Study On The Expression Of NK Cells And Related Factors In Patients With Kidney Deficiency And Blood Stasis Type Of Recurrent Implantation Failure And Intervention Of Bushen Huoxue Decoction

Objective:1.This study aims to observe the expression characteristics of serum and endometrial NK cells and related factors in patients with recurrent implantation failure(Recurrent Implantation Failure,RIF)kidney deficiency and blood stasis,and to analyze their correlation,so as to explore the immunological pathogenesis of RIF.2.Explore the immunological mechanism of Bushen Huoxue Recipe from the perspective of NK cell imbalance.Methods: 33 patients with RIF kidney deficiency and blood stasis syndrome who meet the criteria of the case were selected as the RIF kidney deficiency and blood stasis group(observation group),and 33 fertile control women during the same period as the control group.The ages,years of infertility,infertility type,and body mass index of the two groups,Basic sex hormone levels and other general conditions were selected.Flow cytometry(FACS)was used to determine peripheral blood NK(p NK)cells during the embryo implantation window,endometrial sampler was used to scrape the endometrial tissue,immunohistochemical method was used to detect the expression of u NK cells(u NK),enzyme-linked immunoassay(ELISA)was used to determine the levels of tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ).And then analyze the relationship between NK cells and TNF-α and IFN-γ in patients with kidney deficiency and blood stasis syndrome of RIF.After the observation group was given Bushen Huoxue Decoction for 2 menstrual cycles,changes of TCM syndrome scores and the expression of NK cells,TNF-α and IFN-γ before and after TCM treatment were collected.Results: 1.Comparison of general conditions: There was no significant difference between the observation group and the control group in terms of age,infertility years,type of infertility,body mass index,and basic hormone levels(P>0.05);2.Comparison of NK cells and related factors in the observation group before TCM treatment and the control group: The serum NK cell levels in the observation group before TCM treatment were significantly higher than those in the control group(P<0.05),and u NK cells were lower than the control group(P <0.05).Serum TNF-αand IFN-γwere significantly higher than those in the control group(P<0.05);3.Comparison of changes in NK cells and related factors in the observation group before and after treatment with traditional Chinese medicine:(1)NK cells: The NK cell level of patients in the serum observation group after treatment with traditional Chinese medicine was lower than that before treatment(P<0.05),and the difference was statistically significant;the u NK cell level of the observation group of patients in the observation group was significantly higher after treatment with traditional Chinese medicine than before treatment(P<0.05).(2)NK cell related factors: the level of TNF-αwas lower than that before treatment with traditional Chinese medicine,and the difference was significant(P<0.05);the level of IFN-γ was lower than that before treatment with traditional Chinese medicine,and the difference was significant(P<0.05).4.Comparison of NK cells and related factors between the observation group after treatment with traditional Chinese medicine and the control group:(1)NK cells: The percentage of p NK cells in the observation group after treatment with traditional Chinese medicine is slightly lower than that of the control group,but the difference is not statistically significant(P>0.05)The expression of u NK cells in the observation group after treatment with traditional Chinese medicine was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).(2)NK cell-related factors: TNF-α and IFN-γ in the observation group were slightly higher than those in the control group after treatment with traditional Chinese medicine,but the difference was not statistically significant(P>0.05).5.The relationship between the expression of NK cells and related factors in the observation group: The expression of p NK cells was negatively correlated with the expression of u NK cells,and the expression of p NK cells was positively correlated with serum TNF-α and IFN-γ.The expression of u NK cells is negatively correlated with serum TNF-α and IFN-γ,and TNF-α is positively correlated with IFN-γ;6.The symptoms of kidney deficiency and blood stasis were improved in patients with kidney deficiency and blood stasis of RIF after treatment with Bushen Huoxue Decoction,and the syndrome score was significantly reduced(P<0.05).7.The diagnostic value of NK cells for RIF: The area under the ROC curve of the percentage of p NK cells is 0.778,indicating that p NK cells have a certain reference value for ROC diagnosis.Conclusion: 1.Patients with RIF kidney deficiency and blood stasis syndrome have overexpression of p NK cells and underexpression of u NK cells during the embryo implantation window.It is speculated that the imbalance of NK cell expression may cause the mother to show certain immune rejection and affect embryo implantation to participate in RIF.2.The unregulated expression of p NK cells in patients with RIF kidney deficiency and blood stasis syndrome may be related to related factors such as TNF-α and IFN-γ.3.Bushen Huoxue Decoction may play a therapeutic effect by adjusting the balance between peripheral blood NK cells and uterine NK cells and regulating related factors,improving the immune status and thus exerting a therapeutic effect.