發(fā)布時(shí)間：2018-04-12 19:55

  本文選題：右歸顆粒 + 腎主生殖��； 參考：《山東中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討右歸顆粒對(duì)腎陽(yáng)虛型不孕癥患者卵巢顆粒細(xì)胞線(xiàn)粒體凋亡通路關(guān)鍵效應(yīng)分子Bax、Cyt-c、Caspase-3的干預(yù)作用及其對(duì)卵細(xì)胞質(zhì)量、妊娠結(jié)局的影響,探究腎陽(yáng)虛致不孕在線(xiàn)粒體凋亡通路水平可能的發(fā)生機(jī)制及補(bǔ)腎中藥在此水平可能的作用機(jī)制。方法:選取因輸卵管因素行體外受精-胚胎移植(IVF-ET)術(shù)治療的腎陽(yáng)虛不孕癥患者70例,根據(jù)患者就診次序,隨機(jī)分為右歸顆粒治療組與安慰劑組各35例,另選取因男方因素行IVF的正常對(duì)照組患者35例。治療組于卵泡期始服用右歸顆粒聯(lián)合常規(guī)IVF治療,安慰劑組及正常對(duì)照組患者同一時(shí)期服用安慰劑聯(lián)合常規(guī)IVF治療。觀察腎陽(yáng)虛患者治療前后腎陽(yáng)虛癥候積分變化;三組患者HCG日血E2、LH、P水平;優(yōu)質(zhì)卵率、優(yōu)質(zhì)胚胎率、臨床妊娠率以及取卵日卵巢顆粒細(xì)胞線(xiàn)粒體通路中Bax、Cyt-c、Caspase-3在基因及蛋白水平的表達(dá)。結(jié)果:1、右歸顆粒組患者治療后腎陽(yáng)虛癥狀明顯改善,與安慰劑組相比,優(yōu)卵率、優(yōu)胚率、臨床妊娠率均增高明顯(P0.05);2.比較三組患者卵巢顆粒細(xì)胞線(xiàn)粒體通路中關(guān)鍵效應(yīng)分子Bax及其下游Cyt-c、Caspase-3基因及蛋白表達(dá),發(fā)現(xiàn):治療組與安慰劑組相比,BaxmRNA表達(dá)下調(diào),全細(xì)胞水平Cyt-c、Caspase-3蛋白含量降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05);安慰劑組與正常對(duì)照組相比,BaxmRNA表達(dá)上調(diào),全細(xì)胞水平Cyt-c、Caspase-3蛋白含量明顯升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1、右歸顆�？擅黠@改善腎陽(yáng)虛型不孕癥患者的腎虛狀態(tài),提高其優(yōu)卵率、優(yōu)胚率,改善臨床妊娠率;2、右歸顆�？赡苁峭ㄟ^(guò)抑制線(xiàn)粒體凋亡通路,下調(diào)Bax因子、抑制Cty-c自線(xiàn)粒體中釋放,控制Caspase-3表達(dá),進(jìn)而抑制顆粒細(xì)胞凋亡,改善腎陽(yáng)虛不孕癥患者的IVF結(jié)局;3、從線(xiàn)粒體凋亡通路角度闡釋了“補(bǔ)腎促生殖”的作用機(jī)制,為“腎主生殖”理論提供了較為客觀的依據(jù)。
[Abstract]:Objective: to investigate the intervention effect of Yougui granule on mitochondrial apoptosis pathway of ovarian granulosa cells in patients with kidney-yang deficiency type infertility and its effect on the quality of oocyte and pregnancy outcome.To explore the possible mechanism of apoptosis pathway in mitochondria caused by deficiency of kidney-yang and the possible action mechanism of traditional Chinese medicine for tonifying kidney.Methods: seventy patients with kidney yang deficiency infertility treated by in vitro fertilization and embryo transfer with IVF-ETS due to fallopian tube factors were randomly divided into two groups: the right Gui granule group (35 cases) and the placebo group (35 cases).Another 35 cases of normal control group who were treated with IVF because of male factors were selected.The patients in the treatment group were treated with the right Gui granule combined with conventional IVF at the follicular stage, and the patients in the placebo group and the normal control group were treated with placebo combined with conventional IVF at the same time.To observe the changes of the symptoms of kidney yang deficiency before and after treatment, to observe the level of E2LHU P in HCG daily blood, to observe the rate of high quality eggs, and to observe the rate of high quality embryos in the three groups.Clinical pregnancy rate and the expression of Bax-Cyt-Caspase-3 in the mitochondrial pathway of ovarian granulosa cells on the day of egg taking.Results the symptoms of deficiency of kidney yang were obviously improved after treatment in the control group. Compared with the placebo group, the excellent egg rate, the optimal embryo rate and the clinical pregnancy rate were significantly higher than those in the placebo group (P 0.05).The expression of key effector molecule Bax and its downstream Cyt-caspase-3 gene and protein in the mitochondrial pathway of ovarian granulosa cells were compared among the three groups. The results showed that the expression of BaxmRNA was down-regulated and the content of Cyt-caspase-3 was decreased at the whole cell level in the treatment group compared with the placebo group.Compared with the control group, the expression of BaxmRNA in placebo group was up-regulated, and the protein content of Cyt-caspase-3 in the whole cell level was significantly increased (P 0.05).Conclusion: W1, Yougui granule can obviously improve the state of kidney deficiency, increase the rate of excellent egg and embryo, and improve the clinical pregnancy rate of infertile patients with deficiency of kidney-yang. Yougui granule may be by inhibiting mitochondrial apoptosis pathway, down-regulating Bax factor.Inhibiting the release of Cty-c from mitochondria, controlling the expression of Caspase-3, inhibiting the apoptosis of granulosa cells and improving the outcome of IVF in patients with infertility due to deficiency of kidney yang, the mechanism of "tonifying the kidney and promoting reproduction" was explained from the perspective of mitochondrial apoptosis pathway.It provides an objective basis for the theory of "kidney dominating reproduction".
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R271.14

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