苍附苁仙汤对多囊卵巢综合征患者卵巢颗粒细胞胰岛素样生长因子-1受体基因表达的影响

摘要

目的：观察苍附苁仙汤对人卵巢颗粒细胞胰岛素样生长因子-1受体(IGF-1R)mRNA表达的影响，探讨其治疗多囊卵巢综合征(PCOS)的作用机制。方法采用随机数字表法将48例接受体外受精-胚胎移植(IVF-ET)的不孕症患者随机分为治疗组和对照组各24例。对照组服用炔雌醇环丙孕酮＋常规长方案促排卵，治疗组在对照组治疗基础上加服苍附苁仙汤，疗程1个月。比较2组患者注射人绒毛膜促性腺激素(HCG)日血清黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平及获卵数、优质胚胎数、妊娠数；采用实时荧光定量 PCR 测定取卵日成熟卵泡壁颗粒细胞IGF-1R mRNA表达。结果与对照组比较，治疗组血清LH、E2、P水平差异无统计学意义(P＞0.05)，优质胚胎数明显增高(P＜0.01)，获卵数及妊娠数差异无统计学意义(P＞0.05)；治疗组患者卵巢颗粒细胞IGF-1R mRNA表达显著高于对照组，差异有统计学意义(P＜0.01)。结论苍附苁仙汤通过上调人卵巢颗粒细胞IGF-1R mRNA表达，增加优质胚胎数，达到治疗PCOS的目的。%Objective To explore the effects ofCangfu Congxian Decoction on the mRNA expression of IGF-1R in human mural granulosa cells;To explore the action mechanism for the treatment of polycystic ovary syndrome (PCOS) patients.Methods Totally 48 patients undergoing IVF-ET were randomly divided into treatment group and control group by random number table, 24 cases in each group. Patients in the control group accepted GnRHa/FSH/hCG stimulation, while the treatment group tookCangfu Congxian Decoction orally on the basic treatment of the control group. Serum E2, LH, and P concentration on HCG injection day, number of ovum, high quality embryo rate and clinical pregnancy rate were evaluated. The mRNA expression of IGF-1R on mural granulosa cells in the mature follicle was detected by real-time PCR.Results Compared with the control group, there was no significant difference in serum E2, LH, and P concentration on HCG injection day of treatment group (P>0.05), while the treatment group had higher high quality embryo rate than that of the control group (P<0.01). There was no significant difference in the number of ovum and pregnancy rate between the two groups (P>0.05). The mRNA expression of IGF-1R on granulosa cells in treatment group was significantly higher than the control group (P<0.01).Conclusion The mechanism ofCangfu Congxian Decoction for treating PCOS is up-regulating the mRNA expression of IGF-1R in mural granulosa cells and increasing high quality embryo rate.