Lian Fang, Zhao Bin, Lu Xue-mei
Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2010 Jan;30(1):22-5.
To explore the mechanism of action of Er'zhi Tiangui Granule (ETG) in improving quality of oocytes by observing metabonomics and level of calcium ion in follicle fluid, and to investigate the impacts of calcium ion, cholinesterase (ChE) and creatinine (CCr) levels in human follicle fluid on the quality of oocytes and outcome of pregnancy in patients after in vitro fertilization and embryo transfer (IVF-ET).
Fifty-seven patients after IVF-ET were randomly assigned to two groups: the trial group (27 patients) and the control group (30 patients), both were treated with conventional Western medical treatment, but ETG and Liuwei Dihuang Granule (LDG) was given respectively to the two groups additionally. Changes of Shen-asthenia syndrome, amount of oocyte obtained, fertilization rate, cleavage rate, high-quality embryo rate and pregnancy rate, levels of calcium ion, ChE and Cr in follicle fluid, and metabonomics in the two groups were observed and compared.
After treatment, scores of Shen-asthenia syndrome 8.30 +/- 1.46, fertilization rate 0.82 +/- 0.09, cleavage rate 0.97 +/- 0.07 and high-quality embryos rate 0.51 +/- 0.18 in the trial group were all better than those in the control group (9.16 +/- 1.15, 0.74 +/- 0.18, 0.91 +/- 0.10, 0.41 +/- 0.09, respectively, P<0.05); metabonomics principal component analysis showed that in the trial group, the principal component in follicle fluid distributed mainly in the section I, and that in the control group distributed mainly in the section II, showing significant difference between the two groups; while in most pregnant patients, it distributed in the section I. The Ca2+ concentration in the trial group was significantly higher than that in the control group (P<0.05). Levels of ChE and Cr in the trial group were higher than those in the control group, but the difference between them was insignificant.
ETG is better than LDG in regulating metabonomics, Ca2+ concentration, improving the quality of oocyte and embryo, and increasing pregnant rate in patients after IVF-ET.
通过观察代谢组学及卵泡液中钙离子水平，探讨二至天癸颗粒（ETG）改善卵母细胞质量的作用机制，并研究人卵泡液中钙离子、胆碱酯酶（ChE）及肌酐（CCr）水平对体外受精-胚胎移植（IVF-ET）患者卵母细胞质量及妊娠结局的影响。
将57例IVF-ET术后患者随机分为两组：试验组（27例）和对照组（30例），两组均采用西医常规治疗，试验组加用ETG，对照组加用六味地黄丸颗粒（LDG）。观察并比较两组肾虚证候变化、获卵数、受精率、卵裂率、优质胚胎率及妊娠率，卵泡液中钙离子、ChE及Cr水平，以及代谢组学情况。
治疗后，试验组肾虚证候评分8.30±1.46、受精率0.82±0.09、卵裂率0.97±0.07、优质胚胎率0.51±0.18，均优于对照组（分别为9.16±1.15、0.74±0.18、0.91±0.10、0.41±0.09，P<0.05）；代谢组学主成分分析显示，试验组卵泡液主成分主要分布在Ⅰ区，对照组主要分布在Ⅱ区，两组差异显著；而多数妊娠患者分布在Ⅰ区。试验组Ca2+浓度显著高于对照组（P<0.05）。试验组ChE及Cr水平高于对照组，但差异无统计学意义。
在调节代谢组学、Ca2+浓度、改善卵母细胞及胚胎质量、提高IVF-ET术后患者妊娠率方面，ETG优于LDG。
