滋肾填精法对肾阴虚型IVF-ET患者子宫内膜Hox 10 mRNA表达的影响  

The Effects of Kidney-nourishing Essence-replenishing Method on the Expressions of Endometrial Hox 10 mRNA in IVF-ET Patients of Kidney Yin Deficiency Pattern

作　　者：刘卓[1] 董相丽 张宁[1] 邱月 刘伟[2] LIU Zhuo;DONG Xiangli;ZHANG Ning;QIU Yue;LIU Wei(Affiliated Hospital to Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Shandong University)

机构地区：[1]山东中医药大学附属医院,山东济南250014 [2]山东大学

出　　处：《西部中医药》2020年第7期11-15,共5页Western Journal of Traditional Chinese Medicine

基　　金：山东省自然科学基金(ZR2016HP44);山东省医药卫生科技发展计划项目面上项目(2016WS0583)。

摘　　要：目的:观察滋肾填精中药对肾阴虚型体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)患者子宫内膜同源框基因10(Hox 10)mRNA表达的影响,从基因层面探讨滋肾填精法对子宫内膜容受性的作用机理。方法:收集120例进入IVF-ET周期的不孕症患者,其中80例为肾阴虚型患者,随机分为观察组40例和对照组40例,另外40例单纯因输卵管因素者为空白组。3组患者均采用常规长方案进行超促排卵治疗,观察组在此基础上于降调节前1周期的月经第3-21天、降调节当月月经第3-14天及降调节后月经第3天服用二至天癸颗粒至取卵日。于降调节当天(监测排卵后第7天)采用RT-PCR法检测注射人绒毛膜促性腺性激素(human chorionic gonadotropin,HCG)日3组患者子宫内膜中Hox 10 mRNA的表达;比较观察组、对照组患者中医证候积分变化情况,评定3组患者注射HCG日子宫内膜厚度及分型、子宫内膜容积、子宫动脉搏动指数(pulsatility index,PI)和阻力指数(resistance index,RI)、血清激素水平及临床妊娠率等。结果:1)观察组肾阴虚证候积分低于对照组(P<0.05),肾阴虚症状改善。2)HCG日子宫内膜厚度、容积观察组高于对照组(P<0.05),与空白组比较差异无统计学意义(P>0.05),对照组低于空白组(P<0.05)。3)子宫内膜分型中A型+B型比例观察组高于对照组(P<0.01),略高于空白组,但差异不明显(P>0.05),对照组低于空白组(P<0.05)。4)观察组HCG日PI和RI均低于对照组(P<0.05),与空白组相比PI无明显差异,与对照组相比空白组PI和RI均降低(P<0.05)。5)3组患者HCG日血清雌二醇(estradiol,E2)、血清黄体生成素(luteinizing hormone,LH)及孕酮(progesterone,P)相比差异无统计学意义(P>0.05)。6)临床妊娠率观察组高于对照组(P<0.05),与空白组比较差异无统计学意义(P>0.05),对照组低于空白组(P<0.05)。7)3组患者HCG日子宫内膜中Hox 10mRNA均有表达,空白组表达最强,与观察组比�Objective: To explore the effects of kidney-nourishing essence-replenishing herbs on the expressions of endometrial Hox 10 mRNA of the patients of kidney Yin deficiency pattern who accepted IVF-ET and investigate the mechanism of the method acting on endometrial receptivity from gene level. Methods: All 120 patients who entered in IVF-ET cycle were collected, among them, eighty patients were of kidney yin deficiency pattern, and they were allocated to the observation group and the control group randomly, 40 cases each group;another 40 patients only induced by fullopian tube factor were chosen as the blank group. The patients in three groups adopted conventional long program to perform superovulation therapy, the observation group took Erzhi Tiangui granules from 3 rd to 21 st day of menstrual cycle before down-regulation, from 3 rd to 14 th day of down-regulation menstrual cycle and the 3 rd day of menstrual cycle after down-regulation. RT-PCR method was used at the day of down-regulation to detect the expressions of endometrial Hox 10 mRNA of the patients in three groups at HCG day;to compare TCM syndrome integrals between the observation group and the control group, to evaluate endometrial thickness and patterns, endometrial receptivity, uterine artery PI, RI, the levels of serum hormone and clinical pregnancy rate in three groups. Results: 1) the observation group was lower than the control group in the integrals of kidney Yin deficiency pattern(P<0.05), and the symptoms of kidney Yin deficiency improved. 2)the observation group was higher than the control group in endometrial thickness and receptivity at HCG day(P <0.05), the difference had no statistical meaning compared with the blank group(P>0.05), the control group was lower than the blank group(P<0.05). 3)the proportion of A type and B type of endometrial types of the observation group were higher than these of the control group(P<0.05), slightly higher than these of the blank group, while the difference was not obvious(P>0.05), the control group was low

关 键 词：不孕症 肾阴虚 滋肾填精 子宫内膜容受性 Hox 10 mRNA 临床研究 

分 类 号：R331[医药卫生—人体生理学]