continued to be administered according to the previous method until the 10th day of pregnancy. On the 10th day of pregnancy, maternal-fetal interface tissues were collected from each group of mice, and lactate dehydrogenase colorimetric method was used to detect lactate (LA) content; qPCR method and Western blot method were used to detect the expression of immune-related factors interleukin-4 (IL-4), interferon-gamma (IFN-γ), transforming growth factor beta 1 (TGF-β1), and forkhead box protein 3 (Foxp3) mRNA and protein; flow cytometry was used to detect the numbers of helper T lymphocyte 1 (Th1), helper T lymphocyte 2 (Th2), regulatory T cell (Treg), classical macrophage (M1), and alternative macrophage (M2). The bivariate Pearson test was used to analyze the correlation between LA content and the numbers of Th1, Th2, Treg, M1, and M2 cells, as well as the correlation between LA content and the expression of IL-4, IFN-γ, TGF-β1, Foxp3 protein, and mRNA. ResultsOn the 10th day of pregnancy, compared with the normal group, the LA content decreased in the model group, and the expression of IL-4, TGF-β1, Foxp3 protein and mRNA in the maternal-fetal interface tissues decreased, while the expression of IFN-γ protein and mRNA increased. The numbers of Th1 and M1 cells increased, while the numbers of Th2, Treg, and M2 cells decreased (P<0.05 or P<0.01). Compared with the model group, the LA content increased in the Shoutai Wan group and progesterone group. The expression of IL-4, TGF-β1, Foxp3 protein and mRNA in the maternal-fetal interface tissues increased, while the expression of IFN-γ protein and mRNA decreased. The numbers of Th1 and M1 cells decreased, while the numbers of Th2, Treg, and M2 cells increased (P<0.05 or P<0.01). The LA content was positively correlated with the numbers of Th2, Treg, and M2 cells, and the expression of IL-4, TGF-β1, Foxp3 protein, and mRNA (P<0.05 or P<0.01); the LA content was negatively correlated with the numbers of Th1, M1 cells, and the expression of IFN-γ protein and mRNA (P<0.05 or P<0.01). ConclusionShoutai Wan may improve immune tolerance by regulating the expression of immune-related factors in the acidic microenvironment at the maternal-fetal interface of RSA model mice, thereby exerting its role in preventing miscarriage.
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Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine (TCM). The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology, Western medicine obstetrics and gynecology, and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion, the experts concluded that chromosome, endocrine, and immune abnormalities were the key factors for the occurrence of threatened abortion, and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion, TCM has advantages in preventing miscarriages, alleviating clinical symptoms and TCM syndromes, relieving anxiety, regulating reproductive endocrine and immune abnormalities, personalized and diversified treatment, enhancing efficiency and reducing toxicity, and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.
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Objective To explore the effects ofCangfu Congxian Decoction on the mRNA expression of IGF-1R in human mural granulosa cells;To explore the action mechanism for the treatment of polycystic ovary syndrome (PCOS) patients.Methods Totally 48 patients undergoing IVF-ET were randomly divided into treatment group and control group by random number table, 24 cases in each group. Patients in the control group accepted GnRHa/FSH/hCG stimulation, while the treatment group tookCangfu Congxian Decoction orally on the basic treatment of the control group. Serum E2, LH, and P concentration on HCG injection day, number of ovum, high quality embryo rate and clinical pregnancy rate were evaluated. The mRNA expression of IGF-1R on mural granulosa cells in the mature follicle was detected by real-time PCR.Results Compared with the control group, there was no significant difference in serum E2, LH, and P concentration on HCG injection day of treatment group (P>0.05), while the treatment group had higher high quality embryo rate than that of the control group (P0.05). The mRNA expression of IGF-1R on granulosa cells in treatment group was significantly higher than the control group (P<0.01).Conclusion The mechanism ofCangfu Congxian Decoction for treating PCOS is up-regulating the mRNA expression of IGF-1R in mural granulosa cells and increasing high quality embryo rate.
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Objective To study the relationship between the asthenia TCM syndromes in embryonic development stops and the level of zinc, iron, copper, magnesium, phosphorus, calcium in serum, and provide thoughts for assisting reproduction and preventing miscarriage. Methods Totally 100 patients of embryonic development stops were selected randomly (6-10 weeks gestation) to be the investigated group, with other 100 cases of live fetus as the control group. The contents of trace elements in serum were detected with atomic absorption spectrometry. Results The levels of trace elements in embryonic development stops patients were generally lower than the control group. The serum iron in patients with spleen deficiency syndrome, and serum zinc and iron in patients with kidney deficiency syndrome were significant lower (P<0.05). Conclusion The contents of trace elements in serum have relationships with asthenia TCM syndromes in embryonic development stops. It should be paid attention to supplementing trace elements during the gestation period. For patients with deficiency of kidney and spleen, the supplement of zinc and iron should be given greater prominence.
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Objective To study the effect and its mechanism of Modified Wenjing Decoction(Decoction for warming channels)on vasomotion in patients with menstrual disease of blood stasis due to cold accumulation.Methods The 50 patients of emmeniopathy with blood stasis due to cold accumulation were successively treated with Modified Wenjing Decoction for three menstrual cycles.The therapeutic effect and changes of nitrous oxide(NO),endothelin(ET),thromboxane B2(TXB2),6 ketone prostaglandin F1?(6-keto-PGF1?)of menstrual blood,reproductive hormones estradiol(E2)and progesterone(P)before and after treatment were observed.Results Of the 50 patients,19(38.0%)were short-term cured,24(48.0%)effective,and 7(14.0%)ineffective.After treatment,the levels of menstrual blood ET and TXB2 were decreased significantly(P
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Objective Through the statistical analysis on literature on asthenia cold syndrome in recent ten years,to comprehend the present situation of studies on the feature and objectivization of symptom distribution of asthenia cold syndrome.Methods Collect literature on asthenia cold syndrome from the periodicals of traditional Chinese medicine and integrated traditional and western medicine from the year 1996 to 2006.The described features and objective indices of symptom distribution of this syndrome were systematically analyzed and summarized.Results In the literature,the diagnostic criteria of asthenia cold syndrome were made mainly by the authors themselves,few referring to others',being different in the descriptions of symptom distribution.The researches on objectivization indices were scattered,most of which took the single or multiple index(es) as subject(s).Conclusion Cold limbs,tiredness,aversion to cold,and loose stools are possibly significant in the diagnosis of asthenia cold syndrome.The way of the studies on diagnostic criteria and its objectivization of asthenia cold syndrome need to be improved.
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AIM: To observe the treatment effectiveness of menopathy of excessive-cold syndrome by Modified Wenjing Decoction, and to explore the relationship among excessive-cold syndrome of menopathy and 5-HT,?-EP, and reproduetive hormones. METHODS: Sixty patients with menopathy of excess-cold syndrome were successively treated with Modified Wenjing Decoction for three menstrual cycles. The efficacy and the changes of serum 5-HT, Bendorphine(?-EP) and reproductive hormones before and after treatment were observed. RESULTS: 22 patients(36.7%) were short-term therapeutic effect, 28 patients(45.7%) were effective and 10 patients(17.6%) were ineffective. After treatment, the levels of serum FSH、LH、E_2、?-EP were increased significantly (P
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0.05). The serum levels of E_2 in patient group were significantly lower than those of the regular menses group (P0.05). The serum levels of E_2 were significantly higher in patient group after treatment (P0.05). The menstrual blood levels of NO, E_2 were significantly higher, and ET were significantly higher, respectively, in patient group after treatment (P