补肾健脾法对多囊卵巢综合征先兆流产MCP-1、IL-1β水平及胰岛素抵抗的影响研究  

Effect of Tonifying Kidney and Strengthening Spleen on MCP-1,IL-1β and Insulin Resistance in PCOS Patients with Threatened Abortion

作　　者：冯晓玲[1] 赵小萱 丁宁[2] 陈璐[1] 张杨[1] FENG Xiaoling;ZHAO Xiaoxuan;DING Ning;CHEN Lu;ZHANG Yang(The First Affiated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中华中医药学刊》2020年第11期1-5,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金(81973894,81574014,81373673)。

摘　　要：目的探讨补肾健脾法对于脾肾两虚型多囊卵巢综合征(polycystic ovary syndrome,PCOS)早孕期先兆流产患者血清炎症因子MCP-1、IL-1β及胰岛素抵抗的影响。方法收集PCOS早孕期先兆流产伴胰岛素抵抗患者(脾肾两虚型)、PCOS早孕期先兆流产非胰岛素抵抗患者(脾肾两虚型)、正常早孕女性,将其分为A、B、C 3组,每组20例。对A、B组患者给予补肾健脾法治疗30 d,C组不给予治疗。实验前后分别采集3组受试者外周血,用ELISA法测定血清MCP-1、IL-1β、孕酮(P)、人绒毛膜促性腺激素(β-hCG)、雌二醇(E2)、空腹血糖、空腹胰岛素,计算计算胰岛素抵抗指数(HOMA-IR)。结果经治疗后A、B两组MCP-1、IL-1β显著降低(P<0.05),且B、C组无统计学差异(P>0.05)。治疗后A组HOMA-IR较治疗前显著降低,差异具有统计学意义(P<0.05),B、C组治疗前后HOMA-IR变化无统计学差异(P>0.05);治疗后P、E2、β-hCG水平A组、B组、C组都较治疗前升高(P<0.01),3组间无统计学差异(P>0.05)。结论补肾健脾法能有效改善PCOS早孕期先兆流产患者(脾肾两虚型)慢性炎症状态及胰岛素抵抗,调整生殖内分泌,可促进胚胎发育,有利于维持正常妊娠。Objective To investigate the effect of tonifying kidney and strengthening spleen method on MCP-1,IL-1β and insulin resistance in PCOS patients with threatened abortion of deficiency of spleen and kidney syndrome in early-pregnancy. Methods Sixty subjects from our hospital were divided into three groups. Group A was PCOS with IR threatened abortion,group B was PCOS with IR threatened abortion and group C was normal pregnant women, with 20 cases in each. Patients in group A and B were given tonifying kidney and strengthening spleen treatment for 30 days,while patients in group C were given no treatment. Peripheral blood of subjects in the three groups was collected before and after treatment. Serum levels of MCP-1,IL-1β,progesterone(P),human chorionic gonadotropin(β-hCG),estradiol(E2),fasting blood glucose and fasting insulin were measured by ELISA,and the insulin resistance index(HOMA-IR) was calculated. Results After treatment,MCP-1 and IL-1β in group A and B were significantly reduced(P<0.05),and there was no statistical difference between group B and C(P>0.05). After treatment,HOMA-IR of group A was significantly lower than that before treatment(P<0.05). Before and after treatment,HOMA-IR of group B and C showed no statistically significant difference(P>0.05). After treatment,the levels of P,E2 and β-hCG in group A,B and C were all higher than those before treatment(P<0.01) and there was no statistical difference among the three groups(P>0.05). Conclusion The method of tonifying kidney and strengthening spleen can effectively improve the chronic inflammatory state and insulin resistance of patients with PCOS with threatened abortion in early pregnancy(deficiency of spleen and kidney) and adjust reproductive endocrine,which can promote embryo development and maintain normal pregnancy.

关 键 词：多囊卵巢综合征 先兆流产 MCP-1 IL-1Β 胰岛素抵抗 脾肾两虚 补肾健脾 

分 类 号：R271.911.75[医药卫生—中西医结合]