Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder prevalent in females of reproductive age; insulin resistance (IR) is the major pathogenic driver. Pharmacology is a basic option for PCOS therapy; traditional Chinese medicine (TCM), as a significant part of complementary and alternative medicine, has a long history in the clinical management of PCOS. Cangfudaotan decoction (CFD) has been used clinically for gynaecological diseases especially PCOS. In this study, first, chemical components in CFD were clarified using UPLC-Q/TOF-MS analysis. Then, an animal model of PCOS was established, granular cells were also isolated from the rats with PCOS, and CFD was administrated at different dosages in PCOS rats and granular cells, to investigate the therapeutic effect and mechanisms of CFD for PCOS treatment. The result showed that CFD treatment is effective in PCOS rats and granulosa cells. CFD was able to improve IR, restore the serum hormone levels, inhibit the inflammatory cytokines in PCOS rat, and alleviate ovary morphological injury and apoptosis in PCOS rats. In granulosa cells of PCOS, the result showed that the cell viability was improved, and cell apoptosis was inhibited after CFD administration. Further experiments suggested that CDF improves IR, follicular development, cell apoptosis, and inflammatory microenvironment, and this was associated to the regulation of IGF-1-PI3K/Akt-Bax/Bcl-2 pathway-mediated gene expression. Given that CFD sufficiently suppresses insulin resistance and improves follicular development in this study, exploring these mechanisms might help to optimize the therapeutic treatment of CFD in PCOS patients.

中文翻译：

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苍附道痰汤通过IGF-1-PI3K/Akt-Bax/Bcl-2通路减轻多囊卵巢综合征大鼠胰岛素抵抗并改善卵泡发育

多囊卵巢综合征 (PCOS) 是育龄女性最常见的内分泌和代谢疾病；胰岛素抵抗 (IR) 是主要的致病驱动因素。药理学是 PCOS 治疗的基本选择；中医药作为补充和替代医学的重要组成部分，在多囊卵巢综合征的临床管理中有着悠久的历史。苍附道痰汤（CFD）已在临床上用于妇科疾病尤其是PCOS。在本研究中，首先使用 UPLC-Q/TOF-MS 分析澄清 CFD 中的化学成分。然后，建立PCOS动物模型，分离PCOS大鼠颗粒细胞，分别给予PCOS大鼠和颗粒细胞不同剂量的CFD，研究CFD治疗PCOS的疗效及机制。结果表明CFD治疗对PCOS大鼠和颗粒细胞有效。CFD能够改善IR，恢复血清激素水平，抑制PCOS大鼠的炎性细胞因子，减轻PCOS大鼠的卵巢形态损伤和细胞凋亡。结果表明，在PCOS的颗粒细胞中，CFD给药后细胞活力提高，细胞凋亡受到抑制。进一步的实验表明，CDF 改善 IR、卵泡发育、细胞凋亡和炎症微环境，这与调节 IGF-1-PI3K/Akt-Bax/Bcl-2 通路介导的基因表达有关。鉴于本研究中 CFD 充分抑制胰岛素抵抗并改善卵泡发育，探索这些机制可能有助于优化 PCOS 患者 CFD 的治疗。