Effect Of Cangfu Daotan Granule On IVF-ET Outcomes In Patients With Phlegm Dampness Polycystic Ovary Syndrome Based On AMPK Pathway

Objective:This topic focuses on the differences in adiponectin levels in follicular fluid and adiponect receptor mRNA expression in granulosa cells of patients with phlegmatic polycystic ovary syndrome during IVF-ET.To investigate the mechanism of action of dampness-expectorant herbs cangfu daotan granule in improving clinical manifestations and changing IVF-ET outcomes in patients with phlegm-damp PCOS from the perspective of lipid metabolism.Methods:Seventy-six patients with PCOS who were identified as phlegm and dampness in Chinese medicine and proposed to undergo in vitro fertilization-embryo transfer were selected and divided equally into experimental group(cangfu daotan granule+IVF)and observation group(Chinese medicine placebo granule+IVF)according to the completely randomized number table method,38 cases in each group.Patients in the experimental group were pretreated with cangfu daotan granule for one month starting from the 5th day of menstruation in the cycle before egg retrieval.GnRH-a+dain-35 double-drop regimen was used in both groups,the changes of phlegm-damp Chinese medical evidence points before and after the treatment of the experimental group and the observation group were statistically compared;Determination of adiponectin levels in follicular fluid and expression of adiponectin receptors in ovarian granulosa cells;Blood estradiol(E2),luteinizing hormone(LH)and progesterone(P)levels on the day of HCG injection in both groups;Counting the number of days of gonadotropin(Gn)use,Gn dosage;Body mass index(BMI),waist-hip ratio(WHR),number of eggs obtained,fertilization rate,high quality embryo rate,clinical pregnancy rate were calculated and statistically compared.Results:1.Chinese medicine evidence accumulation:The symptoms of phlegm and dampness improved significantly in the experimental group after treatment,and the chinese medicine evidence score decreased significantly(P<0.05);in the observation group,the difference in the phlegm and dampness syndrome score before and after treatment was not statistically significant(P>0.05);in the experimental group,the difference in the phlegm and dampness syndrome score after treatment was statistically significant compared with the observation group(P<0.05).2.After treatment,BMI and WHR of the experimental group were significantly lower compared with those before treatment,and the differences were statistically significant(P<0.05);the differences in BMI and WHR of the observation group after treatment were not statistically significant compared with those before treatment(P>0.05).3.The number of eggs obtained,fertilization rate,high-quality embryo rate and clinical pregnancy rate were compared between the two groups:the number of eggs obtained in the experimental group was higher than that in the observation group,with statistical significance(P<0.05),and the fertilization rate and high-quality embryo rate were significantly higher than those in the observation group,with statistically significant differences(P<0.01);the clinical pregnancy rate in the experimental group was higher,with statistically significant differences(P<0.05).4.The concentration of APN was higher in the experimental group than in the observation group,and the expression levels of AdipoR1 and AdipoR2 were increased,and the differences were statistically significant(P<0.01).5.HCG day E52 levels were positively correlated with adiponectin and adiponectin receptors(AdipoR1 and AdipoR2)in both groups of patients,respectively(P<0.01).Conclusion:1.The application ofcangfu daotan granule can improve the phlegm and dampness in PCOS patients and improve the phlegm and dampness symptoms of the patients.2.The method of drying dampness and dispelling phlegm may improve the state of phlegm and abnormal state of lipid metabolism in PCOS patients by increasing the expression level of adiponectin and its receptors in AMPK signaling pathway,and improve the developmental potential of early embryos,thus increasing the possibility of pregnancy in PCOS patients.3.The article briefly explains the mechanism of action of"phlegm-dampness causes infertility" based on the level of adiponectin,and enriches the traditional Chinese medicine ideology of "the ovaries hide drainage" and "dry dampness and dispel phlegm to promote fertility" theory.