Objective: To observe the effect of moxibustion at "Shenshu"(BL23) and "Guanyuan" (CV4) on decidua-lization and uterine natural killer cells in rats with thin endometrium, so as to explore its mechanism underlying promotion of embryo implantation.
Methods: Female SD rats were randomly divided into normal control, model and wheat-grain-sized moxa cone moxibustion (moxibustion) groups, with 14 rats in each group. The thin endometrium model was established by bilaterally intrauterine perfusion of 95% ethanol (first) and saline (later) during estrus. For rats of the moxibustion group, the ignited wheat-grain-sized moxa cones were applied to bilateral BL23 and CV4, with 7 moxa cones for each acupoint, once a day, continuously for 3 estrous cycles. Then the male and female rats were raised in the same cage. On the 5th day of pregnancy, the rats were killed under anesthesia and the uterus tissue was collected for measuring the endometrium thickness and the numbers of blood vessels and glands after H.E. staining, detecting the levels of the proportion of natural killer cells with flow cytometry. After the uterine natural killer cells were sorted by the immunomagnetic bead method, the expression levels of insulin-like growth factor binding protein (IGFBP-1), interferon(INF-γ), tumor necrosis factor(TNF-α), transforming growth factor(TGF-β), interleukin 4(IL-4) and IL-10 mRNAs were detected by using fluorescence quantitative real-time PCR.
Results: Compared with the normal control group, the endometrium thickness, number of glands and blood vessels, and the expression levels of IGFBP-1, TGF-β, IL-4 and IL-10 mRNAs were significantly decreased (P<0.01, P<0.05), while the expression levels of IFN-γ and TNF-α mRNAs were significantly increased (P<0.05，P<0.01) in the model group. In contrast to the model group, the endometrium thickness, number of glands and blood vessels, and the expression levels of IGFBP-1, TGF-β, IL-4 and IL-10 mRNAs were significantly increased (P<0.05, P<0.01), while the expression levels of IFN-γ and TNF-α mRNAs were considerably down-regulated (P<0.05, P<0.01) in the moxibustion group. No significant difference was found among the 3 groups in the proportion of natural killer cells in the endometrium (P>0.05).
Conclusion: Moxibustion of BL23 and CV4 with wheat-grain-sized moxa cones can improve the degree of thin endometrial decidualization, which may be related with its functions in regulating the levels of cytokines secreted from natural killer cells in the uterus.
目的：观察麦粒灸“肾俞”“关元”对薄型子宫内膜大鼠子宫内膜蜕膜化及子宫自然杀伤细胞的影响，探讨麦粒灸促进薄型子宫内膜大鼠胚胎着床的作用机制。方法：雌性SD大鼠按随机数字表法分为正常组、模型组及麦粒灸组，每组14只。于大鼠动情期予95%乙醇宫腔灌注建立薄型子宫内膜模型。麦粒灸组于造模次日起予麦粒灸“肾俞”“关元”治疗，每穴每次灸7壮，每日1次，治疗3个动情周期后合笼。于妊娠第5日取材，HE染色法观察子宫内膜形态，测量各组大鼠子宫内膜厚度、血管及腺体数；流式细胞术检测子宫自然杀伤细胞数量；免疫磁珠法分选子宫自然杀伤细胞后，荧光定量PCR法检测子宫自然杀伤细胞中胰岛素样生长因子结合蛋白(IGFBP-1)、γ干扰素(IFN-γ)、肿瘤坏死因子(TNF-α)、转化生长因子(TGF-β)、白细胞介素(IL-4、IL-10)mRNA的表达。结果：与正常组比较，模型组大鼠子宫内膜厚度变薄(P<0.01)，腺体数及血管数均减少(P<0.01)，子宫内膜IGFBP-1、TGF-β、IL-4、IL-10 mRNA表达降低(P<0.01，P<0.05)，子宫内膜IFN-γ、TNF-α mRNA表达升高(P<0.05，P<0.01)。与模型组比较，麦粒灸组子宫内膜厚度、血管及腺体数均增加(P<0.01)，子宫内膜IGFBP-1、TGF-β、IL-4及IL-10 mRNA表达升高(P<0.05，P<0.01)，子宫内膜IFN-γ、TNF-α mRNA表达明显降低(P<0.05，P<0.01)。各组大鼠子宫内膜自然杀伤细胞数量差异无统计学意义(P>0.05)。结论：麦粒灸可改善薄型子宫内膜蜕膜化程度，其机制可能与调节子宫自然杀伤细胞分泌的细胞因子有关。.
Keywords: Decidualization; Natural killer cell; Thin endometrium; Wheat-grain-sized moxa cone moxibustion.