Research Article Understanding the Role of Gui-Zhi-Fu-Ling-Capsules (Chinese Medicine) for Treatment of Endometriosis in the Rat Model: Using NMR Based Metabolomics Jue Zhou , 1,2 Zhi-Ming Ding, 3 and Paul J. Hardiman 2 1 College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310018, China 2 Institute for Women’s Health, Medical School, University College London, London NW3 2PF, UK 3 Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China Correspondence should be addressed to Jue Zhou; juezhou2006@126.com Received 14 May 2018; Revised 8 September 2018; Accepted 3 December 2018; Published 19 December 2018 Academic Editor: Omer Kucuk Copyright © 2018 Jue Zhou et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te objective of this study is to identify the changes of metabolites in the rat endometriosis models treated with Gui-Zhi-Fu-Ling- capsules (GZFLC), a classic Chinese medicinal formula, and to explore the efects of GZFLC on the serum levels of transforming growth factor-1 (TGF-1) and the mRNA expression levels of vascular endothelial growth factor (VEGF) and glucose transporter 4 (GLUT-4) in the endometriotic tissues. Forty female Wistar rats were randomly divided into the sham-operation group (Normal group), Model group, Danazol group, and GZFLC group. Te serum levels of TGF-1 were measured using enzyme-linked immune- sorbent assay (ELISA). Te mRNA expression levels of VEGF and GLUT-4 in the endometriotic tissue of the rat endometriosis models were measured using real-time quantitative PCR. Te metabolites in urine were detected by 1 H NMR method. Eight identifed metabolites of the NMR resonance were involved in the glycolysis metabolism. Among the 8 metabolites, Lactate, Acetate, TMA, and Formate were downregulated with GZFLC. Citrate, TMAO, Taurine, and Hippurate were unregulated with GZFLC. Te serum levels of TGF-1 in the Danazol and GZFLC groups were signifcantly higher than those of Normal group and signifcantly lower than the Model group. GZFLC treatment signifcantly decreased the GLUT-4 and VEGF mRNA expression levels in the endometriotic tissues of the endometriosis rats (P < 0.05). GZFLC signifcantly decreased the GLUT-4 mRNA expression levels in rats of GZFLC group compared with Danazol group. It is through regulating the metabolites changes of glycolysis or gluconeogenesis that GZFLC signifcantly afected the expression levels of TGF-1, GLUT-4, and VEGF of the model rats with endometriosis. 1. Introduction Endometriosis is the most common gynecological disease, which is characterized by the growth of endometrial tissue at ectopic locations [1]. It is a chronic condition characterized by the presence of endometrial tissue outside the uterine cavity, most commonly on the pelvic peritoneum and ovaries [2, 3]. Endometriosis can result in substantial morbidity, including pelvic pain, multiple operations, and infertility [3]. Endome- trial tissue is characterized by an exaggerated infammatory environment around ectopic tissues [4, 5]. Endometriosis afects approximately 10% of women of reproductive age [3, 6]. About 30% of the patients are asymptomatic and the incidence of infertility among women sufering from endometriosis ranges from 30%-40% [6]. Increased peri- toneal fuids concentrations of cytokines that lead to the migration, proliferation, and activation of macrophages have been reported in patients with endometriosis [7, 8]. Surgery provides relief to women in pain, but symptoms recur in 75% of cases within 2 years [9]. Although surgical and hormonal treatment are ap- plied as the common interventions, the unpleasant side efects and high rates of relapse limited the range of these interventions [10, 11]. Some traditional Chinese medicinal herbs, such as Bupleurum (Chinese name, Chai hu) and Chinese angelica (Chinese name, Dang Gui), have signifcant curative efects in treating endometriosis [12, 13]. For traditional Chinese medicinal formulas, Hindawi Evidence-Based Complementary and Alternative Medicine Volume 2018, Article ID 9864963, 9 pages https://doi.org/10.1155/2018/9864963