| 王晨晔,丁彩飞,张伟,鲍严钟.毓麟珠方加减对反复移植失败患者非移植周期子宫内膜内膜容受性影响的机制研究[J].浙江中西医结合杂志,2020,30(9): |
| 毓麟珠方加减对反复移植失败患者非移植周期子宫内膜内膜容受性影响的机制研究 |
| Mechanisms of modified Yulinzhu Fang on endometrial receptivity in non-transplantation period of patients with repeated transplantation failure |
| 投稿时间：2019-10-24 修订日期：2020-07-14 |
| DOI： |
| 中文关键词: 反复移植失败 毓麟珠方加减 子宫内膜容受性 miRNA31 Foxp3 eNOS |
| 英文关键词:Repeated transplantation failure modified Yulinzhu Fang endometrial receptivity miRNA31 Foxp3 eNOS |
| 基金项目:杭州市科技发展计划项目(20170533B68)；国家中医药管理局全国名老中医药专家鲍严钟传承工作室建设项目(No.[2012]149号)； |
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| 中文摘要: |
| 目的：本研究通过毓麟珠方加减治疗反复移植失败非移植周期患者,观察其中医症状体征,黄体中期血清miRNA31水平及子宫内膜Foxp3、eNOS表达变化,以此探讨该方对反复移植失败患者子宫内膜内膜容受性影响的作用机制。方法：选择反复移植失败非移植周期患者30例为治疗组,欲行人工受精曾有妊娠史的育龄期女性30例为对照组。治疗组予中药毓麟珠方加减口服,从月经第5天开始,连续服用21天为一个疗程,治疗3个疗程。对照组：不予任何药物治疗。观察治疗组治疗前后肾虚证候评分,测定两组黄体中期血清miRNA-31水平,随机数字表法抽取对照组25例和治疗组25例患者测定黄体中期子宫内膜Foxp3 miRNA、eNOS miRNA表达。结果：治疗组治疗后中医症候评分较治疗前显著降低,差异有统计学意义(P<0.01)。RIF治疗组治疗前黄体中期血清miRNA31 mRNA水平显著高于对照组,RIF治疗组治疗后黄体中期血清miRNA31 mRNA水平显著低于治疗前,差异均有统计学意义(P均<0.01)。RIF治疗组治疗前子宫内膜Foxp3 mRNA、eNOS mRNA水平均显著低于对照组,RIF治疗组治疗后子宫内膜Foxp3 mRNA、eNOS mRNA水平均显著高于治疗前,差异均有统计学意义(P均<0.01)。治疗组和对照组的血清miRNA-31与子宫内膜Foxp3 mRNA、eNOS mRNA均呈负相关关系(P均<0.05)。结论：毓麟珠方加减治疗反复移植失败患者非移植周期患者,可改善其肾虚临床症状及体征,可能通过降调节血清miRNA-31水平,增加植窗口期子宫内膜Foxp3、eNOS表达,调控母胎界面免疫平衡紊乱,促进血管新生,利于子宫内膜蜕膜化,从而改善子宫内膜容受性。且血清miRNA31作为无创评价RIF种植窗期子宫内膜容受性指标具有一定的临床意义。 |
| 英文摘要: |
| Objective: To investigate the effect of modified Yulinzhu Fang on endometrial receptivity in patients with repeated transplantation failure during non-transplantation cycle by observing the changes of the symptoms and signs of chinese medicine,serum level of miRNA31, expression of Foxp3 and eNOS in endometrium in mid-luteal phase, to explore the mechanism of this recipe on endometrial receptivity in patients with repeated transplantation failure. Methods: Thirty repeated transplantation failure patients in the non-transplantation cycle were selected as the treatment group , and 30 women of childbearing age who wanted to undergo artificial fertilization had a history of pregnancy as the control group. The treatment group was given modified Yulinzhu Fang, which started on the fifth day of menstruation and lasted 21 days for a course of treatment, given three courses of treatment. Control group: no medication was given.To observe the score of kidney deficiency syndrome in the treatment group before and after treatment.To determine the serum levels of microRNA31 in the middle luteal phase of the two groups.The expression of Foxp3 microRNAs and eNOS microRNAs in endometrium of middle luteal phase was determined by random number table method in 25 cases of control group and 25 cases of treatment group.Result: After treatment, the scores of chinese medicine symptoms in the treatment group were significantly lower than those before treatment (P < 0.01). The level of serum microRNA31 in the middle luteal phase before treatment in RIF group was significantly higher than that in the control group. The level of serum microRNA31 in the middle luteal phase after treatment in RIF group was significantly lower than that before treatment, with statistical significance (all P < 0.01). The levels of Foxp3 and eNOS in endometrium of RIF treatment group were significantly lower than those of control group before treatment. The levels of Foxp3 and eNOS in endometrium of RIF treatment group after treatment were significantly higher than those before treatment, with statistical significance (P < 0.01). Serum microRNA-31 was negatively correlated with Foxp3 and eNOS in endometrium of treatment group and control group (P < 0.05). Conclusion: The treatment of non-transplant cycle patients with repeated transplantation failure by modified Yulinzhu Fang can improve the clinical symptoms and signs of renal deficiency. It may regulate the level of serum miRNA-31 by lowering and increasing the expression of endometrium Foxp3 and eNOS during implantation.The control of maternal fetal interface immune balance disorder, promote angiogenesis, conducive to endometriosis,improve endometrial tolerance. Moreover, serum miRNA31 can be used as a non-invasive evaluation index of endometriosis during the window planting period of RIF, and has a certain clinical significance. |
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