ABSTRACT
Objective:To investigate the effect of Guizhi Fulingwan on ovulation dysfunction in rats with polycystic ovary syndrome with insulin resistance （PCOS-IR） induced by letrazole combined with high fat emulsion. Method:A total of 72 female SD rats were randomly divided into control group， model group， metformin group and Guizhi Fulingwan low， medium and high dose groups， with 12 rats in each group. Except for control group， rats were given letrozole 0.001g·kg<sup>-1</sup> combined with high-fat emulsion 15 mL·kg<sup>-1</sup> for 21 consecutive days to establish model of PCOS-IR. Guizhi Fulingwan low， medium and high-dose groups were administrated with Guizhi Fulingwan 0.31， 0.62， 1.24 g·kg<sup>-1</sup> respectively， metformin group was administrated with metformin 0.27 g·kg<sup>-1</sup>， control group and model group were administrated with 12 mL·kg<sup>-1</sup> of normal saline daily for 30 days. Hematoxylin-eosin（HE） staining was used to observe ovarian tissue pathology morphology， and enzyme-linked immunoassay method （ELISA） was used to detect serum follicle stimulating hormone （FSH）， luteinizing hormone （LH）， testosterone （T）， fasting insulin （FINS） level，and LH/FSH and insulin resistance index （HOMA-IR） were calculated． Western blot was used to detect the expression levels of autophagy key molecular Atg6 yeast homologue （Beclin-1）， autophagy related gene 5（Atg5）， microtubule associated protein light chain 3 （LC3） Ⅱ proteins in the phosphatidylinositol 3-kinase/protein kinase B/rapamycin target protein （PI3K/Akt/mTOR） signaling pathway and autophagy related indicators in rat ovarian tissue. Beclin-1 and LC3Ⅱ protein expressions were detected by immunohistochemistry （IHC）. Result:Compared with control group， the thickness of follicles and follicular granulosa cells in the ovary of the model group also decreased， and the number of corpus luteum significantly decreased， while the white membrane thickness of the ovary increased， and the number of atresia follicles and cystic dilatation follicles increased significantly. Serum T， LH， LH/FSH， FINS， FINS， HOMA-IR were significantly increased （<italic>P</italic><0.01）. Phosphorylated （p） -PI3K， p-Akt， and p-mTOR proteins in ovarian tissue were all decreased （<italic>P</italic><0.05，<italic>P</italic><0.01）. The relative expression levels of autophagy-related protein LC3Ⅱ and Beclin-1 were significantly increased （<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with model group， the number of follicles in the low， medium and high dose Guizhi Fulingwan group and the metformin group decreased， the number of follicles in atresia and atresia increased， and the follicular granulosa cell layer thickness increased. Serum T， LH， LH/FSH， FINS and HOMA-IR of Guizhi Fulingwan group were significantly decreased （<italic>P</italic><0.05，<italic>P</italic><0.01）， and serum FINS and HOMA-IR of metformin group were significantly decreased （<italic>P</italic><0.01）. The expressions of p-PI3K， p-Akt， and p-mTOR proteins were increased （<italic>P</italic><0.05，<italic>P</italic><0.01）. The expression levels of LC3Ⅱ， Atg5 and Beclin-1 in the medium and high dose groups were significantly decreased （<italic>P</italic><0.01）. Conclusion:Guizhi Fulingwan can activate the PI3K/Akt/mTOR signaling pathway of granular cells， inhibit excessive autophagy of granular cells， improve ovarian function and insulin resistance， and restore ovulation， and the effect is better with high dose.
ABSTRACT
Objective To investigate the effect of heat sensitive moxibustion combined with Bushen Huoxue traditional Chinese medicine for treating sterility due to ovulatory dysfunction, provide evidence-based medicine proof for clinical treatment of ovulation dysfunction infertility optimization scheme.Methods This was a prospective, randomized, parallel controlled study.The control group injected recombinant human chorionic gonadotrophin ( HCG) by intramuscular, the observation group used the traditional Chinese medicine heat sensitive moxibustion combined with Bushe Huoxue herbs therapy, with the total curative effect, the ovulation rate, pregnancy rate, B ultrasound follicle image as the main observation indexes to judge the effect of treatment.Results After treatment, the of control group and treatment group patients were able to ovulate; the total effective rate of treatment group was 100%, slightly higher than the control group, by Ridit analysis, R =0.523, P =0.720; after treatment, two groups of pregnancy success rate approaches, P=0.243, with no significant difference; the average healing time was shorter than that of control group (P<0.05); the diameter of the largest follicle increased in two groups after treatment, but the difference was not statistically significant;the treatment group improved the total efficiency of the kidney deficiency was higher than that in control group, but the difference was not statistically significant.Conclusion Application of combined treatment of Bushen Houxue herbs and heat sensitive moxibustion can improve the ovulation rate and pregnancy rate in patients of ovulation dysfunction infertility with kidney deficiency and blood stasis, convenient and economic.
ABSTRACT
OBJECTIVE:To evaluate the clinical efficacy and safety of letrozole combined with traditional Chinese medicine for ovulation dysfunction induced by polycystic ovarian syndrome(PCOS). METHODS: 300 PCOS outpatients were randomized to 3 groups of 100 each: clomiphene citrate (CC) group (188 cycles);urinary gonadotropin (HMG) group (104 cycles) and letrozole (LE) group (155 cycles). The occurrence rate of mature follicle,ovulation rate,pregnancy rate,abortion rate,superfoetation-terata rate,cancellation rate,incidence of no dominant follicle forming and OHSS etc were compared between the two groups after treatment. RESULTS: 30 babies were born in CC group,34 in HMG group and 43 in LE group were born. The occurrence rate of mature follicles,ovulation rate and pregnancy rate in the LE group were higher than in either CC group or HMG group(P0.05);the superfoetation rate in HMG group was higher than in CC group or LE group(P