摘要
早发性卵巢功能不全(premature ovarian insufficiency, POI)是卵巢衰老的一种表现形式,全球女性POI发病率为3.5%,若不及时干预,可迅速发展成卵巢早衰(premature ovarian failure, POF)。POI发病主要与遗传原因、医源性因素、自身免疫以及年龄、感染、心理等密切相关。POI不仅出现月经失调、闭经、不孕、性交痛等,还易出现情绪波动、失眠、潮热、乏力等症状,甚至发生骨质疏松、冠心病、糖尿病等,导致女性出现心理和生理长期健康问题。中医对POI多以肾阴虚立论,主要病机以肾虚为本,累及心肝脾,表现为肾虚肝郁、肾虚血瘀、脾肾阳虚等不同证型。中医药利用中医整体观、中药多成分、针刺多位点、协同多靶点与多通路等特点治疗POI,具有个体化强、安全性高、疗效好等独特优势。该文通过系统归纳梳理近10年中医药防治POI的动物与临床相关文献,发现中医药主要通过调节神经内分泌系统[下丘脑-垂体-卵巢轴(hypothalamic-pituitary-ovarian axis, HPOA)],改善卵巢功能,调控相关信号通路,增强机体免疫功能,提高抗氧化应激能力,维持线粒体能量代谢,抑制铁死亡,调节内质网应激等作用机制治疗POI,及改善其所致的月经失调、不孕及情绪不稳等。
Premature ovarian insufficiency(POI)is a manifestation of ovarian aging,with a global incidence of 3.5%.If not addressed in time,POI can rapidly develop into premature ovarian failure(POF).The incidence of POI is mainly related to genetic factors,iatrogenic factors,autoimmunity,aging,infection,psychological factors,and other influences.POI not only causes menstrual disorders,amenorrhea,infertility,and dyspareunia but also tends to present with symptoms such as mood swings,insomnia,hot flashes,fatigue,as well as osteoporosis,coronary heart disease,diabetes,and other conditions,resulting in long-term psychological and physical health concerns for affected women.From traditional Chinese medicine(TCM)'s perspective,POI is primarily attributed to kidney Yin deficiency,with the main pathogenesis rooted in kidney deficiency,which affects the heart,liver,and spleen.It manifests in different syndrome types,including kidney deficiency with liver Qi stagnation,kidney deficiency with blood stasis,and spleen-kidney Yang deficiency.TCM employs a holistic view,utilizing multi-component TCM,multi-site acupuncture,and multi-target and multi-pathway interventions to treat POl.It offers unique advantages such as strong personalization,high safety,and good efficacy.In this paper,the animal and clinical research literature on the prevention and treatment of POI in the past 10 years was systematically summarized and reviewed.It is found that TCM mainly treats POI and alleviates POI-caused issues such as menstrual disorders,infertility,and emotional instability by regulating the neuroendocrine system(hypothalamic-pituitary-ovarian axis,HPOA)and related signaling pathways,improving ovarian function and antioxidant capacity,enhancing immune function,maintaining mitochondrial energy metabolism,inhibiting ferroptosis,and controlling endoplasmic reticulum stress.
作者
田赛男
唐丽
王圣羽
陈瑶
曾晶
TIAN Sai-nan;TANG Li;WANG Sheng-yu;CHEN Yao;ZENG Jing(the First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Hunan University of Chinese Medicine,Changsha 401008,China)
出处
《中国中药杂志》
北大核心
2025年第11期2969-2981,共13页
China Journal of Chinese Materia Medica
基金
湖南省重点领域重点研发项目(2023SK2050)
湖南省中医药管理局委托项目(D2023002)
湖南省卫生健康委重点指导项目(C202305017704)
长沙市自然科学基金项目(Kq2202452)
2024湖南中医药大学第一附属医院中医药传承创新专项(2024XYLH340)
湖南省教育厅科学研究项目一般项目(22C0191)
湖南省卫生健康委卫生科研课题一般课题(W20243198)
湖南中医药大学校院联合基金重点项目(2023XYLHJJ005)
湖南中医药大学校级科研项目一般项目(Z2023XJYB21)
湖南中医药大学校级科研项目重点项目(2024XJZA004,2019XJJJ036)。
关键词
早发性卵巢功能不全
中医药
实验研究
临床研究
作用机制
premature ovarian insufficiency
traditional Chinese medicine
experimental research
clinical research
mechanism of action
