| Objectives1.Clinical research partThrough the clinical research on phlegm and blood stasis type of polycystic ovary syndrome patients,the objective of this part is to observe the lipid metabolism,hormone levels,ovarian volume and TCM syndrome integral,for Heqi San in the treatment of polycystic ovary syndrome and provide a reliable theoretical support to modern medicine.2.Experimental research partThis study aims to investigate the lipid metabolism,sex hormones,gene glucose of part ovarian tissues and the regulation of the PI3K/AKT signaling pathway of Heqi San in rats.To explore the possible molecular mechanism for insulin resistanceof part ovarian tissue in polycystic ovary syndrome rat model.Methods1.Clinical research part60 cases with polycystic ovary syndrome(PCOS)were randomly divided into control group and treatment group from March 2015 to March 2016.Each group of 30 cases.The control group was treated with metformin.On the basis of the control group,the treatment group was treated with Heqi San.The course of treatment was 3 months.Observed body mass index(BMI),fasting blood glucose(FPG),fastinginsulin(FINS),insulinresistanceindex(HOMA-IR),triglyceride(T G),totalcholesterol(TC),highdensitylipoprotein(HDL-C),lowdensitylipoprote in(LDL-C),luteinizing hormone(LH),follicle stimulating hormone(FSH),the ratio of LH/FSH,testosterone(T),the change of ovarian volume and TCM syndrome integral of patients with polycystic ovary syndrome.2.Experimental research partBy subcutaneous injection of dehydroepiandrosterone(DHEA)to establish polycystic ovary syndrome rat model,the rats were randomly divided into model group,Chinese medicine group and Western medicine group,each group were given corresponding drugs by gavage,and set normal control group,15 rats in each group.After 8 weeks of treatment,observe the fasting blood glucose(FPG),fasting insulin(FINS),insulin resistance index(HOMA-IR),total cholesterol(TC),three glycerol ester(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),luteinizing hormone(LH),follicle stimulating hormone(FSH),the ratio of LH/FSH,testosterone(T)of rats.At the same time to observe the morphological changes of ovarian tissue of rats with HE staining and by fluorescence quantitative PCR(Quantitation Real-Time PCR)method to observe the gene expression level of insulin receptor substrate 1(IRS-1),protein kinase B(PKB),glycogen synthase kinase-3(GSK-3),glucose transporter factor-4(GLUT-4),phosphatase deleted on chromosome tenth(PTEN).Results1.Clinical research part(1)After treatment,the BMI,FPG,HOMA-IR,TC,TG,FINS,LDL,LH,T,Ovarian Volume and TCM syndrome score of control group were significantly decreased(P<0.05),HDL and FSH were increased significantly(P<0.05);(2)The BMI,FPG,HOMA-IR,TC,TG,FINS,LDL,LH,T,Ovarian Volume and TCM syndrome score of treatment group were significantly decreased after treatment,(P<0.05),HDL and FSH were significantly increased(P<0.05);(3)The levers of the above indexs had significantly difference between groups after treatment and the comparison of difference before and after treatment of the above indexs between groups also had statistical significance(P<0.05 or P<0.01),furthmore,the improvement degree of the above indexs of the treatment group were superior to the control group.2.Experimental research part(1)Compared with the normal group,the FPG,Fins,HOMA-IR,TC,TG and LDL-C of model group were increased(P<0.01),HDL-C was decreased(P<0.01);compared with the model group,the FPG,Fins,HOMA-IR,TC,TG and LDL-C of the Chinese medicine group and Western medicine group rats were decreased(P<0.01),the HDL-C did not changed significantly;there was no significant difference in FPG,Fins and HOMA-IR between the western medicine group and the traditional Chinese medicine group(P>0.05),the TG and LDL-C of Chinese medicine group and Western medicine group were decreased significantly(P<0.01),but the TC was not decreased significantly in western medicine group(P<0.01);(2)Compared with the normal group,the LH,LH/FSH and T of model group rats were increased(P<0.01),the FSH was decreased(P<0.01);compared with the model group,the LH,LH/FSH and T of Chinese medicine group and Western medicine group rats were decreased(P<0.01);compared with the western medicine group the LH and LH/FSH of the Chinese medicine group were decreased significantly(P<0.01),the T of Chinese medicine group and Western medicine group were decreased(P<0.05),the FSH of Chinese medicine group and Western medicine group were increased(P<0.05);(3)In normal group,the ovarian tissue and the thickness of follicle membrane was normal;In the model group,the follicular sac was dilated,the follicular fluid was contained,the number of corpus luteum was reduced,the structure was loose,and the proliferation of theca cell layer was obvious;Compared with the model group,pathology of ovarian tissue group and Western medicine group rat medicine significantly improved.(4)The ovarian tissue of rats in the model group the expression of IRS-1,AKT,GSK-3 and GLUT-4 genes were significantly decreased,PTEN expression significantly increased compared with the normal group(P<0.01);Chinese medicine group and Western medicine group rat ovarian tissue expression of IRS-1,AKT,GSK-3 and GLUT-4 genes were significantly increased,PTEN gene expression was significantly decreased compared with the model group,(P<0.01);Compared with the western medicine group,Chinese medicine group rat ovarian tissue IRS-1,AKT,GSK-3 and GLUT-4 gene expression were significantly increased,PTEN expression was decreased significantly(P<0.01).Conclusions1.Clinical research partHeqi San can significantly reduce the body weight of patients with polycystic ovary syndrome,correct metabolic abnormalities and endocrine disorders,improve the blood supply of local ovarian tissue,regulate the size and sex hormone levels of the ovary.2.Experimental research part(1)Polycystic ovary syndrome can through down-regulats the ovarian tissue IRS-1,AKT,partial GSK-3,GLUT-4 gene expression and the effects of local ovarian tissue insulin levels,increase insulin resistance and sex hormone level disorder.(2)Heqi San can through the PI3K/AKT signaling up-regulates the local ovarian tissue related important signaling molecules in gene expression,antagonistic genes,improve glucose and lipid metabolism in PCOS rat model of local ovarian tissue,decrease the ovarian local insulin levels in polycystic ovary syndrome rat model,thereby correcting the sex hormone disorder play the role of comprehensive prevention and control of syndrome rat model of ovarian insulin resistance in polycystic ovary. |
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