The Clinical Research Of TCM Therapy Of Tonifying Kidney And Spleen On Serum PAkt,mTOR Of The PCOS With Threatened Abortion

[Objective]PCOS is a common endocrine disorder syndrome among women,causing the childbearing age women of reproductive dysfunction,clinical mainly showing the ovulation disorders,hyperandrogenemia and infertility.Patients with PCOS were usually associated with abnormal glucose metabolism,manifested as insulin resistance(IR)and hyperinsulinemia.In recent years,the pregnancy rate of patients with PCOS was improved after the therapy,but they suffer a higher risk of miscarriage.PI3K/Akt signal pathway is the main means to play a physiological role of insulin,and mTOR,its downstream substrate,is closely related to early embryonic development.This study aimed to explore the correlation between serum pAkt,mTOR and PCOS patients with IR threatened abortion in early pregnancy,to observe the clinical therapeutic effect of traditional Chinese medicine(TCM)of tonifying the kidney and the spleen method on them,to explain the improvement effect of the mechanism of IR and expand the ideas and methods for the treatment.[Methods]PCOS with threatened abortion selected by the inclusion criteria were divided into with IR group(A group,23 cases)and without IR group(B group,22 cases),who all received therapy with TCM of"ZHU YUN NING No.2" oral for 30 days to tonify the kidney and spleen.In addition,normal pregnant women without threatened abortion were selected as the control group(C group,24 cases).The results of serum pAkt and mTOR were tested by ELISA method.The ages,BMI Index,gestational days,the serum P,β-HCG,FPG,FINS,HOMA-IR,pAkt,mTOR levels and the TCM symptom condition of the three groups were statistically analyzed by SPSS 19.0 before and after treatment.[Result]There were 3 cases in group A and 2 cases in group B with spontaneous abortion,and 4 patients withdrew from the study in group C due to personal reason.Before treatment,the levels of serum pAkt,mTOR,P,β-HCG of group A and group B were significantly lower than that of group C(p<0.05);the FPG,FINS,HOMA-IR levels of the group A were significantly higher than that of the group B and C(p<0.05),but there was no significant difference between group B and C(p>0.05).After treatment,the levels of serum pAkt,mTOR,P,β-HCG in group A and group B were significantly increased than before(p<0.05),and compared with the group C,there was no significant difference(p>0.05);the FPG level had no significant difference among the three groups(p>0.05);the FINS,HOMA-IR levels of the group A decreased significantly than before(p<0.05),but still higher than that of group B and C(P<0.05).Comparison of the curative effect of TCM Syndrome:before treatment,the syndrome score of group A was significant higher than that of group B(P<0.05);after treatment,the score of the two groups were significantly decreased than before(P<0.05),and that of group A decreased more significantly than group B(P<0.05).After treatment for 30 days,the group A 23 cases,4 cases invalid,the total effective rate was 8 2.61%;the group B 22 cases,3 failed,the total effective rate was 86.36%,and the two effective rates had no significant difference(p>0.05).[Conclusion]Through this study,patients with PCOS suffered from IR and threatened abortion may be related to the abnormal expression of pAkt and mTOR.The severity of symptoms in PCOS with threatened abortion in early pregnancy may be associated with the degree of IR.In clinic,the TCM treatment of tonifying the kidney and the spleen could effectively improve the serum P,β-HCG,pAkt,mTOR levels,relieve insulin resistance,reduce the clinical syndromes,benefit for the maintenance of intrauterine fetal growth and development,which will be expected to become the method of treating PCOS with threatened abortion and offer thoughts of relieving insulin resistance.