Research Of TNF-α,IL-6 In Follicular Fluid And Granular Cell In Patients Suffered From Endomeriosis With QUYUJIEDU Therapy

Objective:EM-related infertility patients of blood stasis and toxin accumulation syndrome were treated with quyujiedu granule combined with ART. The efficacy was observed and the potential mechanism was explored.Method:Clinical research:60 cases of endometriosis(EM) related infertility patients were randomly divided into treatment group and control group with 30 cases in each. Quyujiedu granule was given orally accompanied by the routine ovarian hyperstimulation with clomiphene citrate(CC) and intra-uterine insemination(IUI)to 20 cases in the treatment group whereas IVF-ET combined with oral Quyujiedu granule was given to another 10 cases. 20 cases in the control group were given CC and IUI. 10 cases only had IVF-ET performed. The symptom scores,pregnancy rate,serum CA125,EMAb,E2,P,PRL and TNF-α,IL-6 in the serum and follicular fluid were measured.The expression of TNF–αmRNA,IL-6mRNA were observed.Experiment 1:40 EM rats were randomly divided into experiment group and control group with 20 in each group. Another 20 rats were processed by only stretching the uterus as pseudo–operation group.Quyujiedu granule was given by gastric injection in experiment group daily for 3 weeks and saline was given in the other 2 groups in the same way. All the rats received peritoneal injection of 50IU of HMG and HCG (100IU/100g) 24 hours and 48 hours after the final gastric injection respectively. 14-16 hours later,the rats were killed and the occytes and granular cells were collected in order to observe the number and rate of quality ovum. The TNF-αmRNA and IL-6 mRNA expression in the granular cells were measured using RT-PCR.Experiment 2:189 2-cell mouse embryos devided into treatment group,control group and blank group were cultured in medium respectively. As a supplement,follicular fluid from endometriosis patients treated with quyujiedufang granule was added to the medium of treatment group and follicular fluid from endometriosis patients to the medium of control group. Then the development of the mouse embryo were closely observed under microscope.Result:1.The symptoms was significantly improved and the pregnancy rate in the treatment group raised. The result also showed that Quyujiedu granule could significantly reduce the positive rate of EMAb and the level of CA125, TNF-α,IL-6 in serum and follicular fluid and their expression in granular cells compared to control group(P<0.05).2.The quality ovum number and rate were significantly higher compared to control group(P<0.05). The expression of TNF-αmRNA and IL-6 mRNA in the granular cells were significantly lower than control group(P<0.05).3.There was significant difference between treatment group and control group in the percent of8-cell stage,morula stage and blastocyst(P<0.05).Conclusion:Quyujiedu granule could improve the symptoms and raise the pregnancy rate significantly. The mechanism might be raising the quality of the ovum through theregulation of the patients'immune state and improving of the ovarian microenvironment. Quyujiedu granule is an effective prescription for EM of blood stasis and toxin accumulation syndrome.