苍附导痰汤对痰湿型PCOS卵巢颗粒细胞脂联素受体基因的表达及妊娠结局的影响  

Effects of Cangfu Daotan Decoction on adiponectin receptor mRNA expression and pregnancy outcome of phlegm-dampness PCOS ovarian granulosa cells

作　　者：连方[1] 崔文娜 相珊 LIAN Fang;CUI Wen-na;XIANG Shan(Reproductive and Genetic Center of Integrated Traditional and Western Medicine,Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan 250000,China)

机构地区：[1]山东中医药大学附属医院中西医结合生殖与遗传中心,济南250000

出　　处：《中华中医药杂志》2020年第9期4725-4728,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81774355)。

摘　　要：目的:探讨苍附导痰汤对痰湿型多囊卵巢综合征(PCOS)卵巢颗粒细胞脂联素受体基因的表达及妊娠结局的影响。方法:选择66例中医诊断属痰湿型接受体外受精-胚胎移植(IVF-ET)的PCOS患者,将其随机分为中药组及对照1组,同时选择33例非痰湿型患者作为对照2组。3组者皆采用达菲林+达英-35双降方案。观察3组患者治疗前后痰湿证候积分及体脂率的变化;比较3组患者临床数据变化。运用酶联免疫吸附法测定取卵日收集的成熟卵卵泡液中脂联素浓度,用RT-PCR技术测定颗粒细胞上脂联素受体基因(AdipoR1、AdipoR2 mRNA)的表达水平。结果:①治疗后中药组痰湿证候积分和体脂率较治疗前显著降低(P<0.01);②中药组HCG日E2水平、获卵数、成胚数、受精率、优胚率、临床妊娠率均显著增高(P<0.01,P<0.05);③中药组卵巢颗粒细胞脂联素受体基因表达水平显著高于对照1、2组。结论:苍附导痰汤可以通过上APN/AMPK信号通路中脂联素受体mRNA表达水平,改善PCOS患者的痰湿症状和脂质代谢异常状态,使颗粒细胞为卵母细胞生物功能提供充分的能量供应,增强卵母细胞发育潜能,从而改善PCOS患者的妊娠结局。Objective:To investigate the effects of Cangfu Daotan Decoction on adiponectin receptor gene expression and pregnancy outcome of polycystic ovary syndrome(PCOS)ovarian granulosa cells.Methods:A total of 66 patients with PCOS diagnosed as phlegm-dampness type accepted in vitro fertilization-embryo transplantation(IVF-ET)were randomly divided into Chinese medicine group and control group 1,and 33 non phlegm-dampness type PCOS patients were selected as control group 2.All the three groups were treated with dafelin+Diane-35 double drop program.The changes of phlegm-dampness syndrome integral and body fat percentage before and after treatment in the three groups were observed,and the changes of clinical data in the three groups were compared.The expression of adiponectin receptor gene(AdipoR1/AdipoR2 mRNA)in granulosa cells was determined by reverse transcription-polymerase chain reaction(RT-PCR).Results:①After treatment,the scores of phlegmdampness syndrome and body fat rate were lower than before treatment(P<0.01);②Estradiol(E2)level,egg numbers,fertilization rate,good embryo rate and clinical pregnancy rate of human chorionic gonadotropin(HCG)day in Chinese medicine group increased significantly(P<0.01,P<0.05);③Adiponectin receptor gene expression level of ovarian granular cells in Chinese medicine group was higher than that in control group 1 and control group 2.Conclusion:Cangfu Daotan Decoction can improve the symptoms of phlegm-dampness and the abnormal state of lipid metabolism of PCOS patients through up-regulating the expression of adiponectin receptor mRNA in the APN/AMPK signal pathway,so that the granulosa cells can provide sufficient energy supply for the biological function of oocytes,enhance the development potential of oocytes,and improve the pregnancy outcome of PCOS patients.

关 键 词：多囊卵巢综合征 颗粒细胞 脂联素受体mRNA 中药 苍附导痰汤 脂联素 体脂率 

分 类 号：R271.9[医药卫生—中西医结合]