消异育嗣汤改善子宫内膜异位症患者的受精和胚胎移植结局。
Xiaoyi Yusi decoction improves fertilization and embryo transfer outcomes in patients with endometriosis.
机构信息
First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, China.
Emergency Department, Laizhou Maternal and Child Health Hospital of Shandong, Laizhou 261400, China.
出版信息
J Tradit Chin Med. 2023 Oct;43(5):1026-1033. doi: 10.19852/j.cnki.jtcm.2023.05.006.
OBJECTIVE
To investigate the effect of - Xiaoyi Yusi decoction (XYYSD, ), a Traditional Chinese Medicine (TCM), on fertilization and embryo transfer (IVF-ET) in patients with endometriosis, and to study the mechanism underpinning the action.
METHODS
Women who underwent IVF-ET were divided into three groups by simple randomization: the treatment ( 32; with TCM treatment), patient (28; with endometriosis alone), and control (33; with male factor alone) groups. The luteal phase short-acting gonadotropin-releasing hormone agonist prolonged protocol was used in all three groups. To compare the changes in TCM scores and reproductive outcomes before and after TCM intervention in patients with endometriosis, partial least-squares discriminant analysis was used to analyze the follicular fluid samples of each group and screen and compare metabolites using the MetaboAnalyst software.
RESULTS
The clinical data indicated that following TCM intervention, kidney deficiency and blood stasis symptom patterns improved dramatically in patients with endometriosis and that their clinical pregnancy rate increased significantly (71.9% 57.1%, 0.05). Metabolomics showed that the two groups of samples were separated before and after TCM intervention. After TCM intervention, the intervention group was close to the control group, indicating that the TCM had a certain effect. Pathway analysis revealed that after TCM intervention, the metabolism of glycerin phospholipid, pyruvate, and citric acid was regulated.
CONCLUSIONS
Through the pyruvate and glycerophospholipid metabolism pathways and tricarboxylic acid cycle, the TCM XYYSD successfully improved kidney deficiency and blood stasis symptom pattern, as well as the clinical reproductive outcomes of patients with endometriosis-related infertility.
目的
探讨中药消异益丝汤（XYYSD）对子宫内膜异位症患者体外受精-胚胎移植（IVF-ET）的受精和胚胎移植的影响，并探讨其作用机制。
方法
采用简单随机分组法将接受 IVF-ET 的患者分为三组：治疗组（32 例，采用中药治疗）、患者组（28 例，单纯子宫内膜异位症）和对照组（33 例，单纯男性因素）。三组均采用黄体期短效促性腺激素释放激素激动剂延长方案。采用偏最小二乘判别分析比较子宫内膜异位症患者中药干预前后 TCM 评分和生殖结局的变化，使用 MetaboAnalyst 软件分析各组卵泡液样本并筛选和比较代谢物。
结果
临床资料表明，中药干预后，子宫内膜异位症患者肾虚血瘀证型明显改善，临床妊娠率显著提高（71.9%比 57.1%，0.05）。代谢组学研究显示，两组样本在中药干预前后均可分离。中药干预后，干预组接近对照组，表明中药有一定疗效。通路分析显示，中药干预后，甘油磷脂、丙酮酸和柠檬酸代谢得到调节。
结论
通过丙酮酸和甘油磷脂代谢途径以及三羧酸循环，中药消异益丝汤成功改善了肾虚血瘀证型及子宫内膜异位症相关不孕患者的临床生殖结局。
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