Study On The Mechanism Of Cangfu Daotan Decoction In Treating Polycystic Ovary Syndrome Of Phlegm-dampness Type Based On The Expression Of Kisspeptin/Kisslr

Objective:To observe the regulatory effect of Cangfu Daotan Decoction on the clinical phenotype of phlegm-dampness syndrome and to explore the correlation between Cangfu Daotan Decoction and HPO axis and Kisspeptin/Kiss1 r system expression in the treatment of PCOS with phlegm-dampness type,so as to further study the mechanism of Cangfu Daotan Decoction in improving the clinical symptoms and signs,ovulation function and improving the pregnancy outcome of in vitro fertilization-embryo transfer(IVF-ET)in patients with phlegm-dampness type ovarian syndrome.Methods:Seventy-six patients with phlegm-dampness ovarian syndrome who underwent IVF-ET in the Reproductive and Genetic Center of Integrated Traditional Chinese and Western Medicine,Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into experimental group(Xangfu Daotan Decoction + IVF)(n = 38)and observation group(placebo + IVF)(n = 38).Ovarian granulosa cells were extracted on the day of egg.The changes of phlegm-dampness score before and after treatment in the experimental group and the observation group were evaluated and compared.Body mass index(BMI),waist-to-hip ratio(WHR),serum FSH,LH,E2 and P levels during menstruation were calculated.The contents of Kisspeptin/Kisslr,FSHmRNA and protein in granulosa cells were measured.Results: 1.TCM score: Compared with the observation group,the phlegm-dampness symptoms of the experimental group were much improved by treatment,and the score was decreased,the difference was statistically significant(P < 0.05).2.In the experimental group,BMI and WHR were lower than before,and the difference had statistical significance(P < 0.05);there was no significant change in BMI and WHR before and after treatment in the observation group,and there was no statistical significance(P > 0.05).3.Comparison of E2,LH and P on HCG day between the experimental group and the observation group: there was no significant difference in LH and P levels(P > 0.05);the E2 level on HCG day that experimental group is higher than control group,and the difference had statistical significance(P < 0.05);4.Comparison of GN dosage and days between the experimental group and the observation group: there was no significant difference in GN dosage and days between the two groups(P > 0.05).5 Comparison of the number of oocytes retrieved,fertilization rate,and excellent embryo rate between the experimental group and the observation group: the number of oocytes retrieved,fertilization rate,and excellent embryo rate in the experimental group were higher,and the difference was apparently significant(P < 0.05).6.Comparison of the expression levels of Kisspeptin,Kisslr and FSHR mRNA and protein in granulosa cells between the two groups: There were significant differences in the expression levels of Kisspeptin/Kisslr and FSHR mRNA in granulosa cells between the two groups: the expression levels in the experimental group were higher than those in the observation group,with significant differences(P < 0.05);the protein contents in the experimental group were higher than those in the observation group,with statistical significance(P <0.05).Conclusion:1.Cangfu Daotan Decoction has a positive regulatory effect in improving the symptoms of phlegm-dampness in PCOS patients.2.Cangfu Daotan Decoction can improve the fertilization rate and excellent embryo rate of patients with phlegm-dampness ovarian syndrome and improve pregnancy outcomes in assisted reproductive technology,suggesting that Cangfu Daotan Decoction may promote the normal development of oocytes to a certain extent and improve the developmental potential of early embryos.3.The method of invigorating the spleen,eliminating dampness and resolving phlegm may improve the symptoms of phlegm-dampness by enhancing the levels of endocrine and metabolic hormones and enhancing the expression levels of Kisspeptin/Kisslr and FSHR mRNA and protein during follicular development,improving the supply of energy for follicular development and ovarian catharsis function,thereby improving egg quality and enhancing embryonic development potential,and promoting the growth and expulsion of eggs.This article discusses the pathogenesis of infertility from the perspective of phlegm-dampness and ovarian stasis,and further enriches the connotation of the theory of "ovarian stasis" and the theory of "dryness,dampness,phlegm and promoting reproduction"...