Based On The PI3K/Akt/GLUT4 Of MiR-320 To Explore The Mechanism Of Cangfu Daotan Decoction Combined With Metformin In The Treatment Of PCOS-IR Of Kidney Deficiency And Phlegm Dampness Type

Objective:To observe the effect of modified cangfu daotan decoction combined with metformin on the expression level of mi R-320 in ovarian granulosa cells and the PI3 K /Akt / GLUT4 insulin metabolic pathway in infertile women with polycystic ovary syndrome(PCOS-IR)of kidney deficiency and phlegm dampness type,as well as the influence on the quality of oocytes and embryonic development potential to investigate the effect of cangfu daotan combined with metformin on pregnancy outcome of PCOS-IR patients with kidney deficiency and phlegm dampness syndrome,so as to further improve the clinical symptoms of polycystic ovary with kidney deficiency and phlegm dampness syndrome and improve the pregnancy outcome of in vitro fertilization embryo transfer(IVF-ET).Methods: 66 patients with polycystic ovary syndrome(PCOS)and insulin resistance(IR)were randomly divided into the treatment group(modified cangfu daotan decoction combined with metformin + IVF)and the control group(placebo combined with metformin + IVF).The treatment group began to take modified cangfu daotan decoction granules and metformin at the same time in the cycle before egg retrieval;the control group took placebo and metformin at the same time and at the same dose.SPSS24.0software was used for data analysis the changes of HOMA-IR and kidney deficiency phlegm dampness syndrome score before and after treatment were compared between the two groups,and the clinical efficacy of the two groups was compared;the expression level of mi R-320 in granulosa cells of the two groups was measured by real time PCR,and Western blot was used to detect the expression of mi R-320 The protein expressions of PI3 K,Akt and GLUT4 in ovarian granulosa cells were detected by blot.Body mass index(BMI),HOMA-IR,fertilization rate,high-quality embryo rate,clinical pregnancy rate and pregnancy outcomewere calculated and compared.Results: 1.The symptoms of PCOS-IR patients with kidney deficiency and phlegm dampness syndrome in the treatment group were significantly improved compared with those before treatment,and the score of syndrome of kidney deficiency and phlegm dampness was decreased,with statistical significance(P< 0.05),but there was no significant difference in the control group(P< 0.05).2.Before and after treatment,BMI and HOMA-IR of the treatment group were lower than those before treatment,with statistical significance(P< 0.05).3.Compared with the control group,the number of oocytes obtained in the treatment group was greater than that in the treatment group,with statistical significance(P< 0.05).The pregnancy outcome was higher than that of the control group.The fertilization rate,good quality embryo rate,and clinical pregnancy rate were higher in the treatment group than in the control group(P< 0.05),2pn cleavage rate of the two groups was not statistically significant(P> 0.05).4.By spearma analysis,mir-320 was correlated with PI3 K / Akt / GLUT4(r =-0.73,P< 0.001).5.The relative expression of mi R-320 in ovarian granulosa cells of the treatment group was down regulated,and the protein expression of PI3 K,Akt and GLUT4 under the pathway was significantly up-regulated compared with the control group,the difference was statistically significant(P< 0.05).Conclusion:1.Modified cangfu daotan decoction combined with metformin can significantly improve the symptoms,fertilization rate,excellent embryo rate and clinical pregnancy rate of PCOS-IR patients with kidney deficiency and phlegm dampness syndrome;2.Modified cangfu daotan decoction combined with metformin may intervene the up regulation of PI3 K / Akt / GLUT4 signaling pathway by down regulating the expression of mi R-320,promote the glucose uptake of peripheral tissue,and improve the state of insulin resistance.3.Relieving symptoms of kidney deficiency and phlegm dampness in patients by using the method of invigorating kidney and invigorating spleen and eliminating phlegm,improve the ovarian function of PCOS-IR patients with kidney deficiency and phlegm dampness,promote the growth,development and excretion of follicles,improve the quality of oocytes and embryo development potential,improve the pregnancy outcome,and further enrich and develop the theoretical connotation of "kidney deficiency as the root,phlegm dampness as the standard" and "ovarian function".