目的研究调经活血汤对多囊卵巢(PCO)大鼠的血清激素水平、卵巢质量、形态及卵巢颗粒细胞凋亡等的影响,探讨其治疗效果及作用机制。方法大鼠造模成功后随机分成中药治疗组和对照组,观察动物体重增加幅度、血清激素水平变化情况,末端脱氧核苷酸转移酶介导的dUTP缺口末端标记法(TUNEL)观察卵巢颗粒细胞凋亡,免疫组化法观察颗粒细胞凋亡调控蛋白Bcl-2、Bax表达水平的变化。结果治疗组动物体重增加幅度明显降低,中药治疗组血清T浓度较对照组、正常组显著性降低;血清E2较对照组明显降低;血清P水平较对照组明显升高,血清FSH、LH浓度与对照组无明显差异。中药治疗组卵巢镜下可见多个囊状扩张的卵泡,但体腔较对照组明显缩小,颗粒细胞层数增加至4～7层,并可见少量黄体形成;中药治疗组卵巢颗粒细胞凋亡率较对照组显著降低,卵巢颗粒细胞Bcl-2表达的OD值较对照组显著增高,Bax表达的OD值显著降低。结论调经活血汤能使多囊卵巢大鼠卵巢颗粒细胞凋亡相关蛋白bcl-2表达明显升高,Bax表达明显降低,巢颗粒细胞凋亡率显著性降低;卵巢颗粒细胞层数增加,黄体形成增加:体重、血清T、E2激素水平明显下降,血清P激素水平明显升高,其作用可能与调节卵巢颗粒细胞上Bcl-2和Bax蛋白表达,影响两蛋白的比例关系,增加Bcl-2/Bax的比值,使Bax与Bcl-2蛋白形成异源二聚体,发挥其抗细胞凋亡的作用有关。 Objective To investigate the effects of Tiaojing Huoxue decoction on serum hormone levels, ovarian mass, morphology and apoptosis of ovarian granulosa cells in polycystic ovary (PCO) rats, and to explore the therapeutic effect and mechanism. Methods Rat models were randomly divided into traditional Chinese medicine treatment group and control group. Animals were observed for weight gain and serum hormone levels. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was used to observe ovarian granulosa cells. Apoptosis and immunohistochemistry were used to observe the expression of Bcl-2 and Bax in granulosa cells. RESULTS: The increase in body weight of the treatment group was significantly lower. The T concentration in the TCM treatment group was significantly lower than that in the control group and the normal group; the serum E2 level was significantly lower than that in the control group; the serum P level was significantly higher than that in the control group, and the serum FSH and LH concentrations were comparable. There was no significant difference in the control group. In the Chinese medicine group, multiple cystic dilated follicles were seen under the ophthalmoscope. However, the body cavity was significantly smaller than that of the control group, and the number of granulosa cells increased to 4-7 layers, and a small amount of corpus luteum formation was observed; the apoptosis rate of ovarian granulosa cells was similar in the Chinese medicine treatment group. In the control group, the OD value of Bcl-2 expression in ovarian granulosa cells was significantly higher than that in the control group, and the OD value of Bax expression was significantly decreased. Conclusion Tiaojinghuoxue decoction can significantly increase the expression of apoptosis-related protein bcl-2 in ovarian granulosa cells of rats with polycystic ovary, and the expression of Bax is significantly decreased. The apoptosis rate of nest granulosa cells is significantly decreased; the number of granulosa cells in ovarian ovary is increased and the corpus luteum is formed. Increase: body weight, serum T, E2 hormone levels decreased significantly, serum P hormone levels increased significantly, its role may be related to regulation of ovarian granulosa cells on the expression of Bcl-2 and Bax protein, affect the ratio of the two proteins, increase Bcl-2/ The Bax ratio causes Bax to form a heterodimer with the Bcl-2 protein and exert its anti-apoptotic effects.