经皮穴位电刺激对高龄妇女卵细胞质量及Bcl-2、Bax的影响

Effect of Transcutaneous Acupoint Electrical Stimulation on Oocyte and Bcl-2 and Bax in the Older Women

目的观察经皮穴位电刺激对体外受精-胚胎移植(IVF-ET)周期肾虚高龄妇女卵颗粒细胞凋亡相关蛋白Bcl-2、Bax表达及卵细胞质量的影响。方法将66例因输卵管因素行IVF-ET的肾虚高龄妇女随机分为治疗组(经皮穴位电刺激治疗)和对照组(伪针),每组33例。观察两组患者肾虚证候积分变化,HCG日单个卵雌激素(E2/卵泡数)、优卵率、优胚率、临床妊娠率的差异,并应用蛋白印迹法(Western blot)检测卵颗粒细胞Bcl-2、Bax蛋白表达。结果与对照组相比,治疗组患者肾虚症状明显改善(P<0.01),HCG日E2/卵泡数、优卵率、优胚率明显升高(P<0.05),Bcl-2蛋白表达明显增多(P<0.01),Bax蛋白表达明显降低(P<0.01),获卵数和临床妊娠率无显著差异(P>0.05)。Bcl-2、Bax蛋白表达与IVF相关参数有明显相关性(P<0.05)。结论经皮穴位电刺激能改善高龄妇女肾虚症状,提高卵细胞及胚胎质量,此作用可能与调节颗粒细胞凋亡相关蛋白Bcl-2、Bax的表达,降低颗粒细胞凋亡有关。

Objective To observe the effect of transcutaneous acupoint electrical stimulation （TAES） on the ovarian granulosa cell apoptosis-related proteins, Bcl-2 and Bax, as well as the oocyte quality in the older women with kidney deficiency receiving in vitro fertilization-embryo transfer （IVF-ET）. Method Sixty-six older women with kidney deficiency who were receiving IVF-ET because of the fallopian tube factor were randomized into a treatment group （intervened by TAES） and a control group （intervened by sham acupuncture）, 33 in each group. The kidney-deficiency syndrome score, HCG E2/follicle count per day, excellent follicle rate, excellent embryo rate, and clinical pregnancy rate were observed and compared between the two groups; Western blot was used to detect the expression of protein Bcl-2 and Bax. Result Compared to the control group, the treatment group had significant improvement in kidney-deficiency symptoms （P〈0.01）, significant increases in the HCG E2/follicle count per day, excellent follicle rate, and excellent embryo rate （P〈0.05）, enhanced expression of Bcl-2 protein （P〈0.01）, and decreased expression of Bax protein （P〈0.01）; while there were no significant differences in comparing the retrieved oocyte number and clinical pregnancy rate （P〉0.05）. The expression of Bcl-2 and Bax proteins were markedly correlated with IVF-related indexes （P〈0.05）. Conclusion TAES can improve the kidney-deficiency symptoms and the quality of oocyte and embryo in older women; this action is possibly related to the regulation of expression of the cell apoptosis-related protein Bcl-2 and Bax, as well as the decrease of granulose cell apoptosis.