目的 探讨内异方对子宫内膜异位症(endometriosis, EM)大鼠改善作用和潜在的机制。方法 采用自体组织移植法建立大鼠子宫内膜异位症模型。随机分为假手术组、模型组、内异方高剂量组、内异方中剂量组、内异方低剂量组。采用HE染色观察异位内膜的病理组织结构；髓过氧化物酶(myeloperoxidase, MPO)检测试剂盒检测异位内膜组织MPO活性；qRT-PCR检测异位内膜组织中缺氧诱导因子-1α (hypoxia inducible factor-1α , HIF-1α)和环氧合酶-2(cyclooxygenase-2, COX-2) mRNA水平；ELISA法检测腹腔液和组织白细胞介素-6(interleukin-6, IL-6)和白细胞介素-8(interleukin-8, IL-8)水平；Western blot检测组织中p-NF-κB p65、COX-2、HIF-1α蛋白表达水平。结果 与模型组相比，采用内异方给药后，异位内膜组织损伤显著降低，MPO活性下降，IL-6和IL-8分泌降低，NF-κB信号通路和HIF-1α信号通路受到抑制。结论 内异方可能通过抑制NF-κB/COX-2信号通路和HIF-1α/COX-2信号通路显著改善子宫内膜异位症缺氧、炎性微环境。

Objective To explore the mechanisms of the beneficial effect of Neiyi decoction on endometriosis in rats.Methods The model of endometriosis in rats was established by autotransplantation.Then all the rats were randomly divided into sham operation group, model group, Neiyi decoction high-dose group, Neiyi decoction medium-dose group, Neiyi decoction low-dose group. Histological damages, MPO activities, the mRNA levels of HIF-1α and COX-2 and the levels of IL-6 and IL-8 of ectopic endometrial tissues were evaluated by HE staining, MPO assay, qRT-PCR and ELISA assay, respectively. Further, the protein expressions of p-NF-κB p65, COX-2 and HIF-1α were determined by Western blot.Results Compared with the model group, Neiyi decoction markedly alleviated histological damages, significantly reduced MPO activities, significantly reduced secretions of IL-6 and IL-8, significantly inhibited the activation of NF-κB and HIF-1α.Conclusions Neiyi decoction can significantly suppress the hypoxia and inflammatory microenvironment of endometriosis may by inhibiting NF-κB/COX-2 and HIF-1α/COX-2 signal pathway.