RESUMO
OBJECTIVE：To study the effect of Cangfu daotan pill （CDP）containing serum on autophagy of ovarian granulosa cells（GCs）of rat. METHODS ：Three-month-old SD rat were divided into normal saline group （normal saline ，ig），FSH injection group（10.71 IU/kg，ih），CDP irrigation high-dose ，medium-dose and low-dse groups [ 0.5，1，2 mg/g（by crude drug ），ig]，with 6 rats in each group. They were given relevant medicine subcutaneously/intragastrically ，once a day ，for consecutive 3 days. After last medication ，blood sample was collected from the abdominal aorta to obtain drug-containing serum. GCs of rat were divided into blank control group ，model group ，FSH group （positive control ）and CDP high-dose ，medium-dose and low-dose groups. The autophagy model was induced by giving testosterone propionate ，except that the blank control group was directly added with 100 μL serum of normal saline group. Then model group was given 100 μL serum of normal saline group，and administration groups were given 100 μL drug-containing serum of corresponding drug group. The contents of estradiol（E2）and progesterone （P）in supernatant of cells were determined by ELISA. Western blot assay was used to detect protein expression of PI 3K，Akt and mTOR in cells. The mRNA expression of PI 3K，Akt，mTOR，Beclin 1，LC3Ⅰ，LC3Ⅱ and p 62 were detected by RT-PCR. RESULTS ： Compared with blank control group ，the content of E 2 in supernatant ，relative mRNA and protein expression of PI 3K，Akt and mTOR were decreased significantly in model group （P＜0.01），while relative mRNA expression of Beclin 1，LC3Ⅰ and LC 3Ⅱ were increased significantly （P＜0.01）. Compared with model group ，the content of E 2 in supernatant were significantly increased in FSH group ，CDP medium-dose and high-dose groups ，while relative mRNA expression of Beclin 1，LC3Ⅰ，LC3Ⅱ and p 62 were decreased significantly （P＜0.05 or P＜0.01）；relative mRNA and protein expression of PI 3K，Akt and mTOR were increased significantly in administration groups （P＜0.05 or P＜0.01）. CONCLUSIONS ：CDP can inhibit autophagy of GCs by activating related protein and mRNA expression of PI 3K/Akt/ mTOR signaling pathway.
RESUMO
OBJECTIVE： To systematically evaluate the efficacy of Compound xuanju capsules combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， in order to provide evidence-based medicine guidelines for clinical medication. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， VIP， CJFD and Wanfang database from database establishment to Apr. 5， 2019， randomized controlled trials （RCTs） about therapeutic efficacy （total response rate， ovulation rate， pregnancy rate， FSH level， LH level， testosterone level， degree of endometrial thickening） of Compound xuanju capsules combined with chemical medicine （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation of included studies with modified Jadad scale， Meta-analysis was conducted by using STATA 14.0 software. Trial sequential analysis （TSA） was conducted by using TSA 0.9 software. RESULTS： A total of 15 RCTs were included， involving 1 259 patients. The results of Meta-analysis showed that the total response rate [RR＝1.27，95％CI（1.13，1.44），P＜0.001]， ovulation rate [RR＝1.18，95％CI（1.03，1.37），P＜0.001]， pregnancy rate [RR＝1.34，95％CI（1.11，1.61），P＜0.001]， serum hormone level {FSH [SMD＝－0.66，95％CI （－0.51， －0.82），P＜0.001]， 95％CI（－1.76，－1.41），P＜0.001]， LH [SMD＝－1.24，95％CI（－1.39， －1.08），P＜0.001]， testosterone [SMD＝－1.59，95％CI（－1.76，－1.41），P＜0.001]} and endometrial thickness [SMD＝1.20，95％CI（1.04，1.37），P＜0.001] of the trial group were better than those of the control group， with statistical significance. The results of TSA were reliable. CONCLUSIONS： In the treatment of PCOS， Compound xuanju capsules combined with chemical medicine is better than chemical medicine alone in improving total response rate， pregnancy rate， ovulation rate and endometrial thickness， and reducing serum hormone levels.
RESUMO
OBJECTIVE： To systematically evaluate therapeutic efficacy of modified Cangfu daotan decoction （MCDD） combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， and to provide evidence-based reference for clinical decision. METHODS： Retrieved from PubMed， Embase， Cochrane Library， CJFD， Wanfang database， VIP and CBM， randomized controlled trials （RCTs） about MCDD combined with chemical medicine [ethynestradiol cycloprogesterone （Diane-35）， clomiphene， metformin] （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale， Meta-analysis was conducted for total response rate， serum hormone level （FSH， LH， LH/FSH， testosterone）， BMI， ovulation rate and physical signs （hirsutism， acne） by using Stata 14.0 software. Trial sequential analysis（TSA）was conducted by using TSA 0.9 software. RESULTS： A total of 20 RCTs were included， involving 1 484 patients. Results of Meta analysis showed that total response rate [RR＝1.13，95％CI （1.02，1.24），P＜0.05]， serum hormone level {FSH [WMD＝－0.59，95％CI（－0.98，－0.20），P＜0.05]，LH [WMD＝－0.95，95％CI（－1.41， －0.52），P＜0.05]，LH/FSH [WMD＝－1.04，95％CI（－1.78，－0.33），P＜0.05]，testosterone [WMD＝－0.93，95％CI（－1.38，－0.28），P＜0.05]}， BMI [SMD＝－1.01，95％CI （－1.76，－0.27），P＜0.05]， ovulation rate [RR＝1.17，95％CI（1.02，1.34），P＜0.05] and physical signs {hirsutism [WMD＝－0.48，95％CI（－0.86， －0.10），P＜0.05]， acne [WMD＝－1.16，95％CI（－1.56，－0.75），P＜0.05]} of trial group were all better than those of control group， with statistical significance. TSA showed that there are reliable evidences for MCDD combined with chemical medicine in the treatment of PCOS. CONCLUSIONS： Versus chemical medicine alone in the treatment of PCOS， MCDD combined with chemical medicine can improve total response rate and ovulation rate， reduce serum hormone levels， BMI and physical signs.