摘要
排卵障碍以卵泡成熟异常或排出障碍为核心表现,病因复杂且临床缺乏特效防治手段。自噬功能紊乱与排卵障碍的发生发展密切相关。本文从自噬角度系统阐述中药在卵泡发育及排卵障碍中的作用机制,并梳理了中药调控自噬影响卵泡发育、改善排卵障碍的相关研究,发现中药单体/活性成分(益母草碱、杜仲总黄酮、山姜素、淫羊藿素等)及复方(苍附导痰汤、归肾育宫汤、助卵汤、益肾养卵方、归肾丸等)可通过调控自噬相关基因和磷脂酰肌醇3激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白、AMP活化蛋白激酶等信号通路,改善卵泡微环境、调节性激素水平、减少卵泡闭锁,从而促进卵泡正常发育与排出,延缓卵巢衰老。该领域的研究主要基于细胞与动物实验,且多聚焦于单一信号通路或因子,部分研究未能充分体现中医药“辨证施治”的个体化治疗特色,亟待进一步研究。
Ovulatory disorders are mainly characterized by abnormal follicular maturation or ovulation,with complex etiologies and a lack of effective prevention and treatment methods.Autophagy dysfunction is closely related to the generation and progression of ovulatory disorders.This article systematically elucidates the mechanisms of TCM on follicular development and ovulatory disorders from the perspective of autophagy.It also reviews relevant studies on how TCM regulates autophagy to influence follicular development and improve ovulatory disorders.The findings reveal that TCM monomers/active ingredients(leonurine,total flavonoids from Eucommia ulmoides,alpinetin,icariin,etc.)and compound formulas(including Cangfu daotan decoction,Guishen yugong decoction,Zhuluan decoction,Yishen yangluan formula,Guishen pill,etc.)improve the follicular microenvironment,regulate sex hormone levels,and reduce follicular atresia by regulating autophagy-related genes and signaling pathways such as phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin and AMP-activated protein kinase.These actions thereby promote normal follicular development and ovulation,and delay ovarian aging.Most research in this field is based on cellular and animal experiments,often focusing on a single signaling pathway or factor.Some studies fail to fully reflect the individualized treatment characteristics of TCM that emphasize“syndrome differentiation and treatment”,highlighting the urgent need for further investigation.
作者
屈亚雪
丁樱
韩姗姗
孙昭恒
邢文超
QU Yaxue;DING Ying;HAN Shanshan;SUN Zhaoheng;XING Wenchao(Dept.of Pediatrics,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;College of Pediatrics,Henan University of Chinese Medicine,Zhengzhou 450046,China)
出处
《中国药房》
北大核心
2025年第24期3132-3136,共5页
China Pharmacy
基金
国家自然科学基金项目(No.82205187)
河南省医学科技攻关计划项目联合共建项目(No.LHGJ20230684)
“止喘灵杯”青年医师创新发展项目(No.EKQNJJ-2024-08)。
关键词
自噬
排卵障碍
中药
作用机制
autophagy
ovulatory disorders
traditional Chinese medicine
mechanism of action
