补肾对超排卵周颗粒细胞gdnf、gfr_α-1表达的影响.pdfVIP

结论：1.获得与既往国家级和省级课题相同的临床妊娠率（54%左右）。在 IVF-ET 治疗周期，应用补肾中药可明显改善患者肾虚症状，减少 Gn 用量，提高优质卵率、 优质胚胎率，进而改善临床妊娠率，是临床常用的有效药物。2.补肾中药提高颗粒细 胞 GDNF、GFR-1mRNA 的表达，改善颗粒细胞分泌功能，这可能是补肾中药改善 IVF 结局的机制之一。3.补肾中药促进小鼠 GV 期卵母细胞生殖泡的破裂（GVBD ） 和第一极体（PB1 ）的排出；提高小鼠卵母细胞GFR-1mRNA 的表达，并改善了小 鼠受精卵的卵裂、形成囊胚的能力。推断：补肾中药提高颗粒细胞 GDNF、GFR-1mRNA 的表达，提高小鼠卵母细胞 GFR-1mRNA 的表达，促进卵母细胞 GVBD 和 PB 1 的 排出，从而改善了卵母细胞成熟度，提高卵细胞质量，从而提高胚胎质量及临床妊娠 率。这可能又是补肾中药改善 IVF 结局的机制之一。 关键词 补肾；肾主生殖；控制性超排卵；颗粒细胞 GDNF 、GFR-1mRNA 1 Effects of Reinforcing Kidney on the Expression of GDNF、GFR-l in Granulosa Cell of Superovulation Cycle Speciality: Gynecology of TCM Author ：CHEN Y an-hua Tutor：Prof. LIAN Fang Abstract Objective：To investigate the effects of reinforcing kidney on the expression of GDNF、GFR-l in granulosa cell of superovulation cycle, In view of GVBD、extrusion of PB1and oocyte maturation paracrine, to explore the mechanism of reinforcing Kidney Chinese herbs Erzhitiangui(ETG) Granule to improve the treatment outcome of in superovulation cycle. Method ： Clinical Study: 80 infertile women with tubal factor undergoing vitro fertilization-embryo transfer (IVF-ET) were randomized into the study group, treated with ETG and Gn(40 cases), and the control group, treated with placebos granules and Gn (40 cases). The long term protocol was adopted. The E2 and P secretion in granule cell after cultured for 24h、48h in vitro was observed to learn about the secreting function of granule cell. The expression of GDNF、GFR-1mRNA in luteinizing granulosa cells were also detected. The syndrome scores of TCM, administration time and number of Gn, number of retrieved oocytes, fertilization rate, high quality embryo rate and pregnancy rate were evaluated. Experimental Stu