| Polycystic ovary syndrome, PCOS, also known as Stein-Leventhal syndrome, Is a kind of endocrine syndrome with the main characteristics is caused by Polygenetic, clinical symptoms is polymorphism. The etiology is complex and wide, so far still unclear, and is one of task for world researchers try to improve. The typical clinical manifestations is polycystic ovarian changes in hyperandrogenism and luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratio increased. Varying degrees of abnormal menstruation (menstrual thin hair, less, amenorrhea, dysfunctional uterine bleeding), infertility, hirsutism, acne, obesity, etc. And of ten accompanied by the emergence with ages insulin resistance or hyperinsulinemia, and hyperlipidemia. According to their symptoms, the Traditional Chinese Medicine can be attributed to "amenorrhea", "bleeding", "Zheng Jia" of the disease areas. The ancient and modern Chinese medicine scholars'diagnosis and treatment has received good results, showing great potential of Chinese medicine in the treatment of PCOS. Therefore, to explore the etiology and pathogenesis of PCOS and effective treatment methods is a major topic of current clinical research with great social significance and clinical value. This thesis from both clinical and experimental to explore the treatment of PCOS and mechanisms, and contribute to Chinese medicine of PCOS.Clinical Research 11.1 Research of PCOS patients'tongue1.1.1 Objective:From Chinese medicine four diagnostic's features and with the objective point of view of the tongue to study the PCOS regularity, Study the features of PCOS tongue and tongue map digital usage.1.1.2 Methods:By study 101 PCOS patients'tongue digital camera photos, through a unified image processing method then using statistical methods to analyze tongue color, shape, tongue, and many other features to sum up the rule.1.1.3 Results:The tongue can be divided into three categories:purple tongue,34.65%, pale tongue 45.54%, purple tongue 19.80%; fat, large tongue, tongue indentation, tender tongue ratio appears high, and of ten appear together. The tongue coating mostly is greasy and slippery.1.1.4 Conclusion: The clinical findings of PCOS patients more common with spleen deficiency, which can occur and blood stasis, phlegm in the pathological product. 1.2 Use Gui Zhu Jian Kun Tang to cure the PCOS patients with yang deficiency of spleen and kidney and phlegm-dampness in body. To compare the differents between the symptoms before and after the treatment.1.2.1 Objective: To explore the effective treatment for PCOS with yang deficiency of spleen and kidney and phlegm-dampness in body. 1.2.2 Methods:By comparing the pregnancy rate, clinical score, BMI index, hormone levels, type-B ultrasonic before and after treatment.1.2.3 Results:Gui Zhu Jian Kun Tang can improving clinical of PCOS patients symptoms, androgen levels, ovarian increases, etc., the effect is extremely significant. For the most typical PCOS symptoms e.g. late menstruation or amenorrhea, less menstruation, obesity, acne, hirsutism, after treatment 6 months the symptoms were significantly improved. Pregnancy rate within 6 months of treatment was 10.2%, pregnancy rate within 12 months of treatment was 37.5%.1.2.4 Conclusion: Gui Zhu Jian Kun Tang can improve the spleen and kidney deficiency, yang deficiency of spleen and kidney and phlegm-dampness type PCOS patients with clinical symptoms and laboratory indicators improved, to promote ovulation and improve the pregnancy rate.2 Experimental Study2.1 Gui Zhu Jian Kun Tang impact to PCOS rats on serum hormone levels and histological2.1.1 Objective: Through animal experiments, from the serum hormone and ovarian histology verify the efficacy of Gui Zhu Jian Kun Tang treatment on PCOS.2.1.2 Methods:Setup PCOS rat model by letrozole induced, fed animals with Gui Zhu Jian Kun Tang, compare with clomiphene as a positive control group, analyze hormone levels and ovarian changes within normal treatment control group, model control group, positive control group, Chinese medicines group.2.1.3 Results:The model control group rats serum testosterone (T) were significantly increased, compare with the normal group, Chinese medicines group and the positive drug group the difference was significantly between groups (P<0.05), normal group, Chinese medicines group, positive medicine group no differences between each groups (P> 0.05). On model group the luteinizing hormone (LH) levels was significantly different with positive drug group (P<0.05), no significant difference between the other groups. The estradiol (E2) and follicle-stimulating EPO (FSH) no significant difference betweer each groups. Most of model rats the follicles were cystic expansion, showing cystic antral follicles, granulosa cell layer decreased, luteal tissue decreased. Chinese medicines group showing a few Graafianfollicle, shows mature follicles, granulosa cells were significantly increased compared with the model group, was multi-layer and luteal visible. Clomiphene group has also seen some Graafian follicle, granulosa cells is multi-layer, arranged orderly, less luteal tissue visible.2.1.4 Conclusion:Gui Zhu Jian Kun Tang can improve the Rat Endocrinology, restore ovarian follicle structure, make the granulosa cell proliferation and follicular development.2.2 Gui Zhu Jian Kun Tang impact to PCOS rats granulosa cells autophagy rate. ovarian morphology and granulosa cell autophagy to explore the role of traditional Chinese medicine treatment of PCOS related mechanisms.2.2.2 Methods:The experiment setup PCOS rat model by using letrozole induce, fed animals with Gui Zhu Jian Kun Tang, use clomiphene as a positive control group, extract rats ovarian granule cells after treatment, apply with MDC fluorescence staining and flow cytometry methord check rat granulosa cells autophagy difference. Use western blot to test animal'sdeliverance of LC3 and Bclin-1, verify the autophagy difference of each groups.2.2.3 Results:MDC measured fluorescence intensity after staining: the model group> positive drug group> Chinese medicine group> normal group. Between any two groups, model group and normal group, Chinese medicine group and the positive drug groups all have significantly difference (P<0.05). While the normal group, Chinese medicine group, positive medicine group had no difference. Normal control group LC3â… andâ…¡, Bclin-1 protein expression levels low, On PCOS model group, LC3, Bclin-1 shows high expression (compared with normal group P<0.01). After treatment by Chinese medicine the LC3, Bclin-1 level had significantly lower trend (compared with model group P<0.05), but still higher than the positive drug group.2.2.4 Conclusion: PCOS rat model the ovarian granulosa cells exist a high incidence of the autophagy, associated with PCOS granulosa cells reduced. Gui Zhu Jian Kun Tang can significantly reduce the occurrence of autophagy, have effective protection of the granule cells, and thus piay a maintenance role for ovarian function.2.3 Gui Zhu Jian Kun Tang regulate PCOS rat granulosa cells autophagy pathway PI3k/Akt2.3.1 Objective: To analysis the Gui Zhu Jian Kun Tang impact to PCOS rat ovarian tissue PI3K I, AKT and mTOR phosphorylation level of protein expression and study the Chinese medicine intervention in PCOS ovaries autophagy signaling pathway.2.3.2 Methods:The experiment setup PCOS rat model by using letrozole induce, fed animals with Gui Zhu Jian Kun Tang, use clomiphene as a positive control group, extract rats ovarian granule cells after treatment, carry on protein quantification after extracted proteins, determined by western blot PI3K, Akt, mTOR protein.2.3.3 Result:The model group PI3K, Akt, mTOR expression was significantly decreased, after the intervention of traditional Chinese medicine and positive drug the PI3K, Akt, mTOR expression was significantly increased.2.3.4 Conclusion: Gui Zhu Jian Kun Tang can regulate the activity of PI3K to increase their protein expression, thus affecting the expression of mTOR and plays a negative regulatory role to autophagy. |
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