基于线粒体能量代谢及氧化应激探讨育肾养卵方治疗肾精亏虚型卵巢储备功能减退的临床研究

Exploring the Clinical Efficacy of the Yushen Yangluan Formula in Treating Diminished Ovarian Reserve with Kidney Essence Deficiency Based on Mitochondrial Energy Metabolism and Oxidative Stress

    摘要
  • 摘要:
    目的 基于线粒体能量代谢及氧化应激探讨育肾养卵方治疗肾精亏虚型卵巢储备功能减退(DOR)的临床疗效。
    方法 选取2023年9月至2024年6月于上海中医药大学附属岳阳中西医结合医院妇科就诊的诊断标准符合肾精亏虚型DOR的患者70例，按照随机数表法分为试验组和对照组各35例(各脱落1例)，试验组服用中药育肾养卵方，对照组服用中药安慰剂，2组疗程均为3个月。治疗前后比较2组患者基础窦卵泡数(AFC)、中医证候积分以及血清抗苗勒管激素(AMH)、卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)值及活性氧(ROS)、三磷酸腺苷(ATP)水平变化情况。
    结果 治疗后，2组肾虚型中医证候积分均较前降低(P＜0.05，P＜0.01)，试验组优于对照组(P＜0.01)。治疗后试验组FSH较治疗前降低(P＜0.05)，AMH较治疗前升高(P＜0.05)，窦卵泡数(AFC)较治疗前升高(P＜0.01)，试验组优于对照组(P＜0.05，P＜0.01)。治疗后试验组患者血清ROS含量降低(P＜0.01)，ATP值上升(P＜0.01)，试验组优于对照组(P＜0.01)。
    结论 育肾养卵方能提高肾精亏虚型DOR患者的卵巢功能，改善中医证候积分，可能与提高线粒体能量代谢，降低氧化应激有关。

     

    Abstract:
    OBJECTIVE To explore the clinical efficacy of the Yushen Yangluan Formula in treating diminished ovarian reserve (DOR) with kidney essence deficiency based on mitochondrial energy metabolism and oxidative stress.
    METHODS A total of 70 patients diagnosed with DOR due to kidney essence deficiency, who visited the gynecology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from September 2023 to June 2024, were selected. The patients were randomly divided into two groups according to the random number table method. The treatment group (35 cases) received the Yushen Yangluan Formula, while the control group (35 cases) received a Chinese herbal placebo, with treatment lasting for 3 months, and during the treatment period, one case dropped out from each group. Antral follicle count (AFC), traditional Chinese medicine (TCM) syndrome scores, and serum levels of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), reactive oxygen species (ROS), and adenosine triphosphate (ATP) levels were compared between the two groups.
    RESULTS After treatment, the TCM syndrome scores for kidney deficiency in both groups decreased compared to before treatment (P < 0.05, P < 0.01), with the experimental group showing greater improvement than the control group (P < 0.01). Following treatment, the FSH levels in the experimental group decreased compared to before treatment (P < 0.05), while AMH levels increased (P < 0.05), and the antral follicle count (AFC) also increased significantly (P < 0.01), with the experimental group outperforming the control group (P < 0.05, P < 0.01). After treatment, serum ROS levels in the experimental group decreased (P < 0.01), and ATP levels increased (P < 0.01), with the experimental group showing superior results compared to the control group (P < 0.01).
    CONCLUSION Yushen Yangluan Formula can improve the ovarian function and TCM syndrome score of patients with DOR of kidney essence deficiency type, which may be related to improving mitochondrial energy metabolism and reducing oxidative stress.

     

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