目的：探讨补肾活血外治法对肾虚血瘀模型大鼠子宫内膜组织形态学的影响。方法：采用阴道涂片法选取处于动情前期普通级健康未交配雌性SD大鼠50只，随机分为空白组、模型组、补肾活血方高、低剂量组、五子组。除空白组外，其余各组采用羟基脲灌胃建造肾虚模型，与此同时，空白组、模型组给予蒸馏水灌肠，高、低剂量组分别给予高、低剂量补肾活血方药灌肠，五子组给予五子衍宗丸灌胃。妊娠第4天，各组大鼠均于末次给药后1 h，尾静脉快速推注10%的高分子右旋糖苷造成血瘀模型后处死，取子宫组织切片苏木精-伊红（HE）染色观察。结果：①模型组子宫内膜被覆上皮厚度低于空白组（P<0.05）；补肾活血方药高、低剂量组和五子组子宫内膜被覆上皮厚度与模型组相比有显著性差异（P<0.01）。②模型组腺体数、腺体面积总和及最大直径/最小直径明显低于空白组（P<0.05或P<0.01）；形状因子最接近“1”，与空白组相比有显著性差异（P<0.01）。补肾活血方高、低剂量组腺体数及腺腔面积总和较模型组有不同程度的增多（P<0.05或P<0.01）。五子组腺体数、腺腔面积总和、形状因子及最大直径/最小直径与模型组相比有显著性差异（P<0.05或P<0.01）。③模型组间质细胞核面积总和、间质细胞核积分光密度及间质血管数均低于空白组（P<0.01）；补肾活血方高、低剂量组间质细胞核面积总和、间质细胞核积分光密度和间质血管数较模型组均明显增高（P<0.05或P<0.01）；五子组间质细胞核面积总和及间质细胞核积分光密度明显高于模型组（P<0.01）。结论：外用补肾活血法能够有效改善肾虚血瘀模型大鼠子宫内膜组织形态，促使子宫内膜腺体与间质同步发育，从而发挥改善子宫内膜容受性的作用。

This study aimed to analyze the effect of the external method of tonifying kidney and promoting blood circulation on endometrial morphology of rats with kidney deficiency and blood stasis model. A total of 50 normal healthy unmated female SD rats of proestrus were selected with vaginal smear. Rats were randomly divided into the blank group, model group, high dose group and low dose group with the prescription of tonifying kidney and promoting blood circulation and the Wu-Zi (WZ) group. Except the blank group, intragastric administration of hydroxyurea was given to other group to establish the kidney deficiency model. Meanwhile, clyster of distilled water was given to the blank group and the model group. And clyster of high dose and low dose prescription of tonifying kidney and promoting blood circulation was given to the high dose and low dose group, respectively. The intragastric administrations of Wu-Zi Yan-Zong (WZYZ) pills were given to the Wu-Zi (WZ) group. On the 4th day of pregnancy, 10% of the macromolecule dextran was quickly injected to the caudal vein to induce blood stasis model 1 hour after the last medication administration. The uterus tissue section was observed by HE dyeing. The results showed that the thickness of covering epithelium of endometrium in the model group was lower than the blank group (P < 0.05). There were significant differences on the thickness of covering epithelium of endometrium in the high dose group and low dose group with the prescription of tonifying kidney and promoting blood circulation, the WZ group and the model group (P < 0.01). The sum of gland number and gland area as well as the maximum diameter / minimum diameter of the model group was significantly lower than that of the blank group (P < 0.05, or P < 0.01). The shape factor was the closest to “1”, which had significant difference compared with the blank group (P < 0.01). Compared with the model group, the sum of gland number and glandular lumen of the high dose and low dose group were increased at different levels (P < 0.05, or P < 0.01). The sum of gland number, glandular lumen area, shape factor, and maximum diameter / minimum diameter of WZ group had significant difference compared with the model group (P < 0.05, or P < 0.01). The sum of interstitial cells’ nucleus area, integral optical density of interstitial cells’ nucleus and number of interstitial blood vessels in the high dose and low dose group were significantly higher compared to the model group (P < 0.05, or P < 0.01). The sum of interstitial cells’ nucleus area and the integral optical density of interstitial cells’ nucleus in the WZ group were obviously higher than the model group (P < 0.01). It was concluded that the external method of tonifying kidney and promoting blood circulation can effectively improve the endometrial morphology of kidney-deficiency and blood-stasis rat model, promote the synchronous development of endometrial gland and stroma, in order to play a role to improve the endometrial receptivity.

四川省教育厅重点项目（13ZA0284）：基于细胞外基质分子网络研究补肾活血法改善子宫内膜容受性的作用机理，负责人：曾倩；成都市科技局攻关项目（H2013050）：助孕1号方经直肠给药对肾虚血瘀模型大鼠生殖功能的调控机制研究，负责人：曾倩；四川省教育厅一般项目（14ZB0080）：助孕1号方灌肠对肾虚血瘀模型大鼠生殖功能的调控机制研究，负责人：邓琳雯。