The Exploration On Regulation Of FS By Kidney-reinforcing Drugs In PCOS Of Shenxu Type

Objective:To explore the pathogenesis of FS in PCOS and regulation of FS by kidney-reinforcing drugs, futher enrich the theory of kidney dominating reproduction..Methods: Fourty infertile patients with PCOS undergoing IVF-ET were divided into two groups, 20 cases in the study group treated with Erzhi Tiangui Granules and western medicine, and the other 20 cases in the control group were treated with gonadotropin- releasing hormone agonist (GnRH-a) and gonadotropin (Gn) alone. The long term protocol was adopted. The expression of FS in follicular fluid on the day of retrieving oocytes were detected by ELISA, and symptom scores, number of retrieved oocytes were evaluated and evalute the relation between FS and these indexes. Thirty mice were allocated into three groups randomly in experimental research,①normal group: performed hypodermic injection with sterile water for injection usp of same volume as model group and study group on the same time schedule;②model group:performed hypodermic injection with Sodium prasterone sulfate, 9mg/100g weight③study group:the same volume of Sodium prasterone sulfate were given; 10 days later, Erzhi Tiangui Granules were given to study group by gastric perfusion . The other two groups were given same volume salt solution. other 10 days later, all mice were killed. Their vaginal smears, uterus index and overy index, histomorphology of uterus and overy ,serum FS,tissue FSmRNA were observed。Results: Kidney yin deficiency were presentated in PCOS patients of IVF-ET, Symptoms of Shenxu in study group had been significantly improved because of kidney-reinforcing drugs. The drugs regulated serum FS,improve,oocyte quality,promoting oocyte maturation. Vaginal smears of the model mice suggested anovulation, their ovary were cystic and small follicle sand atretic follicles were showed. FSmRNA of overy were increased, serum FS also increased. Erzhi Tiangui Granules can regulated FSmRNA, decreased serum FS,promote the mammalian follicular development . Conclusion: The leading mechanism of PCOS patients is insufficient of kidney Yin after down regulation in controlled ovarian hyperstimulation while kidney-reinforcing drugs correct the imbalance state and promote oocyte quality . The possible mechanism of combined therapy is that:①Promoting oocyte maturation by regulating the level FSmRNA expression in overy;②Balancing the paracrine and autocrine of follicular function. Kidney-reinforcing drugs play its role on genic level therapy,reflectded the value of TCM Theory.