首页|补肾促卵冲剂治疗多囊卵巢综合征导致不孕症临床及代谢机制研究

补肾促卵冲剂治疗多囊卵巢综合征导致不孕症临床及代谢机制研究

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临床观察补肾促卵冲剂治疗多囊卵巢综合征(PCOS)导致不孕症的有效性及安全性,并运用代谢组学探讨其作用机制。选取94例肾虚血瘀型PCOS不孕患者,试验组和对照组各47例。观测基础体温(BBT),B超监测卵泡、卵巢体积、子宫内膜及排卵和妊娠情况,血清性激素水平[促卵泡生成素(FSH)、促黄体生成素(LH)、催乳素(PRL)、雌二醇(E2)、孕酮(P)、睾酮(T)、游离睾酮(FT)、雄烯二酮(A2)、抑制素B(INHB)、抗缪勒管激素(AMH)],凝血功能,中医证候积分,血常规,尿常规,肝、肾功能等,并运用代谢组学对26例患者(试验组与对照组各13例)血清代谢物进行比较。结果显示,试验组总有效率和妊娠率明显高于对照组(P<0。001),提示补肾促卵冲剂能明显调节性激素和卵巢功能,可显著降低LH、T、FT、A2及INHB水平(P<0。05或P<0。01)和LH/FSH比值(P<0。05),提高P水平(P<0。05),促进排卵,增加内膜厚度,改善中医证候积分,无不良反应。代谢组学共筛选出24个差异代谢物,且肾虚血瘀型PCOS不孕患者的性激素与差异代谢物之间存在相关性。结果表明,补肾促卵冲剂可能通过脂质、氨基酸代谢等途径调节激素水平。
Bushen Culuan Formula in treatment of infertility caused by polycystic ovary syndrome
This study aims to observe the efficacy and safety of Bushen Culuan Formula in the treatment of infertility caused by polycystic ovary syndrome(PCOS)and to explore the mechanism using metabolomics.Ninety-four patients with infertility caused by PCOS with the syndrome of kidney deficiency and blood stasis were selected and assigned into treatment and control groups(n=47).The basal body temperature(BBT)was measured,and B-ultrasonography was employed to monitor follicles,ovarian volume,endometrium,ovulation,and pregnancy.The serum levels of sex hormones including follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),progestin(P),testosterone(T),free testosterone(FT),androstenedione(A2),inhibin B(INHB),and anti-Müllerian hormone(AMH)were measured.The coagulation function,traditional Chinese medicine(TCM)symptom scores,blood and urine routine,liver and kidney functions and other safety indicators were determined.Metabolomics was employed to comparatively analyze the serum metabolites of 26 patients(13 patients in each group)in the clinical study.The results showed that the total response rate and pregnancy rate of the treatment group were higher than those of the control group(P<0.001),suggesting that Bushen Culuan Formula regulated the sex hormones and ovarian function.Specifically,it reduced the levels of LH,T,FT,A2,and INHB(P<0.05 or P<0.01)and the LH/FSH ratio(P<0.05),elevated the level of P(P<0.05),promoted ovulation,increased endothelial thickness,and lowered TCM symptom scores without causing adverse reactions.A total of 24 differential metabolites were screened by metabolomics,and there were correlations between sex hormones and differential metabolites in the PCOS-induced infertility patients with kidney deficiency and blood stasis.In conclusion,Bushen Culuan Formula may regulate hormone levels through lipid and amino acid metabolism.

Bushen Culuan Formulapolycystic ovary syndromeinfertilitymetabolomics

马堃、李佳妮、宫林娟、张涵

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中国中医科学院西苑医院,北京 100091

中国中医科学院广安门医院南区妇科,北京 102618

天津中医药大学 中医学院,天津 301617

补肾促卵冲剂 多囊卵巢综合征 不孕症 代谢组学

中医药传承与创新"百千万"人才工程(岐黄工程)岐黄学者专项北京市科技计划"首都特色"重点项目首都临床特色应用研究与成果推广项目北京市自然科学基金中国中医科学院科技创新工程项目北京市中医药"薪火传承3+3工程"项目

201826Z1711000010171047212193CI2021A024062017-SZ-B-36

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(8)
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