Meridian Expression Study Of "Kidney-Tiangui-Chongren-Baogong" Axis In Kidney Deficiency Ovulation Disorders

ObjectiveTo explore the meridian expression model of "Kidney-Tiangui-Chongren-Baogong" axis that is suitable for characteristics of acupuncture subject by applying gynecological specificity of acupoints.Methods1. Clinical study on effect of acupuncture acupoints of foot three yi n and ren meridians combined with Roche promoting ovulation decoction on kidney deficiency of ovulation disorders.90cases of patients match the criteria of kidney qi (Yang) deficiency ovulation disorders were divided into high dose treatment group, low dose treatment group and control grou p according to the number of outpatient visits,30cases in each group. T reatment group were treated by acupuncture therapy cycles (mainly the thr ee yin meridians of foot and Ren meridian). The control group was treated by common acupuncture. Three groups were all administrated with Roche pr omoting ovulation decoction for based treatment. Clinical symptoms, BB T, maximum diameter of follicular, thickness of endometrium, the rate of ovulation, rate of pregnancy, and sex hormones were compared after3cycl es of treatment.2. Experimental study of dose effect relationship on acupuncture Sany injiao, Guan Yuan, Zhongwan and "Baogong":110mature female Sprague-Da wley rats were randomly divided into11groups, respectively, the blank group (10rats), model group (10rats), Sanyinjiao group (30rats), Zhong wan group (30rats), and Guanyuan group(30rats). In addition to the blan k group and model group, each group was divided into III(30min), Ⅱ(20mi n), I(10min) stimulation group, referred to as Sanyinjiao group Ⅲ,Ⅱ, I, Guan Yuan group III, Ⅱ,Ⅰ, Zhongwan group III, II, I,10rats in each group. The blank group daily was gavaged the same volume of saline. The remaining9groups daily intragastric administration of hydroxyurea suspe nsion600mg/Kg/d for8days, to prepare kidney deficiency-inhibition of ovulation in rats. In addition to the blank group and model group, other groups were given electroacupuncture corresponding acupoints from first day for8days. The weight, the number of follicles at all levels, FSH, E2, LH, P levels in serum, DA, NE,5-HT in hypothalamus, micro endoscopi c morphology of ovarian and uterine, expression of ovarian FSHR, FSHRmRNA, uterine ER, ERmRNA were observed in each group.Results1. Clinical symptoms of three groups were obviously improved in three cycle’s treatment. Compared with before treatment, high treatment group is batter in clinical symptoms since cycle2(P<0.01). Compared with before treatment, low dose group and control group are batter in clinical symptoms since cycle3(P<0.01). In overall comparison, high dose treatment group is batter in improving clinical symptoms than control group (P<0.05). In overall comparison of endometrium, high dose treatment group is better than that of low dose treatment group and control group (P<0.05). In cycle1and2, there is no advantage in ovulation rate between treatment groups and control group. Ovulation rate of high dose treatment group was obviously better than that of control group in cycle3(P<0.01). In three menstrual cycles, three groups all can increase the basal body temperature bidirectional rate (P<0.01). But there was no statistical difference in the improving bidirectional rate of basal body temperature between three groups (P>0.05). In terms of sex hormone regulation, there was a significant difference in down-regulating PRL and T, rise-regulating E2and LH levels of before and after treatment of each group,(P<0.05). There was a statistical difference in follicular development of patients with poor follicular development in three groups. There was a statistical difference between high treatment group and control group(P<0.01). There was no statistical difference each group in pregnancies in three menstrual cycles (P>0.05).2. Hydroxyurea600mg/Kg/d×8d can result in kidney deficiency-ovulation inhibition SD rat models. Compared with normal group, model group rats appeared back arch vertical hair, hair dull, curled up chills; weight drops slightly, estrus disorders without periodic change, the number of microscopically mature follicle significantly reduced. Hydroxyurea600mg/Kg/d×8d can result in SD rat model of ovarian wet weight, ovarian index, serum LH, E2, β-EP, expression of pituitary GnRHR, ovaries, uterus ER of FSHR expression, hypothalamus, DA, NE drops, the hypothalamus5-HT increased (P<0.05, P<0.01).3. Oovarian wet weight of model rat has been obviously improved in Guan yuan group (P<0.05). Ovarian and uterine wet weight has been improved in other treatment group, but no statistical difference (P>0.05). The number of primary follicles has been reduced and secondary follicle, mature follicle numbers has been improved in treatment Groups. The number of primary follicles has been reduced and secondary follicle, mature follicle numbers has been improved in Sanyinjiao, Guan yuan treatment Groups (P<0.05). There was no statistical difference in serum FSH within Groups (P>0.05). Serum E2, beta EP has been significantly improved in Sanyinjiao, Guan yuan treatment Groups (P<0.05). Serum LH, hypothalamus, NE, DA levels and ovarian FSHR expression has been significantly improved in Sanyinjiao Groups (P<0.01, P<0.05). Hypothalamus5-HT has been significantly reduced in Guan yuan groups (P<0.01). Serum P, GnRHR expression in pituitary, ER, ERmRNA expression in endometrium had been improved in each treatment groups, but no significant difference (P>0.05). Conclusion1. For kidney deficiency-ovulation disorder clinical studies, acupunct ure three yin meridians of foot, Ren meridian acupoints is superior to th e ovulation acupuncture in promoting endometrial and follicle developmen t, improving the ovulation rate, especially in the improvement of menstru ation, regulating menstrual cycle, improving the clinical symptoms, two-w ay regulating hormones such as PRL, LH, E2and T levels.2. Kidney deficiency-inhibit ovulation rat model were established by hydroxyurea to study the relevant meridians and acupoints. Acupuncture Sa nyinjiao, Guan Yuan can significantly improve the serum LH, E2levels, ov aries and uterus histological appearance, the FSHR, ER level expression of ovarian, uterine, regulate follicle ovulation way DA, NE,5-HT in the hypothalamus, overall adjust hypothalami-pituitary-ovarian axis functio n of the kidney deficiency-ovulation inhibition model rats to promote an d discharge follicle. The overall treatment effect is better than that o f point Zhongwan. 3. Acupuncture Sanyinjiao, Guan Yuan by stumilating three foot yin meridians, Ren meridians achieve the effect of ovulation, may be associated with regulation of hypothalamic DA, NE,5-HT levels in rat ovulatory follicles on the relevant pathways. Rat hypothalamic neurotransmitter levels may be related to "kidney". Three foot yin meridians functional contact with the hypothalamus.4. Animal experiments suggest that the overall efficacy of kidney-M eridian stimulate ovulation disorders is Sanyinjiao>Guan Yuan>Zhongwan. Preliminary inference that acupoints on kidney, Chong and Ren meridian h ave the meridian features in regulating "Kidney-Tiangui-Chongren-Baogo ng" axis.