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化痰通脉饮对多囊卵巢综合征大鼠的改善作用机制研究
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          姚新亚    1， 2＊ ，林寒梅 ，逯克娜 ，甘子晴 ，郭 华 ，李文意 ，李健玲 ，金奇霖（1.广西中医药大学第一临床医学
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          院，南宁 530200；2.广西中医药大学第一附属医院妇科，南宁 530023；3.广西中医药大学附属国际壮医医院
          妇科，南宁 530201）
          中图分类号  R965；R285      文献标志码  A      文章编号  1001-0408（2025）23-2918-06
          DOI  10.6039/j.issn.1001-0408.2025.23.06
          摘   要  目的  基于磷脂酰肌醇3-激酶（PI3K）/蛋白激酶B（AKT）/哺乳动物雷帕霉素靶蛋白（mTOR）通路调控自噬途径，探讨化
          痰通脉饮对多囊卵巢综合征（PCOS）大鼠的改善作用机制。方法  将40只大鼠随机分为空白组（纯净水）、模型组（纯净水）、中药
          组[化痰通脉饮，24 g/（kg·d）]和化学药组[二甲双胍，0.16 g/（kg·d）]，每组10只。除空白组外，其余各组均采用灌胃1 mg/kg来曲唑
          混悬液联合高脂饲料喂养的方法建立PCOS大鼠模型。造模成功后，分别灌胃给药或水，每天1次，连续42 d。末次给药后，观察
          大鼠卵巢组织的病理形态学与超微结构变化；检测大鼠血清中促卵泡素（FSH）、睾酮（T）、雌二醇（E2 ）、促黄体素（LH）水平并计算
          LH/FSH 比值；检测大鼠卵巢组织中苄氯素 1（Beclin-1）、p62、微管相关蛋白 1 轻链 3（LC3）的 mRNA 表达水平以及 PI3K/AKT/
          mTOR通路和自噬相关蛋白表达水平。结果  与空白组比较，模型组大鼠卵巢组织病理损伤和超微结构改变明显，可见胞内大量
          自噬小体；血清中T、LH水平和LH/FSH比值，卵巢组织中Beclin-1、LC3 mRNA及其蛋白表达水平均显著升高（P＜0.05）；血清中
          E2、FSH水平，卵巢组织中p62 mRNA及其蛋白表达水平和PI3K、AKT、mTOR蛋白的磷酸化水平均显著降低（P＜0.05）。与模型
          组比较，给药组大鼠卵巢组织的病理损伤明显减轻，自噬小体数量减少，上述指标的表达水平均被显著逆转（P＜0.05）。结论  化
          痰通脉饮可通过激活PI3K/AKT/mTOR通路，抑制卵巢颗粒细胞自噬，调节性激素分泌，减轻卵巢组织的病理损伤，促进卵泡正常
          发育，从而发挥对PCOS大鼠的改善作用。
          关键词  化痰通脉饮；多囊卵巢综合征；PI3K/AKT/mTOR通路；自噬；颗粒细胞

          Study on the improvement mechanism of Huatan tongmai decoction on rats with polycystic ovary syndrome
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          YAO Xinya ，LIN Hanmei ，LU Kena ，GAN Ziqing ，GUO Hua ，LI Wenyi ，LI Jianling ，JIN Qilin（1. The First
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          Clinical  School  of  Guangxi  University  of  Chinese  Medicine，  Nanning  530200，  China；2.  Dept.  of  Gynecology，
          the  First  Affiliated  Hospital  of  Guangxi  University  of  Chinese  Medicine，  Nanning  530023，  China；3.  Dept.  of
          Gynecology，  International  Zhuang  Medicine  Hospital  Affiliated  to  Guangxi  University  of  Chinese  Medicine，
          Nanning 530201， China）
          ABSTRACT    OBJECTIVE  To  investigate  the  improvement  mechanism  of  Huatan  tongmai  decoction  on  rats  with  polycystic
          ovary syndrome （PCOS） by regulating autophagy through phosphatidylinositol-3-kinase（PI3K）/protein kinase B（AKT）/mammalian
          target  of  rapamycin （mTOR）  pathway.  METHODS  A  total  of  40  rats  were  randomly  divided  into  blank  group （purified  water），
          model  group （purified  water），  traditional  Chinese  medicine  group  [Huatan  tongmai  decoction，  24  g/（kg·d）]  and  chemical  drug
          group [metformin， 0.16 g/（kg·d）]， with 10 rats in each group. Except for blank group， other groups were given a combination of
          high-fat diet and intragastric administration of 1 mg/kg letrozole suspension to establish PCOS rat model. After modeling， they were
          given  relevant  medicine  or  water  intragastrically，  once  a  day，  for  42  consecutive  days.  After  the  last  administration，  the
          pathological  and  ultrastructural  changes  of  ovarian  tissue  were  observed.  The  levels  of  follicle  stimulating  hormone （FSH），
          testosterone （T），  estradiol （E2 ）  ，luteinizing  hormone （LH）  in  serum  were  detected，and  the  LH/FSH  ratio  was  calculated.  mRNA
          expressions  of  Beclin-1，  p62  and  microtubule-associated  protein  1  light  chain  3 （LC3）  in  ovarian  tissue  were  detected.  The
          expressions  of  related  proteins  of  PI3K/AKT/mTOR  pathway  and  autophagy  in  rat  ovarian  tissues  were  also  detected.  RESULTS
          Compared with blank group， the pathological damage and ultrastructural changes of the ovarian tissue in the model group rats were
          obvious， and a large number of autophagosomes could be seen in cells. The levels of T and LH and the LH/FSH ratio in serum， as
          well  as  mRNA  and  protein  expressions  of  Beclin-1  and  LC3，  were  increased  significantly （P＜0.05），  while  the  levels  of  E2  and
          FSH in serum， as well as mRNA and protein expressions of p62 and the phosphorylation levels of PI3K， AKT and mTOR proteins
                                                              in  ovarian  tissue，  were  significantly  decreased （P＜0.05）.
              Δ 基金项目 国家自然科学基金项目（No.82360950）；广西壮族自
                                                              Compared  with  model  group，  the  pathological  damage  of
          治区研究生教育创新计划项目（No.YCBZ2024147）
             ＊第一作者 博士研究生。研究方向：中医药防治妇科生殖内分泌                    ovarian  tissue  in  the  administration  groups  was  significantly
          疾病及不孕不育。E-mail：1464975201@qq.com                    reduced，  the  number  of  autophagosomes  was  smaller，  and  the
              # 通信作者 主任医师，博士生导师。研究方向：中医药防治妇科                  expression  levels  of  the  above  indicators  were  significantly
          生殖内分泌疾病及不孕不育。E-mail：Linhm0806@163.com               reversed  （P＜0.05）.  CONCLUSIONS  Huatan  tongmai


          · 2918 ·    China Pharmacy  2025 Vol. 36  No. 23                            中国药房  2025年第36卷第23期
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