The Clinical Research And Mechanism Study Of Treatment Of Replenishing Kidney And Spleen Decotion In Premature Ovarian Failure

Objective:To study the mechanism and clinical effect of replenishing the kidney and spleen decoction, and to provide scientific basis for its use.Method:This study includes experimental research and clinical research. Experimental research: There were 25 female rats which were randomly divided into control group, model group, bushenjianpi high group, bushenjianpi midiun group and bushenjianpi low group. Model was made by cisplatin intraperitoneal injection. Each group was gavaged with saline, high, medium and low concentrations of bushenjianpi decotion. To observe the rats’general condition, including weight and ovarian index. Apoptosis rate of granulose cells (GC) was detected by means of TUNEL. The expression level of mRNA of bcl-2, caspase9 and p27kip1 was detected by RT-PCR. Clinical research:Collect data of 30 patients who received treatment in hospital genecology clinic from March 2014 to March 2015 and met the diagnostic criteria of POF as well as inclusive criteria of this trial.30 patients were divided into treatment group and control group. Treatment group was given the bushenjianpi decotion and control group was given the Kuntai Capsule. One course of treatment is 3 months, and this trial included 2 courses. Before and after treatment, clinical index, MARS index, E2, FSH, LH, OVD and AFCs should be excamined.Result:Experimental research:Compared with model group, the apoptosis rate of GC of high dose group was decreased (p<0.05), and the expression level of mRNA of bcl-2 of high and medium dose group were increased while the expression level of mRNA of caspase9 and p27kip1 were decreased (p<0.05). The gene expression of low dose group was also changed, but with no statistical significance. Clinical research:Compared with control group, the total effective rate of treatment group was 93.3%. After treatment, the clinical index, MARS index, FSH and LH were decreased in both groups (p<0.05), while the E2 and AFCs were increased (p<0.01), and the difference between the two groups had statistical significance. There was no significant difference in OVD between two groups (p>0.05).Conclusion:The replenishing kidney and spleen decotion could improve clinical symptoms, adjust the endocrine level and spur follicle development, so as to recover the function of ovarian. Its working mechanism might be antagonism of GC apoptosis, adjustment of expression of genes associated apoptosis and correction of cell cycle. It was confirmed the replenishing kidney and spleen decotion is effective and can be used in clinical practice.