补肾活血方影响子宫内膜容受性的实验研究

An experimental research on endometrial receptivity is affected by bushenhuoxue Chinese herbs

目的探讨补肾活血中药对多囊卵巢综合征(PCOS)患者促排卵后子宫内膜容受性的影响。方法随机给予患PCOS不孕妇女两种不同的促排卵治疗,A组为用克罗米芬(CC)/绒毛膜促性腺激素(HCG)促排卵成功者;B组为用补肾活血方加CC/HCG促排卵成功者。月经周期正常妇女设为C组。用半定量逆转录-聚合酶链反应技术(RT-PCR)检测三组妇女着床期子宫内膜降钙素(CT)mRNA的表达,同日用阴道B超测定子宫内膜厚度,用电化学发光免疫法测血清雌二醇(E2)及孕酮(P)水平。结果着床期子宫内膜CTmRNA表达比较,A组分别低于B、C组(P分别<0.05、0.01),B组和C组之间无差异(P>0.05)。着床期血清E2、P水平及子宫内膜厚度比较,差异无显著性(P>0.05)。结论补肾活血方增强了着床期子宫内膜CT的表达,推测中药可改善子宫内膜容受性,有利于胚胎着床和临床妊娠率的提高。

Objective ： To study effect of bushenhuoxue Chinese herbs on endometrial receptivity in infertile patients with polycystic ovary syndrome （PCOS） receiving ovulation induction therapies. Methods： The anovulatory patients with PCOS underwent different ovulation induction therapies at random： 29 subjects of group A were given clomiphene citrate （CC） /human chorionic gonadotropin （HCG） therapies, and 32 subjects of group B were given CC//HCG combined with Chinese herbs therapies. 27 infertile women with normal menstrual cycle for male or fallopian tubal factors were selected as control group C. The expression of endometrial Calcitonin （CT） mRNA in the putative window of implantation was detected by reverse transcription -polymerase chain reaction （RT -PCR） in the three groups. Serum concentration of estrogen （ E2 ） and progesterone （P） were measured by electrochemiluminescence immunization during implantation window, while the endometrial thickness measured by ultrasound B. Results： Semi - quantitative analysis of RT -PCR showed the expression of endometrial CTmRNA during period of implantation was significantly weaker in group A as compared with that in group B and in group C （ P 〈 0. 05, 0. 01 ）. The expression of endometrial CTmRNA in group B was similar with that in group C （ P 〉 0. 05）. The significant differences of E2 and P levels as well as endometrial thickness were not found among the groups during implantation window （ P 〉 0. 05）. Conclusion ： The combination therapy of bushenhuoxue chinese herbs and CC/HCG has a better expression of endometrial CT than that of using CC/HCG alone. Chinese herbs might increase endometrial receptivity, which may promote pregnancy rate of patients with PCOS during induced ovulation.