| Objective:This study mainly discussed the differences of TGF-β1 protein levels in follicular fluid and serum of patients with phlegm-dampiness polycystic ovary syndrome(PCOS)and the expression levels of Smad3 and SPK1 protein in granulosa cells during IVF-ET.Based on the effect of TGF-β1/Smad3 signaling pathway on follicular atresia,the mechanism of cangfu Daotan Pill prescription granules,a Chinese herbal medicine for dampness and phlegm-reducing,in improving ovarian function and IVF-ET outcome of patients with phlegm-dampness PCOS was explored.Methods:ninety-nine patients with polycystic ovary syndrome(PCOS)who planned to undergo IVF-ET with phlegm-dampness syndrome were selected according to phlegm-dampness syndrome score table and completely random number table and divided into experimental group(Cangfu Daotan pill formula granule intervention +IVF),observation group(TCM placebo granule +IVF)and blank group(TCM placebo granule +IVF)according to phlegm-dampness syndrome score table and completely random number table.There were 33 cases in each group.Patients in the experimental group were pretreated with cangfu Daotan pill formula granules for one month from the third day of the menstrual cycle before egg collection.The three groups of patients were treated with antagonist program,and the changes of TCM syndrome score of phlegm-dampness syndrome in the experimental group and the control group before and after treatment were statistically compared.The protein levels of TGF-β1 in follicular fluid and serum and the protein expression levels of Smad3 and SPK1 in granulosa cells in the three groups were determined.Serum estradiol(E2),luteinizing hormone(LH)and progesterone(P)levels were injected into HCG of patients in the three groups.The number of follicles≥1.4cm and<1.4cm on the day of HCG injection,the number of days of gonadotropin(Gn)use and Gn dosage were counted.The number of eggs harvested,HCG daily large egg rate,2PN fertilization rate,high quality embryo rate,cumulative pregnancy rate and cumulative live birth rate were calculated and compared statistically.Results:1.Chinese medicine evidence accumulation:The symptoms of the experimental group improved after treatment,and the score decreased significantly(P<0.01);After treatment,the score of the experimental group decreased compared with the control group,with statistical significance(P<0.05).2.Comparison of egg number,HCG daily large egg rate,2PN fertilization rate and high quality embryo rate among the three groups: blank group had the most egg number,and the difference was statistically significant(P<0.05);The large egg rate in the experimental group was higher than that in the control group,and the differences were statistically significant(P<0.025).The 2PN fertilization rate and high-quality embryo rate in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).3.The levels of TGF-β1 protein in follicular fluid and serum and the expression levels of Smad3 and SPK1 protein in granulosa cells of the three groups were compared:The protein expression levels in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:1.Cangfu Daotan Pill formula granules can significantly improve the sputum dampness syndrome of PCOS patients,and the application of Cangfu Daotan Pill formula granules can improve the large egg rate,2PN fertilization rate and high-quality embryo rate on HCG day of PCOS patients undergoing IVF-ET.2.Dampness and phlegm-reducing method may improve the phlegm-dampness state of PCOS patients by inhibiting TGF-β1/Smad3 signaling pathway,promote the growth and development of egg cells,reduce the apoptosis of granulosa cells,ensure the stability of ovarian microenvironment,improve the maturity of eggs and the potential of early embryo development,so as to improve the possibility of pregnancy of patients.3.The article briefly explains the mechanism of action of "phlegm-dampness causes infertility" based on TGF-β1/Smad3 signaling pathway,and enriches the traditional Chinese medicine ideology of "the ovaries hide drainage" and "dry dampness and dispel phlegm to promote fertility" theory. |
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