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基于“态靶辨治”理论构建补肾活血汤分期化裁联合HRT治疗早

发性卵巢功能不全的用药策略
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王伶俐 ，陈秋薇，肖 汐，褚 烔，陈 玥，陈 思（南京中医药大学附属中西医结合医院妇产科，南京
210028）

中图分类号 R969 文献标志码 A 文章编号 1001-0408（2026）10-1329-06
DOI 10.6039/j.issn.1001-0408.2026.10.16

摘 要 目的 探讨补肾活血汤分期化裁联合激素补充疗法（HRT）治疗早发性卵巢功能不全（POI）的协同用药策略。方法 梳理
仝小林院士“态靶辨治”理论内涵及POI的疾病分期特征，划分POI隐匿期、亚临床期、临床期、衰竭期对应的核心病机“态”与关键
客观指标“靶”，以补肾活血汤为基本方，分析其分期化裁方案及其与HRT的时序组合。结果与结论 将POI四期分别对应肾阴亏
虚、肾虚血瘀、心肾不交、阴阳两虚4种“态”，以促卵泡激素（FSH）、抗米勒管激素（AMH）、窦卵泡计数（AFC）、Kupperman评分等
作为分期评估“标靶”，结合各期“态-靶”特征，确立了以补肾活血汤为基础，辨证化裁、随期调整的用药思路：隐匿期以中药治疗为
主，亚临床期采用序贯协同方案，临床期以激素补充疗法为主、中药治疗为辅，衰竭期则采用中西医结合来巩固根本。
关键词 态靶辨治；早发性卵巢功能不全；补肾活血汤；激素补充疗法；用药策略

Construction of a medication strategy integrating staged modifications of Bushen huoxue decoction with
HRT for premature ovarian insufficiency based on the “state-target differentiation and treatment” theory
WANG Lingli，CHEN Qiuwei，XIAO Xi，CHU Tong，CHEN Yue，CHEN Si（Dept. of Obstetrics and Gynecology，
Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese
Medicine， Nanjing 210028， China）

ABSTRACT OBJECTIVE To explore a synergistic medication strategy integrating stage-specific modifications of Bushen huoxue
decoction with hormone replacement therapy （HRT） for premature ovarian insufficiency （POI）. METHODS The connotation of
Academician Tong Xiaolin’s “state-target differentiation and treatment” theory and the disease stage characteristics of POI were
summarized. The latent stage， subclinical stage， clinical stage and exhaustion stage of POI were classified into corresponding core
pathogenesis “states” and key objective indicator “targets”. Taking Bushen huoxue decoction as the basic prescription， its staged
modification scheme and its sequential combination with HRT were analyzed. RESULTS & CONCLUSIONS The four stages of
POI correspond to four pathogenic states respectively： kidney yin deficiency， kidney deficiency and blood stasis， heart-kidney
disharmony， and deficiency of both yin and yang. Follicle-stimulating hormone （FSH）， anti-Müllerian hormone （AMH）， antral
follicle count （AFC） and Kupperman score were taken as the evaluation targets of staging. Combined with the “state-target”
characteristics of each stage， a medication principle based on Bushen huoxue decoction with syndrome differentiation modification
and stage-adjusted administration was established： traditional Chinese medicine dominates in the latent stage， a sequential
collaborative regimen is adopted in the subclinical stage， HRT is dominant supplemented by traditional Chinese medicine in the
clinical stage， and integrated traditional Chinese and Western medicine is applied to consolidate the root cause in the exhaustion
stage.
KEYWORDS state-target differentiation and treatment； premature ovarian insufficiency； Bushen huoxue decoction； hormone
replacement therapy； medication strategy

Δ 基金项目 国家自然科学基金面上项目（No.82374511）；江苏省
中医药学会青年科技人才托举工程项目（No.2023-JSZYQT-B02） 早 发 性 卵 巢 功 能 不 全（premature ovarian insuffi‐
＊第一作者 硕士研究生。研究方向：中西医结合防治女性生殖系 ciency，POI）是指女性 40 岁之前出现卵巢功能衰退，以
统疾病。E-mail：lingliw1@163.com
月经紊乱（月经稀发或闭经）、促性腺激素水平升高、雌
# 通信作者 副主任中医师，硕士生导师，博士。研究方向：中西医
结合防治女性生殖系统疾病。E-mail：chensi8828@163.com 激素水平波动或降低为主要临床特征，发病率为 1%～

中国药房 2026年第37卷第10期 China Pharmacy 2026 Vol. 37 No. 10 · 1329 ·