中药缓解年龄相关卵巢功能减退的研究进展

Prevention and Treatment of Age-related Ovarian Hypofunction with Traditional Chinese Medicine:A Review

年龄相关的卵巢功能减退包括了卵泡数量、质量的下降及卵巢微环境的改变,其机制主要与线粒体功能障碍、自由基与抗氧化系统、端粒及端粒酶改变、细胞凋亡等有关,是造成高龄女性不孕症的主要因素之一。尽管生殖医学领域在近几十年取得巨大进步,但在缓解年龄相关的卵巢功能减退和改善高龄女性生殖结局方面却几乎没有取得任何突破性进展。近年来,中医药通过调整线粒体稳态、缓解氧化应激及抑制细胞凋亡等多层次、多靶点作用机制改善年龄相关的卵巢功能减退的研究越来越多,同时,较多高质量的随机对照试验证明了中医药在辅助生殖领域的临床疗效。鉴于此,该文依据近年来中药活性成分、单味中药和中药复方在延缓年龄相关卵巢功能减退的作用机制研究及随机对照试验取得的进展进行系统综述,明确其研究现状和不足,为有效缓解年龄相关的卵巢功能减退和改善高龄女性生育结局提供中医药临床用药思路。

Age-related ovarian hypofunction includes a decrease in follicle quantity and quality as well as alterations in the ovarian microenvironment,the mechanisms of which are mainly related to mitochondrial dysfunction,free radical and antioxidant systems,telomere and telomerase alterations,and apoptosis,and is one of the major factors contributing to infertility in advanced maternal age(AMA).Despite the tremendous progress in assisted reproductive technology in recent decades,few breakthroughs have been made in alleviating agerelated ovarian hypofunction and improving reproductive outcomes for AMA.In recent years,there has been an increasing number of studies on the multi-level and multi-targeted mechanisms of traditional Chinese medicine(TCM)to improve age-related ovarian hypofunction by modulating mitochondrial homeostasis,alleviating oxidative stress,and inhibiting apoptosis,while more high-quality randomized controlled trials have demonstrated the clinical efficacy of TCM in assisted reproductive technology.Given this,this article presented a systematic review of recent research and randomized controlled trials on the mechanism of Chinese medicine active ingredients,single Chinese medicine,and Chinese medicine compounds in delaying age-related ovarian hypofunction,to clarify the current status and shortcomings of the research.This paper provides medication management of TCM for effectively alleviating age-related ovarian hypofunction and improving reproductive outcomes for AMA.