| 严诗丝，黄金珠，马黔红，周航，夏宛廷，耿静然，杨娅青，李晓艳，曾倩.中医药多途径介入肾虚肝郁血瘀型再次IVF-ET长方案患者临床研究[J].南京中医药大学学报(社会科学版),2020,36(5):756-761. |
| 中医药多途径介入肾虚肝郁血瘀型再次IVF-ET长方案患者临床研究 |
| Clinical Study on Multiple TCM Interventions for Patients with Kidney Deficiency， Liver Depression， and Blood Stasis Syndrome Receiving a Second Long-Protocol IVF-ET |
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| DOI： |
| 中文关键词: 关键词：中医药多途径 再次IVF-ET 肾虚肝郁血瘀 TGF-β<\i>1 Treg Foxp3 |
| 英文关键词: multiple traditional Chinese medicine interventions second-cycle IVF-ET kidney deficiency, liver depression and blood stasis TGF-β<\i>1 Treg Foxp3 |
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| 中文摘要: |
| 目的 观察中医药多途径介入肾虚肝郁血瘀型再次体外受精-胚胎移植（IVF-ET）长方案患者的临床疗效，及对母胎界面转化生长因子-β<\i>1（TGF-β<\i>1）、叉头状/翼状螺旋转录因子3（Foxp3）及调节性T细胞（Treg）表达水平的影响。方法 入组123例患者随机分为治疗组62例和对照组61例，观察2组患者治疗前后中医证候积分及妊娠结局的变化。2组随机各抽取10例，检测免疫细胞因子表达水平。结果 治疗后治疗组TGF-β<\i>1、Foxp3、Treg表达水平升高（P<\i>＜0.05~0.01），高于对照组（P<\i>＜0.05~0.01）；治疗组中医证候积分较治疗前下降（P<\i>＜0.05~0.01），低于对照组（P<\i>＜0.05~0.01）。治疗组自然妊娠率、再次IVF-ET临床妊娠率高于对照组（P<\i>＜0.05~0.01）。结论 以补肾益精、疏肝活血法为核心的中医药多途径治疗IVF-ET长方案失败患者疗效确切，可能与通过调节母胎界面免疫耐受的相关细胞因子水平，保护胚胎免受母体免疫系统的攻击而顺利着床有关。 |
| 英文摘要: |
| OBJECTIVE To observe the clinical efficacy of multiple traditional Chinese Medicine (TCM) interventions for patients with kidney deficiency， liver depression， and blood stasis syndrome receiving a second long-protocol in vitro fertilization-embryo transfer (IVF-ET)-et， and the impacts on expressions of maternal-fetal interface transforming growth factor-β<\i>1 (TGF-β<\i>1) and forkhead box P3 (Foxp3) and regulatory T cell (Treg). METHODS A total of 123 patients were randomly divided into a treatment group of 62 cases and a control group of 61 cases. The changes in the endometrial thickness， TCM syndrome scores and pregnancy outcome of the two groups were observed before and after treatment. Ten cases from each of the two groups were randomly selected to detect the level of immune cytokines. RESULTS After treatment， the expression of TGF-β<\i>1， Foxp3， and Treg of the treatment group increased (P<\i><0.05， P<\i><0.01) and were higher than those of the control group (P<\i><0.05， P<\i><0.01). The TCM syndrome score in the treatment group was lower than that before treatment (P<\i><0.05， P<\i><0.01) and the TCM syndrome score of treatment group was lower than that of the control group (P<\i><0.05， P<\i><0.01). The natural pregnancy rate and the clinical pregnancy rate of second-cycle IVF-ET in the treatment group were higher than those in the control group after treatment (P<\i><0.05， P<\i><0.01). CONCLUSION Multiple TCM treatment with the core thoughts of recuperating kidney and benefiting essence， soothing liver and activating blood has certain effects when applied in patients who failed the long-term IVF-ET protocol， which may be related to the smooth implantation of embryos in the protection of embryos from maternal immune system by regulating the levels of related cytokines in the immune tolerance of the mother-fetal interface. |
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