宁心疏肝汤联合拮抗剂固定方案对多囊卵巢综合征不孕患者IVF-ET结局及血清神经肽吻素表达影响  

Effects of Ningxin Shugan Decoction Combined with Antagonist Fixation Regimen on IVF-ET Outcomes and Serum Kisspeptin Expression in Infertility Patients with Polycystic Ovary Syndrome

作　　者：冯华 许丹 洪学兰 FENG Hua;XU Dan;HONG Xuelan(Jiangsu Medical College,Yancheng 224005,China;Yancheng No.1 People's Hospital,Yancheng 224006,China;Yancheng Affiliated Hospital of Nanjing University of Chinese Medicine,Yancheng 224001,China)

机构地区：[1]江苏医药职业学院,江苏盐城224005 [2]盐城市第一人民医院,江苏盐城224006 [3]南京中医药大学盐城附属医院,江苏盐城224001

出　　处：《中国实验方剂学杂志》2025年第5期177-184,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金青年基金项目(82205160);江苏省中医药管理局面上项目(MS2021103)。

摘　　要：目的:探讨宁心疏肝汤联合拮抗剂固定方案对多囊卵巢综合征不孕患者体外受精-胚胎移植(IVF-ET)结局及血清神经肽吻素(kisspeptin)表达影响。方法:选择于盐城市第一人民医院及南京中医药大学盐城附属医院就诊的多囊卵巢综合征不孕患者96例,采用简单化随机分组方法分为观察组与对照组,各48例,对照组患者给予拮抗剂固定方案辅助生殖治疗,观察组在其基础上给予宁心疏肝汤治疗,对比两组患者治疗前后的临床疗效,中医证候总积分及中医单项证候积分,促排情况,血清生殖激素水平,血清miR-335-5p、miR-141-3p,kisspeptin,IVF-ET结局指标及安全性评价。采用Pearson检验对血清促卵泡生成素(FSH)、kisspeptin水平、血清miR-335-5p、miR-141-3p与IVF-ET结局指标进行相关性分析。结果:治疗后观察组总有效率为90.91%,明显优于对照组的70.45%,差异有统计学意义(P<0.05)。与本组治疗前比较,治疗后两组中医证候总积分和中医单项证候积分、睾酮、促黄体生成素(LH)及LH/FSH水平均明显降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后两组FSH、血清kisspeptin水平、血清miR-335-5p、miR-141-3p表达水平均明显升高,且观察组高于对照组(P<0.05)。观察组促排后的获卵数、MⅡ卵数、胚胎种植率、临床妊娠率、活产率均高于对照组(P<0.05,P<0.01)。血清FSH、kisspeptin、miR-335-5p、miR-141-3p水平均与胚胎种植率、临床妊娠率、活产率呈正相关(P<0.01)。结论:宁心疏肝汤联合拮抗剂固定方案可改善多囊卵巢综合征不孕患者IVF-ET结局,提高血清kisspeptin表达,提高排卵率和妊娠率。Objective:To investigate the effects of Ningxin Shugan decoction combined with an antagonist fixation regimen on in vitro fertilization and embryo transfer(IVF-ET)outcomes and serum kisspeptin expression in infertility patients with polycystic ovary syndrome.Methods:A total of 96 infertile patients with polycystic ovary syndrome treated in Yancheng No.1 People's Hospital and Yancheng Affiliated Hospital of Nanjing University of Chinese Medicine were enrolled in this study and randomized into control and observation groups(n=48).The control group was treated with an antagonist fixation regimen,and the observation group was treated with Ningxin Shugan decoction on the basis of the treatment in the control group.The clinical efficacy was compared between the two groups.The total score and single scores of TCM symptoms,ovulation promotion status,and serum levels of reproductive hormones,miR-335-5p,miR-141-3p,and kisspeptin were determined before and after treatment.The IVF-ET outcome indicators and treatment safety were evaluated.Pearson test was conducted to analyze the correlations of serum levels of follicle-stimulating hormone(FSH),kisspeptin,miR-335-5p,and miR-141-3p with IVF-ET outcomes.Results:The total response rate in the observation group was 90.91%,which was higher than that(70.45%)in the control group(P<0.05).The total score and single scores of TCM symptoms and the testosterone,luteinizing hormone(LH),and LH/FSH levels declined after treatment(P<0.05),and they were lower in the observation group than in the control group(P<0.05).After treatment,the serum levels of FSH,kisspeptin,miR-335-5p,and miR-141-3p rose in both groups,being higher in the observation group than in the control group(P<0.05).The observation group showed higher ovulation number,number of MⅡoocytes,embryo implantation rate,clinical pregnancy rate,and live birth rate than the control group(P<0.05,P<0.01).Serum levels of FSH,kisspeptin,miR-335-5p,and miR-141-3p were positively correlated with embryo implantation rate,clinical pregnancy

关 键 词：宁心疏肝汤 拮抗剂固定方案 辅助生殖 多囊卵巢综合征不孕 体外受精-胚胎移植(IVF-ET)结局 神经肽吻素(kisspeptin) 生殖激素 

分 类 号：R259[医药卫生—中西医结合] R271.1[医药卫生—中医内科学] R711[医药卫生—中医学]