二至天癸颗粒对体外受精周期颗粒细胞GDNF、GFRα-l表达的影响

Effects of Granule of Er-zhi Tian-gui on GDNF and GFRa-l of IVF Cycle Granule Cells

目的:探讨二至天癸颗粒对IVF周期颗粒细胞胶质细胞源性神经营养因子(GDNF)、家族特异性受体a-1(GFRa-l)的影响,从而改善卵母细胞质量,提高妊娠率的可能机制。方法:将80例因输卵管因素行体外授精-胚胎移植(IVFET)患者分为治疗组(IVF治疗周期加用二至天癸颗粒)40例,对照组(IVF治疗周期加用安慰剂颗粒)40例。观察临床肾虚证候积分变化情况,促性腺激素(Gn)用量及用药天数,取卵数、优质卵率、受精率、优质胚胎率、临床妊娠率及颗粒细胞GDNF、GFRa-l mRNA的表达情况。结果:治疗组患者肾虚症状得到明显改善,治疗组Gn用量及用药天数低于对照组,优质卵率、优质胚胎率及临床妊娠率均高于对照组,差异均有统计学意义(P<0.05);颗粒细胞GDNF、GFRa-l mRNA表达都优于对照组,差异均有统计学意义(P<0.05)。结论:二至天癸颗粒可能通过提高颗粒细胞GDNF、GFRa-l mRNA的表达,改善卵母细胞成熟度,提高卵细胞质量,从而提高临床妊娠率。

Objective ： To investigate the effect of Granule of Er-zhi Tian-gui on glial cell line derived neurotro- phic factor （GDNF） of IVF cycle granule cells and family specific receptor a-1 （GFRa-I） so as to improve the quality of oocyte and promote the pregnancy rate. Methods： 80 patients with tubal factor for in vitro fertilization and embryo transfer （IVF-ET） were divided into treatment group and control group with 40 cases in each group. Treatment group was given to Granule of Er-zhi Tian-gui in IVF treatment cycle, and control group was given to placebo granule in IVF treatment cycle. Clinical observation was put into practice, including integral change of syndrome of kidney-deficiency, gonadotropin （Gn） dosage and medication time, obtained egg number, high- quailty egg rate, fertilization rate, good quality embryo rate, clinical pregnancy rate and the expressions of granu- lar ceils of GDNF and GFRa-1 mRNA. Results： The symptoms of kidney deficiency were improved in treatment group. Gn dosage and medication days were lower in treatment group than in control group, high-quality egg rate. High-quality embryo rate and clinical pregnancy rate were higher in treatment group than those in control group. The differences were statistically significant （ P 〈 0.05 ）. Granulosa cell GDNF and the expression of GFRa-1 mR- NA were better in treatment group than in control group, the difference was statistically significance （P 〈 0. 05 ）. Conclusion： By promoting the expressions of granule cells GDNF and GFRa-1 mRNA, Granule of Er-zhi Tian-gui improves the oocyte maturation so as to improve the quality of egg cell and then improve the pregnancy rate.