Ji Chang, Xu Wanling, Zhang Zhiqing, Cui Shuai, Yi Wei
South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, University of Chinese Medicine, Guangzhou 510006, China.
Acupuncture Research Team, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Evid Based Complement Alternat Med. 2021 Dec 26;2021:9968463. doi: 10.1155/2021/9968463. eCollection 2021.
Polycystic ovarian syndrome (PCOS) is a common, complex, and heterogeneous endocrine and metabolic disorder. There is no standardized treatment, and it therefore requires individualized therapies according to the symptoms and pathogenesis of each patient. The present study aimed to determine the effect of electroacupuncture at the acupoints Zusanli (ST36), Sanyinjiao (SP6), and Neiguan (PC6) on reproductive disorders and insulin resistance in a murine model of PCOS induced by dehydroepiandrosterone (DHEA). Vaginal smear analysis was used to determine mice estrous cycle; intraperitoneal glucose and insulin tolerance tests were adopted to analyze metabolic characteristics; enzyme-linked immunosorbent assay was used to measure hormone levels; gene expression was quantified with real-time PCR; hematoxylin and eosin staining was used to observe ovarian morphology. We observed disordered estrous cycle, polycystic ovarian morphology, and higher levels of homeostasis model assessment-insulin resistance (HOMA-IR) and testosterone (T), indicating successful modeling of PCOS. DHEA increased levels of estrogen (E), progesterone (P), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), and EA treatment restored them to levels seen in the control group. EA reduced the days in estrus caused by DHEA, improved the abnormal sex hormone receptor genes, and attenuated the DHEA-induced histomorphological changes in mouse ovaries. The average expressions of the androgen receptor (AR), estrogen receptor (ER), luteinizing hormone receptor (LHR), and follicle-stimulating hormone receptor (FSHR) genes in the ovary greatly increased after DHEA treatment and significantly decreased in the DHEA + EA group. After EA treatment, the cystic follicle (CF) number was reduced and corpora lutea (CL) increased in the DHEA + EA group compared to the DHEA group. EA improved glucose intolerance and insulin intolerance. Statistical analysis of intraperitoneal glucose tolerance test-area under curve (IPGTT-AUC) glucose levels revealed a significant decrease in DHEA group mice compared to the control and DHEA + EA groups. EA was found to restore fasting blood glucose, fasting serum insulin, and HOMA-IR. In summary, our study suggests that EA has a remarkable effect in the DHEA-induced murine PCOS model. Management of EA could improve estrous cycle, hormonal disorders, abnormal sex hormone receptors in ovaries, ovary morphology, and insulin resistance in PCOS mice.
多囊卵巢综合征（PCOS）是一种常见、复杂且异质性的内分泌和代谢紊乱疾病。目前尚无标准化治疗方法，因此需要根据每位患者的症状和发病机制进行个体化治疗。本研究旨在确定电针足三里（ST36）、三阴交（SP6）和内关（PC6）穴位对脱氢表雄酮（DHEA）诱导的PCOS小鼠模型生殖紊乱和胰岛素抵抗的影响。采用阴道涂片分析确定小鼠发情周期；采用腹腔葡萄糖和胰岛素耐量试验分析代谢特征；采用酶联免疫吸附测定法测量激素水平；用实时PCR定量基因表达；用苏木精-伊红染色观察卵巢形态。我们观察到发情周期紊乱、多囊卵巢形态以及稳态模型评估-胰岛素抵抗（HOMA-IR）和睾酮（T）水平升高，表明PCOS模型构建成功。DHEA增加了雌激素（E）、孕激素（P）、睾酮（T）、黄体生成素（LH）和卵泡刺激素（FSH）水平，而电针治疗将它们恢复到对照组水平。电针减少了DHEA引起的发情天数，改善了性激素受体基因异常，并减轻了DHEA诱导的小鼠卵巢组织形态学变化。DHEA处理后，卵巢中雄激素受体（AR）、雌激素受体（ER）、黄体生成素受体（LHR）和卵泡刺激素受体（FSHR）基因的平均表达大幅增加，而在DHEA + 电针组中显著降低。电针治疗后，与DHEA组相比，DHEA + 电针组的囊性卵泡（CF）数量减少，黄体（CL）增加。电针改善了葡萄糖不耐受和胰岛素不耐受。对腹腔葡萄糖耐量试验曲线下面积（IPGTT-AUC）葡萄糖水平的统计分析显示，与对照组和DHEA + 电针组相比，DHEA组小鼠的葡萄糖水平显著降低。电针被发现可恢复空腹血糖、空腹血清胰岛素和HOMA-IR。总之，我们的研究表明电针在DHEA诱导的小鼠PCOS模型中具有显著效果。电针治疗可改善PCOS小鼠的发情周期、激素紊乱、卵巢中性激素受体异常、卵巢形态和胰岛素抵抗。
