【摘要】：目的觀察二至天癸方干預(yù)調(diào)節(jié)PI3K/Akt信號通路關(guān)鍵效應(yīng)分子p-Akt、PI3K及與通路相關(guān)的Bad水平對腎氣虛體外受精-胚胎移植(IVF-ET)患者卵細胞質(zhì)量的影響。方法選取行IVF-ET的腎氣虛不孕癥患者80例,按照隨機數(shù)字表法分為治療組(二至天癸方結(jié)合IVF-ET治療),安慰劑組(安慰劑顆粒結(jié)合IVF-ET治療),每組40例,另選取40名因男方因素行IVF-ET的女性志愿者為健康對照組(安慰劑顆粒結(jié)合IVF-ET治療)。3組患者均于促性腺激素釋放激素激動劑(GnRH-a)降調(diào)節(jié)的前一周期開始加服二至天癸方或安慰劑顆粒至人絨毛膜促性腺激素(HCG)注射日停藥。觀察3組患者臨床妊娠率、顆粒細胞凋亡率。Western blot法檢測PI3K/Akt信號轉(zhuǎn)導(dǎo)通路p-Akt、PI3K、Bad蛋白水平。結(jié)果與健康對照組比較,安慰劑組PI3K、p-Akt蛋白表達量降低,Bad蛋白表達量升高(P0.05,P0.01);與安慰劑組比較,治療組PI3K、p-Akt蛋白表達量升高,Bad蛋白表達量降低(P0.05,P0.01)。與安慰劑組比較,健康對照組及治療組卵巢顆粒細胞凋亡率均降低,臨床妊娠率增高(P0.05,P0.01)。結(jié)論二至天癸方可能是通過PI3K/Akt信號轉(zhuǎn)導(dǎo)通路,下調(diào)Bad因子表達,抑制顆粒細胞凋亡,從而提高IVF-ET患者卵細胞質(zhì)量,最終改善腎氣虛不孕癥患者的IVF-ET結(jié)局。
[Abstract]:Objective to investigate the effect of Erzhi Tiangui Fang on the quality of egg cells in patients with in vitro fertilization and embryo transfer (IVF-ET) due to deficiency of kidney qi. Methods Eighty patients with kidney qi deficiency infertility treated with IVF-ET were randomly divided into two groups: treatment group (2 to Tiangui decoction combined with IVF-ET) and placebo group (placebo granule combined with IVF-ET therapy), 40 cases in each group. Another 40 female volunteers who were treated with IVF-ET because of male factors were selected as the healthy control group (placebo granule combined with IVF-ET treatment). 3 patients in the control group were treated with GnRH agonist (GnRH-a) at the beginning of the first cycle of hyporegulation. Prescription or placebo granule to human chorionic gonadotropin (HCG) injection day withdrawal. The clinical pregnancy rate, granulosa cell apoptosis rate and protein level of PI3K/Akt signal transduction pathway p-AktPI3Knbad were measured by Western blot. Results compared with the healthy control group, the expression of PI3K,p-Akt protein in the placebo group decreased significantly (P0.05 + P0.01), and in the treatment group, the PI3K,p-Akt protein expression increased (P0.05p0.01). Compared with the placebo group, the apoptosis rate of ovarian granulosa cells in the healthy control group and the treatment group was decreased, and the clinical pregnancy rate was increased (P0.05 and P0.01). Conclusion Erzhi Tiangui prescription can down-regulate the expression of Bad factor and inhibit the apoptosis of granulosa cells through PI3K/Akt signal transduction pathway so as to improve the quality of egg cells in patients with IVF-ET and finally improve the outcome of IVF-ET in patients with infertility due to deficiency of kidney qi.
【作者單位】： 山東中醫(yī)藥大學(xué)附屬醫(yī)院中西醫(yī)結(jié)合生殖與遺傳中心;山東中醫(yī)藥大學(xué)第一臨床學(xué)院;
【基金】：國家自然科學(xué)基金資助項目(No.81273790) 山東省自然科學(xué)基金資助項目(No.ZR2016HP29)
【分類號】：R714.8

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