基于氧化应激探讨中医药治疗早发性卵巢功能不全的作用机制

Exploring the Mechanism of Traditional Chinese Medicine in Treating Early Ovarian Insufficiency Based on Oxidative Stress

近年来由于女性工作压力及生活压力与日俱增,早发性卵巢功能不全(POI)发病率在不断增加,且有年轻化趋势。氧化应激是导致POI的重要机制之一,机体内活性氧的失调将诱导卵巢颗粒细胞凋亡,严重影响卵母细胞的生长发育。对近年来相关文献进行梳理,发现中医药可以有效提高POI的抗氧化能力,抵抗卵巢氧化应激损伤,其机制可能与线粒体活性、铁死亡以及PI3K、Nrf2、SIRT1、MAPK多条信号通路相关,治疗方式以中药单体、单味中药、中药复方、中成药、针灸及针药结合为主。

Oxidative stress is one of the important mechanisms leading to premature ovarian insufficiency(POI).Studies have found that traditional Chinese medicine(TCM)can effectively improve the antioxidant capacity of POI and reduce oxidative stress.This paper reviewed the literature on the mechanism of oxidative stress treatment of POI by TCM in recent years,and found that the main TCM treatment methods were Chinese medicine monomer extract,single Chinese medicinal,Chinese medicine formulae,Chinese patent medicine,acupuncture and combination of acupuncture and medicine.The monomers include ginsenoside Rg1,ginsenoside Rg3,hypericin,lycium barbarum polysaccharide and allantoin.Currently,only pearls have been found to be associated with POI oxidative stress in single Chinese medicinal.Chinese herbal medicine formulae include Yulin Zhu,Bushen Huoxue decoction,Chinese Angelica Blood-Supplementing decoction,Erxian decoction,as well as clinical experience of Chinese medicine formulae such as Huchao drink,Bushen Culuan formula,and Zigui Yichong formula.Chinese patent medicines include Liuwei Dihuang pill,Nongsuo Dangguiwan and Bushen Yangjing granules.Acupuncture and moxibustion mainly involves conventional acupuncture,electroacupuncture,warm acupuncture combined with moxibustion,and moxibustion,as well as the acupuncture of needle insertion from Zhibian(BL54)to Shuidao(ST28).The commonly used acupoints are Guanyuan(CV4),Qihai(CV6),Shenshu(BL23),Zusanli(ST36),etc.Chinese medicine intervention in POI can resist ovarian oxidative stress damage by affecting mitochondrial activity in ovarian granulosa cells,influencing molecules involved in oxidative stress mechanisms,and regulating oxidative stress-related signaling pathways,achieving the goal of restoring ovarian function.