Clinical And Experimental Study On The Treatment Of Ovarian Reserve Dysfunction With Kidney Deficiency And Liver Depression By Tonifying The Kidney And Soothing The Liver Metho

Objective:1.By observing the changes in the Traditional Chinese medicine(TCM)syndrome score,modified Kupperman scale,serum basal sex hormones and anti-Mullerian hormone(AMH)before and after the treatment of patients with diminished ovarian reserve(DOR)by tonifying the kidney and dredging the liver formula(Jiajian Guishen Formulation,hereafter referred to as JJGSW).The practical effectiveness of the kidney-tonifying and liver-sparing approach on DOR were evaluated.2.To investigate the feasibility of constructing a Drosophila ovarian aging model with a high-sugar diet,and to verify the ability of JJGSW to improve ovarian aging and to explore its regulatory effect on Nrf2 gene expression.Methods:1.24 patients with DOR with kidney deficiency and liver depression attending Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine were selected.To assess the therapeutic effects of the method of tonifying the kidney and sparing the liver on DOR,we observed the TCM evidence score,modified Kupperman scale score,serum basal sex hormones(FSH,LH,FSH/LH,and E2),and AMH before and after treatment with JJGSW.2.To create a high-sugar diet-based ovarian aging model in Drosophila.The dried solid of the Chinese herbal supplement of JJGSW was prepared,and low,medium,and high dose groups were set up in accordance with the gradient of 0.02g(raw herbs)/10mL(medium),0.1g(raw herbs)/10mL(medium),and 0.5g(raw herbs)/10mL(medium),and added to the high sugar medium.Five groups were used for this test:a blank control group,a high sugar model group,a low dosage group of JJGSW,a medium dose group of JJGSW,and a high dose group of JJGSW.In groups of 5:2 male to female flies,300 virgin ones were selected and crossed.Since day 3 of the experiment,the medium has been changed daily.Beginning on day 4,the total number of eggs deposited in 24 hours on the same day has been tallied,and the number and sex of dead flies have been recorded to determine the average number of eggs laid.The Drosophila ovaries were removed on the tenth day of the experiment,and the morphological alterations were assessed using DAPI staining and real-time fluorescence quantitative PCR to gauge Nrf2 gene expression levels.Results:1.The patients’ FSH and LH values declined considerably(P<0.01)after three menstrual cycles of therapy with JJGSW.The FSH/LH ratio also reduced,while the levels of AMH and E2 rose.However,none of these changes were statistically different from the baseline values.Patients’ menstrual volume increased considerably(P<0.01),and symptoms of low libido,agitation,anxiety and sadness,exhaustion,and lumpy menstruation were significantly(P<0.05)alleviated.The overall TCM symptom effectiveness percentage was 79.19%.The patient’s sleeplessness,anxiety,exhaustion,palpitations,and sexual discomfort ratings on the modified Kupperman scale dropped considerably as compared to those before therapy(P<0.05).2.(1)After using high sugar in the modeling,the mean number of eggs laid in the model group decreased significantly compared to that in the blank group(P<0.001),and the ovary morphology revealed a wrinkled state,an irregular shape,and a smaller size,as well as a significant decrease in the expression of the Nrf2 gene(P<0.001).(2)After the intervention with varied gradients of JJGSW concentration,Drosophila melanogaster lay more eggs to varying degrees,with substantial differences in the low-dose group in comparison to the model group(P<0.001).Beginning on the third day of egg counting,the low and medium dosage groups’ egg production curves were consistently higher than those of the model group.(3)With varied concentration gradients of JJGSW,the improvement in ovarian morphology was not statistically significant.(4)When compared to the model group,the expression of the Nrf2 gene in the ovaries of Drosophilas exhibited an increasing trend in the low,medium,and high dosage groups,with a statistically significant difference in the low dose group(P<0.05).Conclusions:1.In DOR patients with kidney deficiency and liver depression,the kidney-tonifying and liver-sparing approach can increase menstrual blood volume,relieve symptoms of sex hormone fluctuation such as hypoactive libido,lower serum basal FSH and LH levels,and have some improvement on ovarian reserve function.2.It is feasible to create a high-sugar diet-based Drosophila ovarian aging model.the process of ovarian senescence in Drosophila boosting fertility,which may be connected to the intentional control of Nrf2 gene expression.