摘要
卵巢储备功能下降(DOR)已成为女性生殖系统面临的主要难题之一,其患病率持续攀升,对女性的生育能力和生活质量造成显著影响。DOR发病机制复杂,涉及年龄增长、自身免疫、遗传因素及环境影响等多方面,目前其具体的病理机制尚未被完全阐明,激素替代治疗为DOR主要治疗方法,但长期服用激素类药物存在一定不良反应。中药具有多靶点、多途径、多成分的治疗优势,强调整体论治、因人制宜,药物作用温和,可协助降低西药的不良反应。磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)信号通路在卵巢功能调节中发挥重要作用,通过调控卵泡激活与休眠、抑制颗粒细胞自噬、抑制卵巢氧化应激及细胞凋亡、促进卵母细胞成熟、促进颗粒细胞的增殖、促进卵巢血管生成等方面干预DOR。中药单体及复方可以通过调控PI3K/Akt信号通路调控卵巢微环境、促进卵泡活性及抑制细胞凋亡,有效保护DOR患者的卵巢细胞,恢复卵巢功能和生育能力。该文旨在系统梳理PI3K/Akt信号通路与DOR之间的病理关联,重点综述中药单体成分及复方在通过调控该信号通路干预DOR的最新研究进展,为未来开发新型中药治疗策略奠定理论基础。
Diminished ovarian reserve(DOR)has become one of the major challenges in women's reproductive health,with a continuously increasing prevalence that significantly affects female fertility and quality of life.The pathogenesis of DOR is complex,involving aging,autoimmunity,genetic factors,environmental influences,and other aspects,and its specific pathological mechanisms have not yet been fully elucidated.Hormone replacement therapy is the main treatment for DOR,but longterm use of hormonal drugs carries certain side effects.Chinese medicine has the therapeutic advantages of multi-target,multipathway,and multi-component actions.It emphasizes holistic treatment and individualized therapy,and its mild pharmacological effects can help reduce the side effects of Western medicines.The phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt)signaling pathway plays a crucial role in regulating ovarian function by controlling follicular activation and dormancy,inhibiting granulosa cell autophagy,reducing ovarian oxidative stress and apoptosis,promoting oocyte maturation,stimulating granulosa cell proliferation,and facilitating ovarian angiogenesis,thereby intervening in DOR.Chinese medicine monomers and compound formulas can modulate the ovarian microenvironment,enhance follicular activity,and inhibit apoptosis by regulating the PI3K/Akt signaling pathway,effectively protecting ovarian cells in DOR patients and restoring ovarian function and fertility.This review aims to systematically summarize the pathological association between the PI3K/Akt signaling pathway and DOR,and to highlight the latest research progress on Chinese medicine monomers and compound formulas that intervene in DOR by modulating this pathway,providing a theoretical basis for the development of novel Chinese medicine-based therapeutic strategies.
作者
张萍
徐燕文
周紫嫣
杨丽娟
ZHANG Ping;XU Yanwen;ZHOU Ziyan;YANG Lijuan(Jiangxi University of Chinese Medicine,Nanchang 330004,China;Affiliated Reproductive Hospital of Jiangxi University of Chinese Medicine,Nanchang 330004,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第23期266-275,共10页
Chinese Journal of Experimental Traditional Medical Formulae
基金
江西省中医药管理局(第三批)中医不孕疾病重点研究室项目(KP202202007)
江西省中医药管理局科技计划项目(2024B0581)。
