电针结合克罗米芬对多囊卵巢综合征大鼠子宫内膜胰岛素受体和胰岛素受体底物1蛋白表达及胚泡着床的影响

目的:探讨电针提高克罗米芬促排多囊卵巢综合征(PCOS)大鼠胚泡着床的作用机制。方法:24日龄雌性SD大鼠皮下注射含脱氢表雄酮的麻油溶液结合高脂饮食造模;PCOS大鼠随机分为模型组、克罗米芬组、电针组、电针+克罗米芬组,每组25只。各组均于80日龄起进行干预,其中电针组及电针+克罗米芬组先电针治疗,选取"中脘""关元""天枢"穴,1周3次,连续5周;治疗结束后第1、2天,克罗米芬组、电针+克罗米芬组灌服克罗米芬(100mg·kg-1·d-1)。全部治疗结束后,各组分别取出大鼠(15只)与雄鼠交配,妊娠第8天处死,观察大鼠妊娠率及胚泡着床情况;各组其余大鼠断头处死,留取子宫内膜标本,Western blot法检测受体胰岛素受体(INSR)及胰岛素受体底物1(IRS 1)蛋白的表达。结果:模型组大鼠妊娠率和胚泡着床数显著低于正常组(P0.05);与模型组相比,克罗米芬组、电针组、电针+克罗米芬组大鼠妊娠率和胚泡着床数均显著增加(P0.05),其中电针+克罗米芬组妊娠率和胚泡着床数显著高于电针组和克罗米芬组(P0.05)。与正常组比较,模型组子宫内膜组织INSR及IRS 1蛋白表达降低(P0.05);与模型组比较,电针、电针+克罗米芬组INSR及IRS 1蛋白表达显著增加(P0.05);与克罗米芬组比较,电针、电针+克罗米芬组INSR及IRS 1蛋白表达显著增加(P0.05)。结论:电针能够提高克罗米芬促排PCOS大鼠的妊娠率和胚泡着床数,其机制可能与提高PCOS大鼠子宫内膜组织中INSR和IRS 1蛋白表达水平有关。

Electroacupuncture Combined with Clomiphene Promotes Pregnancy and Blastocyst Implantation Possibly by Up-regulating Expression of Insulin Receptor and Insulin Receptor Substrate 1 Proteins in Endometrium in Rats with PCOS

Objective To observe the effect of electroacupuncture(EA)intervention combined with clomiphene critate(CC)on the blastocyst implantation and pregnancy rate and expression of insulin receptor(INSR)and insulin receptor substrate 1(IRS 1)proteins in the endometrium in rats with polycystic ovary syndrome(PCOS),so as to reveal its mechanisms underlying improvement of PCOS.Methods One hundred and twenty-five female SD rats were randomly divided into normal control,PCOS model,medication(CC),EA and EA+CC groups(n=25in each group,15 for checking blastocyst implantation,and 10 for Western blot).The PCOS model was established by subcutaneous injection of Dehydroepiandrosterone(DHEA)and fed with high-fat diet.Rats of the normal control group were treated by subcutaneous injection of sesame oil and fed with the normal forage.EA stimulation was applied to"Zhongwan"(CV 12),"Guanyuan"(CV 4)and bilateral"Tianshu"(ST 25)for 30 min,3times a week,5weeks altogether.Rats of the CC and EA+CC groups were fed with CC(100mg·kg-1·d-1)for 2days after regular restriction(30min,3times a week,5weeks altogether).The pregnancy was determined by vaginal smear tests and the number of blastocyst implantation determined by examination of the uterus after execution.The expression of INSR and IRS 1proteins in the endometrium was detected by Western blot.Results The pregnancy rate and the number of blastocyst implantation were significantly lower in the model group than in the normal control group(P<0.05),and remarkably increased after EA and EA+CC interventions(P<0.05).The effects of EA+CC were obviously superior to those of simple EA and simple medication in raising the pregnancy rate and the number of blastocyst implantation(P<0.05).No significant differences were found between the EA and CC groups in the pregnancy rate and the number of blastocyst implantation(P>0.05).The relative expression levels of both INSR and IRS 1proteins were markedly lower in the model group than in the normal control group(P<0.05),and significantly higher in both EA and EA+CC groups than in the model group(P<0.05).No significant differences were found between the model and the CC groups and between the EA and EA+CC groups in the expression levels of INSR and IRS 1 proteins(P>0.05).Conclusion EA intervention can improve pregnancy rate and the number of blastocyst implantation in PCOS rats,which may be related to its effects in up-regulating the expression of INSR and IRS 1proteins in the endometrium.