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目的观察体外受精—胚胎移植术(IVF-ET)分别联合补肾调经方、逍遥散方治疗不孕症的临床疗效及可能机制。方法 40例不孕症患者辨证分为补肾组、疏肝组各20例,另设单纯控制性超排卵20例为对照组。各组均接受IVF-ET治疗,补肾组同时服用补肾调经方,疏肝组同时服用逍遥散方。治疗后检测各组患者卵巢颗粒细胞中活化素受体样激酶5(ALK5)mRNA的表达,观察患者获卵数、受精率、优质胚胎率和临床妊娠率。结果对照组优质胚胎率、临床妊娠率分别为29.3%、45.0%,补肾组分别为50.3%、65.0%,疏肝组分别为50.6%、60.0%,补肾组、疏肝组优质胚胎率均高于对照组(P<0.05),各组临床妊娠率以及获卵数、受精率比较差异均无统计学意义(P>0.05)。补肾组、疏肝组ALK5 mRNA表达均高于对照组(P<0.05)。结论补肾调经方、逍遥散方均可以上调不孕症患者颗粒细胞膜受体ALK5 mRNA的表达,促进颗粒细胞的增殖,从而调节卵巢功能而治疗不孕症。
Objective To observe the clinical efficacy and possible mechanism of in vitro fertilization and embryo transfer (IVF-ET) combined with Bushen Tiaojing Decoction and Xiaoyaosan Decoction in the treatment of infertility. Methods 40 cases of infertility patients were divided into Bushen group, Shugan group of 20 cases, respectively, another set of 20 cases of controlled ovarian hyperstimulation as the control group. Each group received IVF-ET treatment, Bushen group taking Bushen Tiaojing side, Shugan group taking Xiaoyao Sanfang. After treatment, the expression of activin receptor-like kinase 5 (ALK5) mRNA in ovarian granulosa cells of each group was detected. Obstetrics and gynecology, Obstetrics and Gynecology, Obstetrics and Gynecology, Obstetrics and Gynecology, Obstetrics and Gynecology Results The rate of high quality embryo and clinical pregnancy in the control group were 29.3% and 45.0%, respectively, 50.3% and 65.0% in the kidney transplantation group and 50.6% and 60.0% in the Shugan group, respectively In the control group (P <0.05), there was no significant difference in the clinical pregnancy rate, the number of oocytes retrieved and the fertilization rate in each group (P> 0.05). Kidney group, Shugan group ALK5 mRNA expression were higher than the control group (P <0.05). Conclusion Bushen Tiaojing Recipe and Xiaoyao San recipe can upregulate the expression of granulocyte membrane receptor ALK5 mRNA and promote the proliferation of granulosa cells in order to regulate ovarian function and treat infertility.