多囊卵巢综合征线粒体功能障碍机制及中医药干预研究进展

Mechanism of mitochondrial dysfunction in polycystic ovary syndrome and traditional Chinese medicine intervention: a review

多囊卵巢综合征(PCOS)是一种高度流行的生殖内分泌疾病,以稀发排卵、高雄激素血症(HA)和多囊卵巢形态(PCOM)为特征,常伴有胰岛素抵抗(IR)、肥胖、代谢紊乱等,易导致心血管疾病、子宫内膜癌等远期并发症,严重影响绝经前妇女的身心健康和生活质量。PCOS的病因不明,近年来许多学者提出线粒体功能障碍可能是PCOS发病的一个重要因素。中医药可发挥中医整体观、中医辨证论治及中医药多系统、多靶点调理等独特优势,多方面协同改善PCOS的症状与体征。虽然国内外已有PCOS线粒体功能障碍机制的相关综述,但目前尚缺乏中医药通过干预线粒体功能以改善PCOS的综述。因此该文综述了PCOS线粒体功能障碍的病理机制,并归纳总结近5年中医药基于线粒体功能以及炎症、氧化应激(OS)、自噬和凋亡等与线粒体功能相关的机制以干预PCOS的研究,以期为中医药防治PCOS提供新的研究思路,为临床上中医药治疗PCOS提供理论依据。

Polycystic ovary syndrome(PCOS) is a highly prevalent endocrine and reproductive disorder characterized by ovulatory dysfunction, hyperandrogenism(HA), and polycystic ovarian morphology(PCOM). It is often accompanied by insulin resistance(IR), obesity, and metabolic disorders and can lead to cardiovascular diseases, endometrial carcinoma and many other late complications, seriously affecting the physical and mental health and quality of life in premenopausal women. The etiology of PCOS is still unknown and many scholars assume that mitochondrial dysfunction may represent a major pathogenic factor in PCOS in recent years. With a holistic view, treatment based on syndrome differentiation, and multi-system and multi-target treatment manner, traditional Chinese medicine(TCM) can mitigate the symptoms and signs of PCOS from multiple aspects. Although there have been reviews on the mechanism of mitochondrial dysfunction in PCOS, there is still a lack of reviews on the intervention of mitochondrial function by TCM to treat PCOS. Therefore, this paper focuses on the role of mitochondrial dysfunction in PCOS and summarizes the studies about the TCM intervention of PCOS by regulating the mitochondrial function, inflammation, oxidative stress(OS), autophagy, and apoptosis in the last five years, aiming to shed new light on the prevention and treatment of PCOS with TCM.