大补元煎加味治疗月经过少的药理研究进展

A review on the pharmacological effect of the Dabuyuan decoction on hypomenorrhea

月经过少是妇科常见疾病之一。随着现代社会节奏的加快、工作压力的增高以及人流、药流等宫腔操作的增多而造成子宫内膜的损害,月经过少的发病率逐年上升。西医认为月经过少只是妇科诸多疾病的临床症状之一,不作为单独的疾病,根据病因多采用激素疗法或手术治疗,但长期服用激素有增加心脑血管疾病、下肢静脉血栓及内膜癌的风险,伴有明显的不良反应。而中医理论认为此病之本在于肝肾,故治疗以滋补肝肾、益气活血为主。使用大补元煎加味能够滋肝肾,益气血,使得肾气旺盛,气血充足,冲任调和,对月经过少患者有显著疗效。且有较多药理研究与实验显示,方中的补肾药、补气药、活血药具有类激素作用;活血化瘀药可调节血脂、血液流变、血液黏度,增加子宫及卵巢血液供应、减少卵巢细胞免疫损伤,促使卵泡正常发育;补肾药可通过干预氧化应激过程保护卵巢功能及改善卵母细胞质量,调节下丘脑-垂体-卵巢轴功能,起到调节卵泡刺激素(Follicle-stimulating Hormone,FSH)、促黄体生成素(Luteinizing Hormone,LH)、雌二醇(E_(2))、孕酮水平的作用。总而言之,大补元煎可以改善性激素水平,保护卵泡发育,具有类雌激素样作用。文章主要对大补元煎治疗月经过少中的单味药及该方的药理作用进行梳理归纳,为临床应用与研究提供参考。

Hypomenorrhea is one of the common gynecological diseases.With the acceleration of the modern society rhythm,the increase of work pressure,as well as the increase of induced abortion and medical abortion and other uterine cavity operations resulting in damage to the endometrium,the incidence of hypomenorrhea is increasing year by year.Western medicine believes that hypomenorrhea is only one of the clinical symptoms of many gynecological diseases,which is not a separate disease.According to its etiology,hormone therapy or surgery is often used.However,long-term use of hormone therapy increases the risk of cardiovascular and cerebrovascular diseases,lower extremity venous thrombosis and endometrial cancer,and it is accompanied with obvious adverse reactions.The theory of traditional Chinese medicine believes that the foundation of this disease lies in the liver and kidney,so the treatment is to nourish the liver and kidney,invigorate Qi(气)and blood circulation.The Dabuyuan decoction(大补元煎)can nourish the liver and kidney,Qi and blood,make the kidney Qi vigorous,Qi and blood sufficient,Chong(冲)and Ren(任)harmonized,and has a significant effect on patients with hypomenorrhea.Many pharmacological studies and experiments have shown that the kidney-tonifying drugs,Qi tonifying drugs and blood activating drugs in the prescription have hormone-like effects.Drug for invigorating blood circulation and eliminating stasis can regulate blood lipid,blood rheology and blood viscosity,increase blood supply to uterus and ovary,reduce ovarian cell immune damage,and promote the normal development of follicles.Kidney-tonifying drugs can protect ovarian function and improve oocyte quality by intervening oxidative stress process,regulate the function of hypothalamic-pituitary-ovarian axis,and play a role in regulating FSH,LH,estradiol,progesterone levels.In conclusion,the Dabuyuan decoction can improve sex hormone levels,protect follicle development,and has estrogen-like effects.This paper mainly summarizes the single medicine and its pharmacological effect of the Dabuyuan decoction,so as to provide a reference for the clinical application and research.