基于“肾主生殖”探赜细胞自噬机制与卵泡发育的微观联系

Explore microcosmic connection between autophagy mechanism and follicular development based on "kidney governing reproduction" theory

肾藏精，主生殖，生殖之精是肾精的重要组成部分，是形成子代胚胎的原始物质。精子、卵细胞及受精卵都应当列入生殖之精的范围。卵子属先天生殖之精，卵泡能否发育成熟取决于卵母细胞质量之优劣和肾精是否充盛，而成熟卵子能否排出又有赖于肾气的激发和推动。自噬几乎发生于哺乳动物各种细胞，且存在于细胞的不同阶段。在卵巢中，自噬发生于卵泡的各发育阶段，参与了卵巢疾病的发生、发展。近年来，越来越多的学者将自噬与中医学相联系，认为细胞自噬是探索中医药微观作用机制的新领域。补肾中药可通过促进卵泡发育，抑制颗粒细胞凋亡，减少卵泡闭锁，改善卵巢功能，进而改善各种临床症状，而颗粒细胞的凋亡与自噬密切相关。该文基于中医“肾主生殖”理论阐释了细胞自噬与卵泡发育之间的微观联系，从而更深～步探讨补肾中药促卵泡发育的分子机制，以期为中医药补肾法促卵泡发育、改善卵巢功能提供一定的理论依据，将对适时有效地预防和干预生殖系统的疾病都具有重大的意义。

In the theory of traditional Chinese medicine（TCM） that ＂ kidney storing essence and governing reproduction＂ , repro- ductive essence is an important part of the kidney essence and acts as the original material of offspring embryos. Sperm, oocyte and zy- gote should be all included in the range of reproductive essence. Ovum is the essence of reproduction from inborn. The follicles matura- tion depends on the quality of oocyte and the vigor of kidney essence. Meanwhile, discharge of mature ovum relies on the stimulation and promotion by kidney Qi. Autophagy almost exists in different cells stages and all various of mammalian cells. Many studies have found that autophagy not only participates in the formation of follicles, but also in every phase of the follicles development, and is in- volved in the occurrence and development of ovarian diseases. Recently, more and more scholars believe that autophagy is a new field to explore the microcosmic relationship between autophagy and TCM. Kidney-nourishing TCM could promote follicular growth and im- prove variety clinical symptoms by inhibiting the apoptosis of ovarian granulosa cells and reducing follicular atresia. Meanwhile, apopto- sis of ovarian granulosa ceils is closely related to autophagy of ovarian granulosa ceils. In order to provide some theoretical foundation for kidney-nourishing therapy＇s promoting effect on follicular growth and improving effect on ovarian function, also to further explore the molecular mechanism of kidney-nourishing medicine in promoting follicular development, this paper would explain the microcosmic re- lationship between autophagy and follicular development based on the theory of ＂kidney governing reproduction＂. AII of these would be of great significance to prevent and intervene the diseases of reproductive system timely and effectively.