目的 探讨益肾祛浊方对多囊卵巢综合征胰岛素抵抗(PCOS-IR)模型大鼠胃动素相关肽(Ghrelin)、性激素结合球蛋白(SHBG)及血清内脂素(VF)水平的影响.方法 将84只6周龄SD雌性大鼠完全随机化分组分为7组,每组各12只,具体如下:空白组、模型组、益肾祛浊方高剂量组、益肾祛浊方中剂量组、益肾祛浊方低剂量组、益肾组及二甲双胍组.造模成功后,灌服不同剂量益肾祛浊方或益肾方(益肾祛浊方高剂量组6460 mg/kg,益肾祛浊方中剂量组3230 mg/kg,益肾祛浊方低剂量组1615mg/kg,益肾组1400 mg/kg,空白组灌服生理盐水),以二甲双胍作对照,观察用药后各组大鼠Ghrelin、SHBG及VF水平的变化.结果 模型组Ghrelin水平较空白组显著降低(P＜0.05),益肾祛浊方各剂量组及益肾组Ghrelin水平较模型组升高,差异有统计学意义(P＜0.05).模型组SHBG水平较空白组降低(P＜0.05),各治疗组SHBG水平较模型组升高,差异有统计学意义(P＜0.05).模型组VF水平较空白组升高(P＜0.05),各治疗组VF水平较模型组降低,差异有统计学意义(P＜0.05).模型组睾酮(T)、黄体生成素/卵泡刺激素(LH/FSH)比值与空腹胰岛素(FINS)较空白组显著升高(P＜0.05),益肾祛浊方各剂量组T及LH/FSH比值较模型组降低,益肾组T水平较模型组降低,益肾祛浊方各剂量组及二甲双胍组FINS较模型组降低,差异有统计学意义(P＜0.05).结论 益肾祛浊方能通过改善PCOS-IR模型大鼠的胰岛素抵抗相关因子,抑制雄激素合成增加,恢复机体糖、脂代谢平衡,遏制PCOS-IR的恶性循环,达到治疗PCOS-IR的目的.%Objective To observe the effects of Yishen Quzhuo Decoction on the expression of Ghrelin,sex hormone-binding globulin (SHBG) and visfatin (VF) in rats with polycystic ovarian syndrome-insulin resistance (PCOS-IR).Methods Eighty-four female SD rats aged 6-week old were completely randomized into 7 groups,with 12 rats in each group,the groups were as followed:blank group,model group,high dose of Yishen Quzhuo Decoction group,middle dose of Yishen Quzhuo Decoction group,low dose of Yishen Quzhuo Decoction group,Yishen group and Metformin group.After the model was established successfully,different doses of Yishen Quzhuo Decoction or Yishen Decoction were given by garage (high dose of Yishen Quzhuo Decoction group:6460 mg/kg;middle dose of Yishen Quzhuo Decoction group:3230 mg/kg;low dose of Yishen Quzhuo Decoction group:1615 mg/kg;Yishen group:1400 mg/kg;blank group:normal saline),Metformin was taken as control,the level changes of Ghrelin,SHBG and VF in rats of each group after medication were observed.Results The level of Ghrelin in the model group was significantly lower than that of blank group (P ＜ 0.05),while the levels of Ghrelin in each dose of Yishen Quzhuo Decoction group and Yishen group were significantly higher than that of model group,the differences were statistically significant (P ＜ 0.05).The level of SHBG in the model group was significantly lower than that of blank group (P ＜ 0.05),while the levels of SHBG in each treatment group were significantly higher than that of model group,the differences were statistically significant (P ＜ 0.05).The level of VF in the model group was significantly higher than that of blank group (P ＜ 0.05),while the levels of VF in each treatment group were significantly lower than that of model group,the differences were statistically significant (P ＜ 0.05).The levels of testosterone (T),luteinizing hormone/follicle stimulating hormone (LH/FSH),fasting insulin (FINS) were significantly higher than those of blank group (P ＜ 0.05),the levels of T,LH/FSH in each dose of Yishen Quzhuo Decoction group were lower than those of model group,the level of T in Yishen group was lower than that of model group,the levels of FINS in each dose of Yishen Quzhuo Decoction group and Metformin group were lower than that of model group,the differences were statistically significant (P ＜ 0.05).Conclusion Yishen Quzhuo Decoction can improve the factors related to insulin resistance of rats with PCOS-IR,inhibit the increase of androgen synthesis,restore the balance of glycometabolism and lipid metabolism,contain the vicious circle of PCOS-IR,so as to achieve the purpose of treating PCOS-IR.
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