| Objective1.Analysis on the Zishen Yutai Pill under the influence of thin endometrium-patients with the changes of menstrual volume,endometrial thickness,hormone levels and TCM syndrome,in order to explore the Chinese medicine treatment of thin endometrium.2.Analysis on the Zishen Yutai Pill under the influence of miR-135a、miR-196b on endometrial HOXA10 gene、ITGβ3 gene and EMX2 gene regulation effect,in order to clarify to Zishen Yutai Pill shot the target and the efficacy of the treatment of thin endometrium mechanism,so as to enrich the viewpoints of clinical scope of application,also for traditional Chinese medicine in the application of assisted reproductive technology to provide scientific basis.Methods1.clinical effect:90 patients with thin endometrium were randomly into Zishenyutai pill group,Estradiol valerate group,estradiol valerate +Zishenyutai pill group,each group contained 30 cases.From the fifth day of menstruation,the estradiol valerate group oral estradiol valerate 2mg daily once a day,continued for 10d;From the fifth day of menstruation,the Zishenyutai pill group oral Zishenyutai pill with light salt water or honey water.5 grams One time(about 2/3 bottles),3 times a day,menstrual withdrawal;estradiol valerate + Zishenyutai pill group were given estradiol valerate + Zishenyutai pill,Use the same dose as before.The three groups were both 3 months for 1 courses.To observe three groups of clinical symptom changes,menstrual changes,endometrial thickness and pregnancy rate evaluation.2.Animal experiment:Twenty-eight female mice were randomized into 4 groups according to the different treatment:control group,Shenxu-thin endometrium model group,Aspirin group,Zishen Yutai pill group.The expressions of miR-135a、miR-196b、HOXA10、EMX2、integrin β3 mRNA in endometrial were detected by qRT-PC after treatment.Results1.Before treatment,there was no significant difference in TCM symptom scores between the three groups(P=0.635>0.05),there was significant difference after treatment(P=0.000<0.01),There were significant differences between the three groups before and after treatment(P=0.000<0.001),and significant differences(P=0.000<0.01)between the scores before and after the treatment within group itself.2.Comprehensive curative effect of TCM symptoms:in 90 cases,the total effective rate of Western medicine group was 6.67%,and the total effective rate of TCM and WM group was 100%,and the total effective rate of TCM group was 70%.3.Menstruation improvement:there were significant differences in the scores of menstrual volume between the three groups before and after treatment(t=-6.407,P=0.000<0.01).4.Endometrial thickness improvement:he thickness of endometrium in three cases was significantly thicker than before treatment(P=0.000<0.01).5.The expressions of EMX2 in Shenxu-thin endometrium model group were significantly increased compared with control group、Aspirin group、Zishen Yutai pill group(P<0.05).The expressions of EMX2 in Zishen Yutai pill group were significantly decreased compared with other groups(P<0.05).6.The expressions of integrinβ3 in Shenxu-thin endometrium model group were significantly decreased compared with control group、Aspirin group、Zishen Yutai pill group(P<0.05).The expressions of integrinβ3 in Zishen Yutai pill group were significantly increased compared with other groups(P<0.05).7.The expressions of HOXA10 in Zishen Yutai pill group were significantly increased compared with other groups(P<0.05).The expressions of HOXA10 in Shenxu-thin endometrium model group were significantly decreased compared with other groups(P<0.05).8.The expressions of miR-135a in Shenxu-thin endometrium model group were significantly increased compared with control group、Aspirin group、Zishen Yutai pill group,Among them,the maximum value of the Zishen Yutai pill group(P<0.05).9.The expressions of miR-196b in Shenxu-thin endometrium model group were significantly decreased compared with control group、Aspirin group、Zishen Yutai pill group(P<0.05).10.The HOXA10 gene was negatively correlated with the expression of EMX2 gene(r=-0.683,P<0.01);the HOXA10 gene was positively related to the expression of ITGβ3 gene(r=0.714,P<0.01).11.There was a negative correlation between miR-135a and HOXA10 gene(r=-O.683,P<0.01);miR-135a and EMX2 gene expression was highly correlated(r=0.886,P<0.01);miR-135a and ITGβ3 gene expression were negatively correlated(r=-0.722,P<0.01).12.MiR-196b and HOXA10 gene expression were negatively correlated(r=-0.736,P<0.01);the expression of miR-196b and EMX2 genes were significantly correlated(r=0.778,P<0.01);miR-196b and ITGβ3 gene expression were negatively correlated(r=-0.778,P<0.01).ConclusionIn this study,the clinical observation showed that Zishenyutai pill combined with estrogen can effectively improve uterine endometrial thickness,menstrual volume,clinical symptoms,pregnancy rate of Shenxu-thin endometrium patients which Suffer from infertility,the effect is better than the simple use of estrogen therapy.the animal experiment show that Zishen Yutai pill can improve endometrial receptivity by up-regulating the mRNA expressions of integrin β3、HOXA10 and cut down the mRNA expressions of EMX2,miR-135a、miR-196b. |
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