Effect Of Phlegm-resolving Therapy On Oocyte Quality In Phlegm-dampness PCOS Patients Based On IRS-1/PI3K/GLUT4 Pathway

Objective:To study the effect of Cang fu Dao tan Decoction on insulin metabolism pathway,oocyte quality and embryo development potential of local IRS-1/PI3K/GLUT4 in PCOS patients with phlegm-dampness infertility.To explore the possible mechanism of IR in patients with phlegm-dampness polycystic ovary from the perspective of energy metabolism,and the possible mechanism of spleen-invigorating,dampness-removing and phlegm-resolving method in improving IR.Methods: Seventy-six patients with phlegm-dampness type PCOS were selected and divided into experimental group(Cang fu dao tan Decoction IVF)and placebo group(IVF,38 cases)according to random numerical table,and the patients were divided into two groups: control group(n = 38)and placebo group(n = 38).In addition,38 PCOS patients with non-phlegm-dampness type(placebo IVF)were selected as control group.All patients in the three groups were treated with double descending regimen(Gn RH-a-35).The changes of phlegm-dampness syndrome integral and insulin resistance index(HOMA-IR)were compared between the experimental group and the observation group before and after treatment,and the number of eggs obtained,the fertilization rate,the 2PN cleavage rate,the embryo formation rate,and the high-quality embryos in the three groups were compared.The expression of IRS-1,PI3 K,GLUT4m RNA in granulosa cells was measured by real-time quantitative fluorescence(Real time-PCR).Results: 1.The phlegm-dampness syndrome and HOMA-IR group decreased significantly after treatment(P < 0.05).05),there was no significant difference between the observation group and the observation group(P > 0.05).There was a significant positive correlation between the scores of phlegm-dampness syndrome and HOMA-IRbefore treatment in the control group,the experimental group and the observation group(r= 0.728,P < 0.05).01)3.The number of eggs obtained in the control group was more than that in the experimental group,and that in the experimental group was more than that in the experimental group(P < 0.05).The fertilization rate,embryo formation rate and excellent embryo rate in the control group were higher than those in the experimental group,the observation group was higher than the observation group,and the experimental group was higher than that in the observation group.There was no significant difference in the cleavage rate of 2PN among the three groups(P > 0 05).The expression of IRS-1,PI3 K and GLUT4 m RNA in the granulosa cells of the ovary in the three groups were significantly higher than those in the experimental group and the control group,and the expression in the experimental group was significantly higher than that in the observation group(P < 0.05).Conclusion:1.Cang fu dao tan Decoction can improve the symptoms of phlegm and dampness in patients with PCOS,relieve the state of insulin resistance,improve the quality of egg cells,and then improve the developmental potential of embryos.2.There is a significant positive correlation between phlegm-dampness syndrome and HOMA-IR.3.The method of eliminating phlegm may improve the status of insulin resistance in ovary of PCOS patients by up-regulating the expression of IRS-1/PI3K/GLUT4 signaling pathway,and then improve the quality of oocyte and embryo.