Page 135 - 《中国药房》2022年21期

中药单体改善卵巢早衰的作用机制研究进展 Δ

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严如根 ，王雨琦 ，何 静 ，陈 银 ，蔡平平 ，李长忠（1.南京中医药大学中医学院·中西医结合学院，南京
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210023；2.山东中医药大学第一临床医学院，济南 250355；3.盱眙县中医院妇产科，江苏 盱眙 211700；4.山
东第一医科大学附属省立医院中医科，济南 250012）
中图分类号 R965 文献标志码 A 文章编号 1001-0408（2022）21-2685-04
DOI 10.6039/j.issn.1001-0408.2022.21.23

摘 要 卵巢早衰是妇科内分泌常见病，可引发卵巢内卵泡发育停滞或提前衰竭，从而导致卵巢功能丧失，严重影响女性的身心
健康。我国传统中药治疗卵巢早衰的毒副作用较少、效果显著。中药单体是中药发挥药效的活性成分，且化学结构确定。笔者从
中药单体角度出发，综述其改善卵巢早衰的作用机制，结果发现，淫羊藿苷、槲皮素、白藜芦醇、人参皂苷Rg1可通过激活卵巢组织
磷脂酰肌醇3-激酶/蛋白激酶B信号通路、抑制氧化应激和颗粒细胞凋亡、促进卵巢细胞自噬、调节性激素水平来改善卵巢早衰模
型动物的卵巢功能；葛根素、白藜芦醇可通过干预卵巢组织Wnt/β-连环蛋白信号通路、减轻氧化应激反应、抑制卵泡闭锁来改善卵
巢早衰模型动物的卵巢功能等。虽然目前中药单体在改善卵巢早衰方面具有一定效果，但大多数停留在实验阶段，尚不能客观评
价其改善卵巢早衰的临床疗效。后续应加强中药单体新剂型的开发，以期为治疗卵巢早衰的新药开发奠定基础。
关键词 卵巢早衰；中药单体；作用机制

Advances of the mechanism study on Chinese herb monomers in improving premature ovarian failure
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YAN Rugen ，WANG Yuqi ，HE Jing ，CHEN Yin ，CAI Pingping ，LI Changzhong（1. School of Traditional
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Chinese Medicine & School of Integrated Chinese and Western Medicine，Nanjing University of Chinese
Medicine，Nanjing 210023，China；2. The First Clinical Medical College，Shandong University of Traditional
Chinese Medicine，Jinan 250355，China；3. Dept. of Obstetrics and Gynecology，Xuyi County Hospital of
Chinese Medicine，Jiangsu Xuyi 211700，China；4. Dept. of TCM，Shandong Provincial Hospital Affiliated to
Shandong First Medical University，Jinan 250012，China）
ABSTRACT Premature ovarian failure （POF） is a common gynecological endocrine disease， which can cause follicular
development stagnation or premature failure in the ovary，leading to ovarian function loss，and seriously affecting women’s
physical and mental health. Traditional Chinese medicine shows less toxicity and side effects but significant effect in the treatment
of POF. Chinese herb monomers are the active ingredients of traditional Chinese medicine that exert their effects，and their
chemical structure are determined. From the perspective of Chinese herb monomers，the author reviewed the mechanism of their
effect on improving POF. The results showed that icariin，quercetin，resveratrol and ginsenoside Rg1 could improve the ovarian
function of POF model animals by activating the phosphatidylinositol 3-kinase/protein kinase B signaling pathway，inhibiting
oxidative stress and apoptosis of granulosa cells，promoting ovarian autophagy，and regulating the level of sex hormones；puerarin
and resveratrol can improve the ovarian function of POF model by interfering with Wnt/β -catenin signaling pathway，reducing
oxidative stress response，and inhibiting follicular atresia. Although the Chinese herb monomers have certain effect in improving
POF，most of them remain in the experimental stage，and the clinical efficacy in improving POF cannot be objectively evaluated.
In the future，the development of new dosage forms of Chinese herb monomers should be strengthened to lay a foundation for the
development of new drugs for treating POF.
KEYWORDS premature ovarian failure；Chinese herb monomers；mechanism of action

Δ 基金项目 国家中医药管理局全国名老中医药专家传承工作室
卵巢早衰（premature ovarian failure，POF）是指女性
建设项目（No.国中医药人教函〔2018〕134号）；国家中医药管理局第五
批全国中医临床优秀人才研修项目（No.国中医药人教函〔2022〕1号）； 在40岁以前由于遗传性、医源性、自身免疫性、环境等因
山东省重点研发计划项目（No.2019GSF108197） 素引发卵巢内卵泡发育停滞或提前衰竭，而导致的卵巢
＊第一作者 主治医师，博士。研究方向：妇科疾病。E-mail： 功能丧失 [1―2] 。POF作为妇科内分泌常见病，在我国的发
13793196710@163.com
[3]
病率为 1%～3%，且呈逐年上升趋势 。POF 患者前期
# 通信作者 主任医师，教授，博士。研究方向：月经病及不孕症。
E-mail：pingpingcai@126.com 会出现闭经、不孕、更年期综合征等表现，后期则会导致

中国药房 2022年第33卷第21期 China Pharmacy 2022 Vol. 33 No. 21 ·2685·