Effects of Cangfudaotan Tang on Expression of Organic Anion Transporting Polypeptide (oatp2b1) in Liver and Kidney Tissues of Rats with Phlegm Dampness Type Polycystic Ovary Syndrome (PCOS)

Objective: To explore the effect of Cangfudaotan Tang on phlegm dampness type of PCOS and the role of oatp2b1 in transportation and transformation of phlegm dampness. Methods: 36 SD female rats were randomly divided into three groups: blank control group, model group and Cangfudaotan Tang group, 12 cases in each one. After PCOS rat models were made, rats of Cangfudaotan Tang group were treated with Cangfudaotan Tang (1.42 g/kg/d) by intragastric administration for 14 days;blank control and model group were given with isodose saline. The expression of oatp2b1 mRNA/Protein in liver and kidney tissues was measured and the level of testosterone (T), follicle stimulating hormone(FSH), estradiol (E2), luteinizing hormone(LH), Serum total cholesterol (TG), Triacylglycerols (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected at the same time. Results: Compared with blank control group, the expression of oatp2b1 mRNA and the level of TC, TG, LDL, LH, FSH, T in model group were significantly increased (P < 0. 05), while the level of HDL was significantly decreased (P < 0. 05);compared with model group, the expression of oatp2b1 mRNA and the level of TC, TG, LDL in Cangfudaotan Tang group were significantly lowered (P < 0.05);the level of HDL was significantly higher;the oatp2b1 protein in kidney and liver tissues had different degrees of expression, while there was no statistical significance among the three groups. Conclusions: Oatp2b1 might be one of the material bases participating in transportation and transformation of phlegmy dampness. The mechanism of Cangfudaotan Tang treating phlegm dampness type of PCOS may be achieved by regulating the expression of oatp2b1.

The Effect of Cangfudaotan Tang on Expression of Organic Anion Transporting Polypeptide (oatp4a1) in Rat Ovary and Uterus Tissues of Obese PCOS

Objective: The objective is to explore the effect of Cangfudaotan Tang on expression of organic anion transporting polypeptide (oatp4a1) in ovary and uterus tissues in rats with obese polycystic ovary syndrome. Methods: Poresky method and high fat diet were used to build obese PCOS rat models. The PCOS rat models were randomized into model control group, metformin group, the low dose Cangfudaotan Tang group and the high dose Cangfudaotan Tang group with 10 rats in each group. The metformin group was treated with metformin 43 mg/100g intragastric administration for two weeks, and the high dose Cangfudaotan Tang group and the low dose Cangfudaotan Tang group were given Cangfudaotan Tang 5.68 g/kg/d and 1.42 g/kg/d intragastric administration respectively for two weeks. Then the rats were anesthetized. Each rat was taken ovary and uterus tissues, and the expression of oatp4a1 Protein was detected in the tissues by using Western Blot techniques. The level of sex hormones as testosterone (T), follicle stimulating hormone (FSH), estradiol (E2), and luteinizing hormone (LH) and insulin resistance were detected by ELLISA techniques. Results: The expression of oatp4a1 in rat ovary and uterus tissue of model group was down-regulated compared to blank control group (p ≤ 0.05). The expression of oatp4a1 in ovary and uterus tissue of treatment group was up-regulated compared to model group (p < 0.05). The metformin group and the high does Cangfudaotan group were more apparent, while there was no statistical significance between the metformin group and the high dose Cangfudaotan group. Moreover, the model PCOS group had higher serum T, LH/FSH (p < 0.01) and lower E2 level (p < 0.01) compared to normal group. After treatment, serum T, LH (p < 0.01) and LH/FSH (P < 0.01) were decreased in metformin group and Cangfudaotan Tang group (p < 0.01) compared with those in PCOS model group. However, there was no significantly difference in serum T, LH, LH/FSH and E2 between metformin group and the high dose Cangfudaotan Tang group. Conclusion: The mechanism of Cangfudaotan Tang treatment of obese PCOS may be correlated to oatp4a1 by transportation and transformation of phlegmy dampness and regulating the levels of sex hormone.

