| Objective:To investigate the changes of follicular fluid-related metabolites before and after treatment of Chinese medicine for tonifying phlegm and blood stasis by quasi-targeted metabolomics study and quantification of traditional Chinese medicine syndrome before and after Chinese medicine intervention.Comprehensive analysis of the treatment outcomes,in order to explore the potential targets and pathways of traditional Chinese medicine,and provide a scientific basis for the clinical application of Chinese medicine for tonifying kidney and phlegm.Methods:A prospective randomized controlled trial was conducted to select women with in vitro fertilization-embryo transfer(IVF-ET)who were diagnosed as having endometriosis of kidney deficiency and blood stasis syndrome.Thirty-two patients in the Chinese medicine intervention group were treated group,28 patients in the endometriosis group alone were in the control group,and 33 patients with IVF/ICSI alone were selected as the normal control group,and the three groups were short-acting in the luteal phase.Long program.Clinical studies were conducted to compare the changes of syndrome scores before and after Chinese medicine intervention,as well as the number of eggs,embryos,eugenics,high quality embryos,biochemical pregnancy rate and clinical pregnancy rate of each group of patients.The experimental study used MetaboAnalyst’s professional omics processing software to use the partial least squares-discriminant analysis(PLS-DA)to screen and analyze the metabolites of each group of follicular fluid samples,and compare the differences and changes of metabolites between the groups.Find metabolites related to syndrome improvement and the pathway of action of Chinese medicine.Results:1.The results of clinical research showed that the symptoms of kidney deficiency and blood stasis inpatients with EMS after Chinese medicine intervention were improved,and the scores of kidney deficiency and blood stasis syndrome were decreased.The difference was statistically significant(p<0.01).The treatment group and normal control group were gonadotropins.The dosage of(Gn)was lower than that of the control group.The number of eggs and embryos increased compared with the control group.The excellent egg rate,high quality embryo rate and clinical pregnancy rate were higher than the control group(p<0.05 or p<0.01).),although the biochemical pregnancy rate was not statistically significant(P>0.05),it had an increasing trend.2.Quasi-targeted metabolomics experimental study found that there was a certain separation between the treatment group and the control group,and the metabolites had a certain change.After the intervention of traditional Chinese medicine,the treatment group was close to the normal control group,indicating that the Chinese medicine intervention had certain Effect.After intervention of traditional Chinese medicine,N-acetyltryptophan,2-Propenyl 1-(1-propenylsulfinyl)propyl disulfide,Metanephrine,20a-Dihydroprogesterone,Acrylamide,p-Cresol sulfate,Eicosatrienoic acid,Glycerophosphocholine,lactate,17-beta-estradiol-3,17-beta-sulfate,oxaloacetate,tryptophan,3-Carboxy-4-methyl-5-propyl-2-furanpropionic acid,Proline,Lipoamide,etc.,up-regulated,and Dihomolinoleic acid,Indoleacrylic acid,Choline The contents of components such as 1H-indole-3-carboxaldehyde,3-hydroxyoctanoyl carnitine,Acetylcarnitine,Retinol acetate,Indole,Testosterone Acetate were down-regulated.Through the Pathway analysis metabolic pathway analysis,after the intervention of traditional Chinese medicine,the glycerophospholipid metabolic pathway,pyruvate metabolic pathway,and citric acid cycle were regulated.Conclusion:1.Chinese medicine for tonifying kidney and phlegm can effectively improve the syndrome and clinical outcome of kidney deficiency and blood stasis in patients with endometriosis infertility.2.Improving the follicular fluid metabolomics component may be one of the possible mechanisms of the Chinese medicine for tonifying kidney and phlegm.3.Phospholipid choline substances can be used as potential markers of TCM syndromes in infertility related to kidney deficiency and blood stasis type endometriosis.4.Chinese medicine plays a therapeutic role in EMS-related infertility patients.The mechanism of improving IVF outcome may be related to tryptophan,N-acetyltryptophan,proline,glycerylphosphorylcholine,lactic acid,17-β-sulfate,20A.-dihydroprogesterone,testosterone acetate,eicosatrienoic acid,acetyl carnitine,3-hydroxyoctylcarnitine,hydrazine,1H-indole-3-carboxyaldehyde,hydrazine acrylate,oxaloacetate Related to metabolites such as salt,Chinese medicine for tonifying kidney and kidney phlegm may improve the clinical outcome of IVF through the pyruvate metabolic pathway,citric acid cycle,and glycerophospholipid metabolic pathway for EMS-related infertility patients. |
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