中医药治疗非肥胖型多囊卵巢综合征研究进展

Research progress of traditional Chinese medicine for non⁃obese polycystic ovary syndrome

多囊卵巢综合征(PCOS)是育龄期女性常见的一种生殖和内分泌代谢紊乱性疾病,临床表现具有高度异质性,可分为肥胖型和非肥胖型两种表型。有别于肥胖型PCOS,非肥胖型PCOS的关键病理特征为高雄激素血症及相应的临床表现,治疗时应当予以区别。从病因病机、临床研究、作用机制研究3个方面综述中医药治疗非肥胖型PCOS的研究进展。非肥胖型PCOS的核心中医病机是肾虚肝郁,中医药疗法(中药复方、单味中药、针刺)能有效调节非肥胖型PCOS患者的月经周期及性激素水平,增加排卵率,改善多毛、痤疮等高雄激素相关临床表现,提高妊娠率并改善妊娠结局。其机制可能与调节机体肠道菌群、炎症因子、神经生长因子,以及调控下丘脑-垂体-卵巢轴有关。

Polycystic ovary syndrome(PCOS)is a common reproductive and endocrine metabolic disorder in women of childbearing age.Due to a highly heterogeneous clinical presentation,PCOS has two phenotypes:obese and non-obese.Hyperandrogenemia and related clinical manifestations are the key pathological features that distinguish obese PCOS from non-obese PCOS,and treatment should vary accordingly.The research progress of TCM treatment of non-obese PCOS is reviewed from three aspects:etiology and pathogenesis,clinical research,and mechanism research.The core pathogenesis of non-obese PCOS is kidney deficiency and liver depression.Traditional Chinese medicine therapy(herbal formulas,single herbs,and acupuncture)can effectively regulate menstrual cycle and sex hormone levels in non-obese PCOS patients,increase ovulation rate,improve clinical manifestations of hyperandrogenism such as hirsutism and acne,increase pregnancy rate and improve pregnancy outcome.The therapeutic mechanism may be related to the regulation of the body’s gut microbiota,inflammatory cytokines,nerve growth factors,and the hypothalamic-pituitary-ovarian axis.