赵井苓 王娟 萧闵 谢莉 李成银 秦丹梅

〔摘要〕 目的 探討补肾活血方对卵巢储备功能下降（diminished ovarian reserve， DOR）大鼠生殖激素水平及卵巢组织形态的影响。方法 采用Ataya法复制DOR大鼠模型。随机分为6组，每组10只。空白组不予处理;模型组给予蒸馏水;戊酸雌二醇组给予戊酸雌二醇水溶液（90 μg/kg），补肾活血方低、中、高剂量组给予补肾活血方水煎剂（7.875、15.750、31.500 g/kg）。按大鼠体质量1 mL/100 g的容积灌胃，每日1次，共14 d。每天观察并记录各组大鼠一般生理反应。造模结束7 d后，从第8天开始，每日早上9点抓取各组大鼠，行阴道涂片观察。14 d治疗结束后，HE染色光镜下观察卵巢组织的形态，ELISA法检测血清中卵泡刺激素、黄体生成素、雌二醇及抗米勒管激素（anti-Müllerian hormone， AMH）的含量。结果 在增加DOR模型大鼠卵泡计数上，补肾活血方高剂量组优于戊酸雌二醇组（P<0.05），也优于补肾活血方低剂量组（P<0.05）;在调节AMH上，补肾活血方高、中剂量组优于戊酸雌二醇组（P<0.05），更优于补肾活血方低剂量组（P<0.01）。结论 补肾活血方可能通过增加DOR模型大鼠卵泡数、提高AMH水平、促进性激素分泌、调节动情周期，进而改善DOR模型大鼠的卵巢储备功能。

〔关键词〕 补肾活血方;卵巢储备功能;卵泡数;动情周期;性激素

〔中图分类号〕R271.9       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.07.010

〔Abstract〕 Objective To explore the effects of Bushen Huoxue Decoction on the levels of reproductive hormones and ovarian tissue morphology in diminished ovarian reserve （DOR） rats. Methods The DOR rat model was established by Ataya method. They were randomly divided into six groups， with 10 rats in each group. Blank group was not treated; model group was given distilled water; estradiol valerate group was given estradiol valerate solution （90 μg/kg）; Bushen Huoxue Decoction low， middle and high dose groups were given Bushen Huoxue Decoction （7.875， 15.750， 31.500 g/kg）. The rats were fed intragastrically according to the volume of 1 mL/100 g of body weight. The rats were given intragastric administration once a day for 14 days. The general physiological responses of rats were observed and recorded every day. After 7 days of modeling， from day 8， each group of rats was captured at 9 o'clock every morning for vaginal smear observation. After 14 days of treatment， the morphology of ovarian tissue was observed under light microscopy with HE staining， and the content of follicle stimulating hormone， luteinizing hormone， estradiol and anti-Müllerian hormone （AMH） in serum was detected by ELISA. Results In increasing the follicle count of DOR model rats， Bushen Huoxue Decoction high dose group was better than estradiol valerate group （P<0.05）， and also better than Bushen Huoxue Decoction low dose group （P<0.05）; in the regulation of AMH， the high and medium dose groups of Bushen Huoxue Decoction were better than the estradiol valerate group （P<0.05）， and better than the low dose group of Bushen Huoxue Decoction （P<0.01）. Conclusion Bushen Huoxue Decoction may increase the number of follicles in DOR model rats， increase the level of AMH， promote the secretion of sex hormones， and regulate the estrous cycle， thereby improving the ovarian reserve of DOR model rats.

〔Keywords〕 Bushen Huoxue Decoction; ovarian reserve function; number of follicles; estrous cycle; sex hormones

卵巢储备功能（ovarian reserve， OR）是指卵巢皮质区卵泡生长、发育、形成卵子、排出卵子以及具有分泌性激素的能力。中医认为卵巢储备功能下降（diminished ovarian reserve， DOR）以肾气亏虚、气滞血瘀等为其主要病因病机，治疗上多以补肾、活血等为原则[1-4]。

本课题组前期开展了补肾活血方的系列临床科研课题[1-2]，显示出该方在DOR治疗上的优势，但作用机制尚不清楚。为此，本研究采用Ataya法注射环磷酰胺复制大鼠DOR的模型，观察补肾活血方对大鼠生殖激素水平和卵巢组织形态的影响，探明其作用机制，为临床研究提供科学依据，也为下一步研究有效药物的物质基础奠定基础。……