苍附导痰汤对肥胖型PCOS-IR模型大鼠卵巢TLR4/NF-κB p65信号通路的影响

目的 探讨苍附导痰汤对肥胖型PCOS-IR (polycystic ovarian syndrome-insulin resistance, PCOS-IR)模型大鼠卵巢Toll受体4(TLR4)/核转录因子κB p65(NF-κB p65)信号通路的调控作用。方法 48只♀大鼠随机分为正常组8只和模型组40只。来曲唑(1 mg·kg^(-1))联合高脂饮食建立肥胖型PCOS-IR大鼠模型,快速革兰染色法观察动情周期,挑选24只模型大鼠随机分为:模型组、阳性药(二甲双胍135 mg·kg^(-1))组、苍附导痰汤高、低剂量(57.96、14.49 g·kg^(-1))组,每组各6只,药物干预21 d。观察动情周期、卵巢和子宫指数变化;血液生化仪测定空腹血糖(FBG)和血脂(甘油三酯TG和总胆固醇TC)变化;酶联免疫吸附(ELISA)法测定空腹胰岛素(FINS)水平;免疫组化法和荧光定量PCR法检测卵巢中TLR4和NF-κB p65蛋白及基因的表达。结果 与正常组比较,模型组大鼠动情周期紊乱,卵巢多囊性改变明显,FBG、TG、TC含量和FINS、HOMA-IR水平上调,卵巢中TLR4和NF-κB p65蛋白及mRNA表达均增加(P<0.05);与模型组比较,苍附导痰汤高剂量组大鼠排卵周期得到改善,卵巢多囊性改变减轻,上述指标出现明显逆转(P<0.05)。结论 苍附导痰汤能有效改善肥胖型PCOS-IR大鼠卵巢排卵和糖脂代谢功能,作用机制可能与调控卵巢TLR4/NF-κB p65信号通路有关。

苍附导痰丸对肥胖型PCOS不孕症患者妊娠结局的影响

目的研究苍附导痰丸对肥胖型多囊卵巢综合征(PCOS)不孕症患者妊娠率的影响,比较激素水平的变化。方法选择2016年7月至2020年10月妇产科门诊及病房肥胖型PCOS合并不孕患者120例,以入组先后顺序分为对照组和观察组,每组60例。共105例顺利完成临床研究,其中对照组55例,观察组50例。对照组患者给予常规西药治疗(二甲双胍+克罗米芬),观察组在对照组的基础上给予苍附导痰丸,进行连续3个月的干预治疗。观察治疗前后患者的胰岛素抵抗指标[C肽(CP)、空腹血浆胰岛素(FINS)、胰岛β细胞功能(HOMA-β)]、胰岛素抵抗指数(HOMA-IR)、激素水平[黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH、总睾酮(T)、雌二醇(E2)]、卵巢与子宫内膜情况及其临床症状积分,最后统计妊娠结局。结果2组患者治疗后的CP、FINS、HOMA-IR均低于治疗前(P<0.05),且观察组的CP、FINS、HOMA-IR低于对照组(P<0.05)。2组患者治疗后的LH、T均低于治疗前(P<0.05),且观察组低于对照组(P<0.05),2组患者治疗后的FSH、E2均高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。2组患者治疗后的主卵泡直径、卵泡数目、卵巢体积、子宫内膜厚度均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。观察组妊娠率、临床妊娠率均高于对照组(P<0.05)。结论苍附导痰丸对于改善胰岛素抵抗、改善激素水平及其临床症状具有很好的效果,对肥胖型PCOS患者具有较好的临床疗效。

燥湿化痰补肾活血方联合克罗米芬治疗痰湿阻滞型多囊卵巢综合征所致不孕症临床观察

目的研究燥湿化痰补肾活血方联合克罗米芬治疗痰湿阻滞型多囊卵巢综合征不孕症的临床疗效。方法将60例痰湿阻滞型多囊卵巢综合征不孕症患者随机分为治疗组和对照组各30例。对照组使用克罗米芬治疗,治疗组在对照组治疗手段基础上,加用燥湿化痰补肾活血方,监测两组患者子宫内膜厚度、周期排卵率、妊娠率、体重指数,比较两组治疗总有效率。结果治疗组总有效率83.3%,高于对照组63.3%,差异有统计学意义(P<0.05),且治疗后子宫内膜厚度、妊娠率、体重指数等指标均显著好于对照组,差异有统计学意义(P<0.05)。结论对于痰湿阻滞型多囊卵巢综合征不孕症患者,在常规克罗米芬治疗基础上联合应用燥湿化痰补肾活血方疗效显著,值得临床推广应用。

