中医药调控相关信号通路治疗卵巢早衰研究进展

Research Progress of TCM Regulating Related Signaling Pathways in the Treatment of Premature Ovarian Failure

卵巢早衰(premature ovarian failure,POF)作为妇科常见的生殖内分泌疾病,发病率逐年上升。激素替代疗法是目前临床最常用的治疗方法,但难以从根本上恢复卵巢功能,长期使用还会增加乳腺癌、子宫内膜癌等疾病的发病风险。近年来,中医药在治疗卵巢早衰方面表现出独特的优势,其深层次的作用机制正在被广泛研究,但尚未被系统总结。越来越多的研究发现,中药单体、单味中药、中药复方、针灸等可从分子层面,通过调控磷脂酰肌醇-3激酶/蛋白激酶B(PI3K/Akt)、沉默信息调节因子(SIRT)、核因子E2相关因子2(Nrf 2)、Wnt/β-连环蛋白(β-catenin)、转化生长因子-β/信号转导蛋白(TGF-β/Smad)、脂肪酸合成酶/脂肪酸合成酶配体(Fas/FasL)等信号通路,抑制细胞凋亡,对抗氧化应激,调节性激素水平,从而改善卵巢功能,治疗卵巢早衰。现查阅近年国内外相关文献,对中医药治疗卵巢早衰的相关信号通路进行总结,以期为卵巢早衰的治疗和新药研发提供参考。

Premature ovarian failure(POF)is a common reproductive endocrine disease in gynecology,and its incidence is increasing year by year.Hormone replacement therapy is currently the most commonly used treatment in clinic,but it is difficult to restore ovarian function fundamentally,and long-term use can increase the risk of diseases such as breast cancer and endometrial cancer.In recent years,traditional Chinese medicine(TCM)has shown unique advantages in the treatment of premature ovarian failure.Its deep-seated mechanism of action is being extensively studied,but has not been systematically summarized.More and more studies have found that Chinese herb monomers,single TCM,TCM compounds,acupuncture and moxibustion can inhibit apoptosis and combat oxidative stress and regulate sex hormone levels at the molecular level by regulating phosphatidylinositol 3 kinase/threonine kinase(PI3K/Akt),silent information regulator(SIRT),nuclear factor E2 related factor 2(Nrf2),Wnt/β-catenin,transforming growth factor-β/signal transduction protein(TGF-β/Smad),fatty acid synthase/fatty acid synthase ligand(Fas/FasL)and other signaling pathways,thereby improving ovarian function and treating premature ovarian failure.The relevant literature at home and abroad in recent years is reviewed to summarize the relevant signaling pathways of TCM in the treatment of premature ovarian failure,in order to provide reference for the treatment of premature ovarian failure and the research and development of new drugs.