The Clinical Experience And Experimental Study Of The Tutor In The Treatment Of Follicular Dysplasia With Tonifying Kidney,Nourishing And Activating Blood Therapy

Objective:To summarize the clinical experience of tutor in the treatment of follicular dysplasia,and to enrich the theory and method of traditional Chinese medicine in the treatment of follicular dysplasia.In order to provide an objective theoretical basis for the clinical treatment of this kind of disease,the effect of Chinese medicine compound XJCRTSZW on Promoting Follicular development was studied in the rat model of follicular dysgenesis caused by Tripterygium wilfordii.Methods:1.This paper expounds the understanding of etiology and pathogenesis of follicular dysplasia in traditional Chinese and Western medicine,and the progress of treatment of follicular dysplasia by tonifying kidney,nourishing blood and activating blood circulation in traditional Chinese medicine.This paper summarizes the related academic thoughts of tutors in the treatment of this kind of disease,and summarizes the clinical experience of tutors in the treatment of this kind of disease combined with three clinical classic medical records.2.The 56 female SD rats were randomly divided into 7 groups.8 rats were randomly selected and gavaged with distilled water as the normal control group.The other 6 groups were gavaged with triptolide(TP)at a dose of 400?g / kg for 60 days.After successful modeling,it was divided into normal control group,TP model group,western medicine group,Chinese medicine high dose group and low dose group,inhibitor group,Chinese medicine high dose + inhibitor group.The change of estrous cycle was observed by smear and staining of vaginal exfoliated cells after 2weeks of gavage.Blood was drawn after gavage and serum E2,P,FSH,LH,AMHlevels were detected by ELISA,AI,HCT,ESR were detected by blood analyzer;rats were killed after blood collection,ovarian tissues were taken out and weighed,ovarian index was calculated,the number of primary,secondary,antral,atretic follicles and corpus luteum were counted under optical microscope,and the thickness of granulosa cell layer was measured by transmission electron microscope WB and RT-PCR were used to detect the protein expression and m RNA level of autophagy related factors in ovarian granulosa cells.Results :1.Compared with the normal control group,the estrous cycle of TP model group was prolonged and disordered(P<0.01),the wet weight of ovary and ovarian index were significantly reduced(P<0.01).The number of secondary and sinusoidal follicles decreased(P<0.01),the number of luteal cells and the thickness of granular cell layer decreased(P<0.01),the number of atretic follicles increased(P<0.01),and the number of primary follicles did not change significantly(P>0.05).Serum E2,P,AMH were significantly decreased(P<0.01),FSH and LH were significantly increased(P<0.01),AI and ESR index were increased(P<0.01),HCT was not significantly changed(P>0.05),and the number of autophagy bodies and lysosomes in rat ovarian granulosa cells was increased(P<0.01).2.Compared with the model group,the wet weight and index of ovary in the western medicine group and the traditional Chinese medicine group were increased(P<0.01);the number of secondary follicles,antral follicles,corpus luteum and granulosa cell layer were increased(P<0.01)The number of atretic follicles decreased(P<0.01);the level of serum E2,P,AMH increased(P<0.01);the level of FSH,LH decreased(P<0.01);AI,ESR index decreased(P<0.01);and the effect of high-dose group of traditional Chinese medicine was similar to that of Western medicine group(P>0.05);after using pathway inhibitor,the effect ofhigh-dose group of traditional Chinese medicine on the above indexes of ovary disappeared(P<0.01).3.Compared with the model group,the number of autophagy corpuscles and lysosomes in ovarian granulosa cells in the western medicine group and the traditional Chinese medicine group decreased(P<0.01).The phosphorylation level of PI3 K,Akt and mTOR protein was significantly increased(P<0.01),but there was no significant effect on the m RNA level(P>0.05);the protein expression and m RNA expression of Beclin1,lc3 ii,lc3i and p53 were down regulated(P<0.01).Under the action of inhibitors,the effect of high-dose Chinese medicine group on the above-mentioned related factors disappeared(P<0.01).Conclusion :1.After the establishment of triptolide model,the general situation of rats changed,the estrous cycle was disordered,the changes of serum sex hormone and ovarian histology were consistent with the performance of ovarian function damage,which indicated that triptolide can successfully establish the model of follicular development disorder.2.XJCRTSZW can improve the serum sex hormone level,increase the ovarian index and wet weight of ovary,increase the number of secondary and antral follicles and corpus luteum,increase the thickness of granular cell layer,and reduce the erythrocyte aggregation index(AI)and ESR.On the basis of nourishing kidney to protect the ovarian function of rats,the function of nourishing blood and promoting blood circulation of this Chinese medicine compound was exerted to improve the state of blood stasis of model rats.3.It is possible that PI3K/Akt/mTOR pathway can inhibit rat granulocyte autophagy to promote follicular development,improve ovarian function and repair the damage caused by triptolide.