苍附导痰汤对痰湿型不孕症患者瘦素的影响

目的:探究有排卵的痰湿型不孕症患者体质及中药苍附导痰汤治疗有排卵的痰湿型不孕的作用机理。方法:比较有排卵的痰湿型不孕患者与健康者BMI、雌二醇、孕酮、瘦素、子宫内膜厚度,并对有排卵的痰湿型不孕患者服用苍附导痰汤治疗前后BMI、雌二醇、孕酮、瘦素、子宫内膜厚度进行比较。结果:有排卵的痰湿不孕患者BMI值高、瘦素水平高、子宫内膜薄,与对照组比较有显著性差异(P﹤0.01)。试验组经苍附导痰汤治疗后BMI、瘦素水平下降、子宫内膜增厚,与治疗前比较有显著性差异(P﹤0.05)。结论:有排卵的痰湿型不孕患者有肥胖、高瘦素水平、子宫内膜厚度较薄的特点。中药苍附导痰汤可降低BMI值,调节瘦素水平和子宫内膜厚度从而改善受孕条件,增加受孕机会。

苍附导痰汤加减对多囊卵巢综合征患者visfatin水平及胰岛素抵抗的影响

目的 探讨苍附导痰汤加减对多囊卵巢综合征(PCOS)患者visfatin水平及胰岛素抵抗的影响。方法 选择2018年1月至2020年1月至浙江省中西医结合医院中医妇科门诊60例符合纳入标准年龄在20~40岁的PCOS患者,用随机数字表法分为对照组和治疗组各30例。对照组予二甲双胍片餐中口服500 mg每日2次,治疗组月经第5天起每日分两次口服苍附导痰汤加减100 ml,至下次月经来潮,同时口服二甲双胍同对照组,两组均服用药物3个月经周期,治疗前后均测定患者胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、血浆visfatin水平。结果 两组组内治疗前后HOMA-IR比较,对照组治疗后(1.655±0.359)低于治疗前(2.022±0.346),治疗组治疗后(1.493±0.136)低于治疗前(2.260±0.502),差异均有极其显著的统计学意义(P<0.001);治疗后,治疗组HOMAIR低于对照组,差异有统计学意义(P<0.05)。两组组内治疗前后ISI比较,对照组治疗后为(0.028±0.002),高于治疗前为(0.022±0.004),治疗组治疗后为(0.030±0.002),高于治疗前的(0.020±0.004),差异均有极其显著的统计学意义(P<0.001);治疗后,治疗组ISI高于对照组,差异有统计学意义(P<0.05)。两组治疗前后visfatin比较,对照组治疗后为(1.024±0.602) ng/ml,低于治疗前的(1.605±1.300) ng/ml,治疗组治疗后为(0.662±0.405) ng/ml,低于治疗前的(1.522±1.080) ng/ml,差异均有统计学意义(P<0.05,P<0.001);治疗后,治疗组visfatin低于对照组,差异有统计学意义(P<0.05)。结论 苍附导痰汤加减可以有效改善多囊卵巢综合征患者visfatin水平及胰岛素抵抗。

加减苍附导痰汤治疗痰湿阻滞型无排卵性不孕症对患者性激素水平及卵巢动脉血流的影响

目的:探讨加减苍附导痰汤治疗痰湿阻滞型无排卵性不孕症对患者性激素水平及卵巢动脉血流的影响。方法:选择2018年5月-2020年5月本院就诊的痰湿阻滞型无排卵性不孕症患者96例为研究对象,随机数字表法分为对照组(予以枸橼酸氯米芬胶囊治疗)与观察组(对照组基础上加减苍附导痰汤治疗)各48例,对比两组治疗前、治疗1个及4个月经周期后的性激素、血流动力学指标,随访1年排卵及妊娠情况。结果:治疗1、4个周期,观察组雌二醇(E_(2))高于对照组,而卵泡刺激素(FSH)、黄体生成素(LH)、LH/FSH低于对照组,卵巢动脉收缩期最大血流速度(PSV)高于对照组、而阻力指数(RI)、搏动指数(PI)低于对照组(均P<0.05)。随访1年,排卵率观察组(83.3%)与对照组(75.0%)无差异,妊娠率观察组(50.0%)高于对照组(29.2%)(均P<0.05)。结论:加减苍附导痰汤治疗痰湿阻滞型无排卵性不孕症,能有效调节患者性激素水平及改善卵巢动脉血流,提高临床效果。

