摘要
目的:观察穴位埋线法干预调节PI3K/Akt信号通路关键效应分子Akt、与通路相关的GLUT4水平及其对胰岛素抵抗多囊卵巢综合征(PCOS)患者体外受精(IVF)卵细胞质量的影响。方法:选取行体外受精-胚胎移植(IVF-ET)的胰岛素抵抗PCOS患者60例,按照随机数字表法分为穴位埋线治疗组(穴位埋线+GnRH-a+达英-35双降治疗),基础治疗组(GnRH-a+达英-35双降治疗),每组各30例,穴位埋线治疗组于GnRH-a降调节周期的第10天,降调节日,COH周期经净第1天埋线治疗。观察穴位埋线治疗组患者治疗前后胰岛素抵抗指标HOMA-IR变化,两组患者的受精率、优胚率、临床妊娠率、胚胎发育时间参数(t2、t3、t4、t5、s2、cc2),以及PI3K/Akt信号转导通路p-Akt、GLUT4蛋白水平。结果:①穴位埋线治疗组取卵日HOMA-IR显著低于治疗前(P<0.05);②与基础治疗组比较,穴位埋线治疗组受精率、临床妊娠率差异无统计学意义,但有升高的趋势,优胚率显著增高(P<0.05);t2、t3、t5、s2时间段比较,两组差异无统计学意义,在t4、cc2时间段的比较中,穴位埋线治疗组发育时间显著快于基础治疗组(P<0.05);③穴位埋线治疗组较基础治疗组p-Akt和GLUT4蛋白表达显著上调(P<0.05)。结论:穴位埋线可能是通过PI3K/Akt信号转导通路,上调GLUT4蛋白表达,改善胰岛素抵抗状态,从而提高PCOS患者IVF卵细胞质量。
Objective:To observe the effects of acupoint embedding method on the regulation of the key effector molecule Akt of PI3 K/Akt signaling pathway and the level of GLUT4 associated with pathway on the quality of IVF egg cells in patients with insulin resistance PCOS.Methods:Sixty patients with insulin resistance PCOS,who underwent in vitro fertilizationembryo transfer(IVF-ET)were randomly divided into acupoint embedding treatment group(acupoint embedding combined with GnRH-a+Daying-35 double descending treatment)and basic treatment group(GnRH-a+Daying-35 double-dose treatment),30 cases in each group.The acupoint catgutization treatment group(GnRH-a)decreased the regulation of the 10 th day of the previous cycle.On the day of the down regulation,the first day of menstruation of the COH cycle.The changes of insulin resistance index,HOMA-IR,before and after treatment in the acupoint embedding treatment group were observed.The fertilization rate,the rate of excellent embryos,the clinical pregnancy rate,the time parameters,and the levels of p-Akt and GLUT4 proteins in the PI3 K/Akt signal pathway were observed.Results:①With the treatment of the acupoint embedding,HOMA-IR was significantly lower than that before treatment(P<0.05).②Compared with the basic treatment group,the fertilization rate and clinical pregnancy rate of the acupoint embedding treatment group were not statistically significant,but there was a growth trend,the rate of excellent embryos was significantly increased(P<0.05);t2,t3,t5 and s2 time period comparison,the difference between the two groups was not statistically significant,in the t4,cc2 time period comparison,the development time of the acupoint embedding treatment group was significantly faster than that of the basic treatment group(P<0.05).③The expressions of p-Akt and GLUT4 protein were upregulated in the acupoint embedding group compared with the basic treatment group(P<0.05).Conclusion:Acupoint embedding may be through PI3 K/Akt signal transduction pathway,up-regulate GLUT4 protein expression,improve insulin resistance,thereby improving IVF egg cell quality in PCOS patients,and ultimately improving the outcome of pregnancy.
作者
相珊
连方
XIANG Shan;LIAN Fang(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Reproductive and Genetic Center of Integrated Traditional and Western Medicine,Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan 250011,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2019年第5期1898-1902,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金面上项目(No.81771355)
山东省重大科技创新工程(No.17G006016)~~
关键词
穴位埋线
胰岛素抵抗
肾主生殖
PI3K/AKT信号转导通路
体外受精-胚胎移植
Acupoint embedding
Insulin resistance
Renal main reproduction
PI3K/Akt signal transduction pathway
In vitro fertilization-embryo transfer
作者简介
通讯作者:连方,山东省济南市历下区文化西路42号山东中医药大学附属医院中西医结合生殖与遗传中心,邮编:250011电话:0531-68617980,E-mail:f_lian@163.com
