补肾健脾法影响PCOS-IR先兆流产者血清pAkt、mTOR的研究

Effect of the tonifying kidney and invigorating spleen on serum pAkt and mTOR in patients with threatened abortion of polycystic ovary syndrome in insulin resistance

[目的]观察补肾健脾法对多囊卵巢综合征胰岛素抵抗(PCOS-IR)先兆流产患者的临床疗效,进一步探讨其机制。[方法]酶联免疫吸附测定(ELISA)法检测PCOS先兆流产者中药治疗前后及健康妇女血清激素水平[孕酮(P)、特异性人绒毛促性腺激素(β-HCG)]、HOMA-IR、pAkt和mTOR的表达变化。[结果]治疗前:PCOS-IR先兆流产者(A组)、PCOS非胰岛素抵抗(PCOS-NIR)先兆流产者(B组)和健康妊娠妇女(C组)相比,pAkt和mTOR水平差异具有统计学意义(P<0.05)。治疗后:A组、B组与C组比较,P、β-HCG,pAkt和mTOR水平无显著差异(P>0.05),A组HOMA-IR明显下降。[结论]1)血清pAkt、mTOR水平降低可能跟PCOS-IR患者先兆流产的发生有关。2)补肾健脾法能够改善PCOS-IR妊娠者胰岛素抵抗状态,上调pAkt、mTOR水平。为进一步利用pAkt、mTOR相关靶点治疗PCOS-IR先兆流产患者提供理论依据。

[Objective]To observe the clinical efficacy of the use of tonifying kidney and invigorating spleen on Polycystic ovary syndrome in insulin resistance(PCOS-IR)patients with threatened abortion,and to further explore its mechanism.[Methods]Elisa method was used to detect the changes of serum hormone(progesterone(P)and human chorionic gonadotropin(β-HCG)),pAkt and mTOR in Polycystic ovary syndrome patients with threatened abortion and healthy pregnant women before and after traditional Chinese medicine treatment.[Results]Before treatment:group A(PCOS in insulin resistance patients with threatened abortion),group B(PCOS without insulin resistance(PCOS-NIR)patients with threatened abortion)compare with C(healthy pregnant women),the levels of pAkt and mTOR were statistically significant(P<0.05).After treatment:compared with group C,the levels of P,β-HCG,pAkt and mTOR in group A and group B had no significant difference in serum(P>0.05),HOMA-IR was significantly lower in group A.[Conclusion]1)The decrease of pAkt and mTOR levels in serum may be related to the occurrence of threatened abortion in PCOS-IR patients.2)The method of tonifying kidney and strengthening spleen can improvement of insulin resistance status in PCOS-IR pregnant women,can up regulate the levels of pAkt and mTOR.To provide theoretical basis for further use of pAkt and mTOR related targets in the treatment of threatened abortion patients with PCOS-IR.