左归丸联合苍附导痰汤治疗肾虚痰湿型多囊卵巢综合征不孕症的临床效果分析

目的:评价左归丸联合苍附导痰汤治疗肾虚痰湿型多囊卵巢综合征(PCOS)不孕症的临床效果。方法:选取广西钦州市中西医结合医院2018年2~12月收治的120例肾虚痰湿型PCOS不孕患者,随机分为观察组和对照组,每组60例。对照组患者予对症及克罗米芬治疗,观察组在对照组基础上加用左归丸和苍附导痰汤治疗。检测治疗前、后两组患者血清激素水平[血清睾酮(T)、雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)水平及LH与FSH比值(LH/FSH)];记录排卵和妊娠情况(随访1年);对比治疗前、后两组子宫内膜容受性指标[子宫内膜厚度(Em)、子宫内膜螺旋动脉搏动指数(PI)、阻力指数(RI)];观察克罗米芬抵抗情况。结果:治疗后两组患T、E2、LH、FSH、LH/FSH比值均较治疗前显著改善(均P<0.05),且观察组激素水平改善显著优于对照组(均P<0.05);治疗后两组患者子宫内膜容受性指标改善均显著优于治疗前(P<0.01),且观察组子宫内膜容受性指标显著优于对照组(均P<0.01);治疗后,观察组排卵率和妊娠率显著高于对照组(均P<0.05),两组排卵后流产率和克罗米芬抵抗率比较,差异无统计学意义(均P>0.05)。结论:左归丸联合苍附导痰汤能通过改善肾虚痰湿型PCOS不孕症患者相关激素水平及子宫内膜容受性,进而改善其妊娠结局。

苍附导痰汤治疗痰湿内阻证肥胖型多囊卵巢综合征的临床效果

目的探究与分析苍附导痰汤治疗痰湿内阻证肥胖型多囊卵巢综合征(PCOS)的临床效果。方法选取山东省聊城市中医医院2019年1月至2021年1月收治的痰湿内阻证肥胖型PCOS患者120例,按照随机数字表法分为观察组和对照组,各60例。对照组给予盐酸二甲双胍肠溶片治疗,在对照组基础上,观察组加用苍附导痰汤治疗,两组均连续治疗3个月。比较两组临床疗效、治疗前后体重指数(BMI)、糖代谢指标、血脂代谢指标变化及排卵情况。结果观察组临床总有效率及排卵率高于对照组(P<0.05)。治疗后两组BMI、空腹胰岛素、空腹血糖、血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇较治疗前降低,且观察组低于对照组,高密度脂蛋白胆固醇较治疗前升高,且观察组高于对照组(P<0.05)。结论苍附导痰汤治疗痰湿内阻证肥胖型PCOS具有较好的临床效果,可有效降低患者的BMI值,调节糖脂代谢指标,还可在一定程度上改善排卵情况。

基于oatp3a1表达的苍附导痰汤治疗肥胖型多囊卵巢综合征模型大鼠机制的探讨

目的探讨苍附导痰汤(CFDTT)对肥胖型多囊卵巢综合征(PCOS)大鼠组织中oatp3a1表达的影响及作用机制的探讨。方法采用改良Poresky联合高脂饮食造模法,制作肥胖型多囊卵巢综合征大鼠模型,造模后将大鼠随机分为模型组、二甲双胍(metformin)组、苍附导痰汤低剂量组、苍附导痰汤高剂量组,每组12只,另选12只大鼠作为正常对照组,观察药物干预14天后各组大鼠肺、脾、肝、肾组织中oatp3a1基因及蛋白表达的变化。结果与正常对照组比较,模型组肝、脾、肾组织中oatp3a1表达量明显下降(P﹤0.01),肺组织中oatp3a1无明显变化(P>0.05);与模型组比较,CFDTT高剂量组和二甲双胍组大鼠肝、脾、肾组织中oatp3a1明显升高(P﹤0.01),CFDTT低剂量组肝、脾、肾组织中oatp3a1表达轻度升高(P﹤0.05),CFDTT高剂量组与二甲双胍组比较差异无显著性(P>0.05)。结论苍附导痰汤可能通过调节肝、脾、肾组织中oatp3a1的表达,改善肝、脾、肾脏腑的功能,增强痰湿运化而发挥作用。