启宫丸对痰湿型多囊卵巢综合征患者卵细胞质量及颗粒细胞CYP19A1表达的影响OA
Effects of Qigong Pills on oocyte quality and CYP19A1 expression in granulosa cells in patients with polycystic ovary syndrome of phlegm-dampness type
目的 观察启宫丸对痰湿型多囊卵巢综合征(PCOS)患者体外受精(IVF)周期中卵细胞质量和颗粒细胞中细胞色素 P450 家族19 亚家族A 成员1(CYP19A1)表达的影响.方法 将2019 年1 月—2020 年12 月山东中医药大学附属医院中西医结合生殖与遗传中心收治的122 例行IVF 的PCOS 患者随机分为对照组和观察组,每组61 例.在IVF 前1 个月,对照组给予西药拮抗剂方案治疗,观察组在对照组治疗基础上给予启宫丸口服,用至卵泡发育成熟、HCG 日前1 d.比较2组患者治疗后中医证候疗效、获卵数、受精率、2PN 卵裂率、优质胚胎率;卵泡刺激素受体(FSHR)细胞免疫荧光染色法鉴定人原代卵巢颗粒细胞,荧光定量 PCR 法和 Western blot 法检测取卵日颗粒细胞中 CYP19A1 mRNA 及蛋白表达情况.结果 观察组中医证候总有效率明显高于对照组[88.33%(53/60)比28.81%(17/59),P<0.05];2 组获卵数、受精率比较差异均无统计学意义(P均>0.05),观察组 2PN 卵裂率、优质胚胎率均明显高于对照组[91.84%比 88.62%,41.02%比32.01%,P均<0.05];免疫荧光染色显示,颗粒细胞呈现弥漫性红色;观察组卵巢颗粒细胞中CYP19A1 mRNA 及蛋白相对表达量均明显高于对照组(P 均<0.05).结论 启宫丸能够明显缓解痰湿型PCOS 患者临床症状,提高2PN 卵裂率、优质胚胎率及卵细胞质量,其机制可能与上调颗粒细胞中CYP19A1 表达有关.
Objective It is to observe the effects of Qigong Pills on oocyte quality and the expression of cytochrome P450 family 19 subfamily A member 1(CYP19A1)in granulosa cells during in vitro fertilization(IVF)cycles in patients with polycystic ovary syndrome(PCOS)of phlegm-dampness type.Methods A total of 122 patients with PCOS undergoing IVF at the Reproductive and Genetic Center of Integrated Traditional Chinese and Western Medicine,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2019 to December 2020 were randomly divided into a control group and an observation group,with 61 patients in each group.At one month before IVF,the control group was treated with western medicine antagonist regimen,while the observation group was treated with Qigong Pills via oral admin-istration until follicular maturity and 1 day before hCG administration based on the therapy in the control group.The effica-cy of TCM syndrome,number of retrieved oocytes,fertilization rate,2PN cleavage rate,and high-quality embryo rate after treatment were compared between the two groups;the human primary ovarian granulosa cells were identified by follicle-stimulating hormone receptor(FSHR)cellular immunofluorescence staining,and the mRNA and protein expressions of CYP19A1 in granulosa cells on the day of oocyte retrieval were detected by quantitative real-time PCR and Western blot a-nalysis.Results The overall efficacy rate of TCM syndrome in the observation group was significantly higher than that in the control group[88.33%(53/60)vs 28.81%(17/59),P<0.05];there were no statistically significant differences in the number of retrieved oocytes or fertilization rate between the two groups(both P>0.05);however,the 2PN cleavage rate and high-quality embryo rate in the observation group were both significantly higher than those in the control group[91.84%vs 88.62%,41.02%vs 32.01%,both P<0.05];immunofluorescence staining revealed that the granulosa cells were diffuse red;the relative mRNA and protein expressions of CYP19A1 in ovarian granulosa cells of the observation group were significantly higher than those in the control group(both P<0.05).Conclusion Qigong Pills can significantly alleviate clinical symptoms,improve the 2PN cleavage rate,high-quality embryo rate and oocyte quality in patients with P-COS of phlegm-dampness-type,its mechanism may be related to the upregulation of CYP19A1 expression in granulosa cells.
董双千;张建伟
北京中医药大学东方医院,北京 100078山东中医药大学附属医院,山东 济南 250011
医药卫生
启宫丸多囊卵巢综合征痰湿型细胞色素P450家族19亚家族A成员1卵细胞质量
Qigong Pillpolycystic ovary syndromephlegm-dampness typecytochrome P450 family 19 subfamily A member 1oocyte quality
《现代中西医结合杂志》 2026 (15)
2057-2061,2068,6
山东省自然科学基金项目(ZR2020MH363)
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