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1.澳门科技大学药学院,澳门 999078
2.珠海市人民医院/澳门科技大学医学院第一附属医院国家药物临床试验机构办公室,广东 珠海 519000
3.遵义医科大学珠海校区,广东 珠海 519041
4.澳门科技大学天然药物发现和产业化实验室,澳门 999078
主任药师,硕士生导师。研究方向:药理学、临床药学、药事管理。E-mail:sunyinxiang_3@163.com
讲座教授,博士生导师。研究方向:心脑血管、炎症免疫保护机制和新药开发产业化。E-mail:yzzhu@must.edu.mo
收稿:2026-03-20,
修回:2026-06-15,
录用:2026-06-16,
纸质出版:2026-06-30
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孙银香,谭桂坚,余文龙,等.中药改善早发性卵巢功能不全的作用机制研究进展[J].中国药房,2026,37(12):1641-1647.
SUN Yinxiang,TAN Guijian,YU Wenlong,et al.Research progress on the mechanisms of traditional Chinese medicine in improving premature ovarian insufficiency[J].ZHONGGUO YAOFANG,2026,37(12):1641-1647.
孙银香,谭桂坚,余文龙,等.中药改善早发性卵巢功能不全的作用机制研究进展[J].中国药房,2026,37(12):1641-1647. DOI: 10.6039/j.issn.1001-0408.2026.12.21.
SUN Yinxiang,TAN Guijian,YU Wenlong,et al.Research progress on the mechanisms of traditional Chinese medicine in improving premature ovarian insufficiency[J].ZHONGGUO YAOFANG,2026,37(12):1641-1647. DOI: 10.6039/j.issn.1001-0408.2026.12.21.
早发性卵巢功能不全(POI)是严重影响女性生殖健康的生殖内分泌疾病,但临床仍缺乏能够有效恢复卵巢功能且安全性理想的治疗手段。中药凭借多成分、多靶点的整体调节优势,在防治POI方面展现出独特潜力。中药单体中,姜黄素、白藜芦醇、淫羊藿苷可通过调控核转录因子红系2相关因子2/血红素加氧酶1、磷脂酰肌醇3激酶/蛋白激酶B、促分裂原活化的蛋白激酶等信号通路,发挥抗氧化、抗炎及抑制卵巢颗粒细胞凋亡等作用;单味中药如西洋参、菟丝子、肉苁蓉等能调节性激素水平,改善卵巢氧化应激与免疫损伤;中药复方如益经汤、四物汤、左归丸、坤泰胶囊等则可通过调控血管内皮生长因子/血管内皮细胞生长因子受体2、磷脂酰肌醇3激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白、沉默信息调节因子1/p53等多条信号通路,促进血管生成、抑制线粒体凋亡、调节细胞自噬与铁死亡,从而延缓卵泡闭锁,改善卵巢储备功能。建议后续学者可利用人工智能技术,深入探索相关作用机制,并开展高质量的临床试验,推动中医药在POI防治中的规范化应用。
Premature ovarian insufficiency (POI) is a reproductive endocrine disorder that severely affects female reproductive health. However, there remains a lack of clinically effective and safe therapeutic options to restore ovarian function. Traditional Chinese medicine (TCM), with its advantages of multi-component and multi-target holistic regulation, has shown unique potential in the prevention and treatment of POI. Among TCM monomers, curcumin, resveratrol, and icariin exert antioxidant, anti-inflammatory, and anti-ovarian granulosa cell apoptosis effects by regulating signaling pathways such as nuclear factor-erythroid 2-related factor 2/heme oxygenase-1, phosphoinositide 3-kinase/protein kinase B, and mitogen-activated protein kinase. Single TCM herbs, including American ginseng, Cuscutae Semen, and Cistanches Herba, can regulate sex hormone levels, and alleviate ovarian oxidative stress and immune damage. TCM compound formulas such as Yijing decoction, Siwu decoction, Zuogui pill, and Kuntai capsule modulate multiple signaling pathways, including vascular endothelial growth factor/vascular endothelial growth factor receptor-2, phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin, and silence information regulator 1/p53, thereby promoting angiogenesis, inhibiting mitochondrial apoptosis, and regulating autophagy and ferroptosis, which ultimately delay follicular atresia and improve ovarian reserve function. Further studies are suggested to apply artificial intelligence to deeply explore the underlying mechanisms and carry out high-quality clinical trials, so as to promote the standardized application of TCM in the prevention and treatment of POI.
冯晓玲 , 李力 , 曲凡 , 等 . 早发性卵巢功能不全中西医结合诊疗指南 [J ] . 中医杂志 , 2022 , 63 ( 12 ): 1193 - 1198 .
HUANG Y J , LIU Z , GENG Y L , et al . The risk factors,pathogenesis and treatment of premature ovarian insufficiency [J ] . J Ovarian Res , 2025 , 18 ( 1 ): 134 .
PUY V , BARROCA V , MESSIAEN S , et al . Mouse model of radiation-induced premature ovarian insufficiency reveals compromised oocyte quality:implications for fertility preservation [J ] . Reprod Biomed Online , 2021 , 43 ( 5 ): 799 - 809 .
GLAMOCLIJA V , VILOVIĆ K , SARAGA-BABIĆ M , et al . Apoptosis and active caspase-3 expression in human granulosa cells [J ] . Fertil Steril , 2005 , 83 ( 2 ): 426 - 431 .
YEUNG C K , WANG G , YAO Y , et al . BRE modulates granulosa cell death to affect ovarian follicle development and atresia in the mouse [J ] . Cell Death Dis , 2017 , 8 ( 3 ): e2697 .
WANG X F , WANG L J , XIANG W P . Mechanisms of ovarian aging in women:a review [J ] . J Ovarian Res , 2023 , 16 ( 1 ): 67 .
KASAPOĞLU I , SELI E . Mitochondrial dysfunction and ovarian aging [J ] . Endocrinology , 2020 , 161 ( 2 ): bqaa001 .
TESARIK J , GALÁN-LÁZARO M , MENDOZA-TESARIK R . Ovarian aging:molecular mechanisms and medical management [J ] . Int J Mol Sci , 2021 , 22 ( 3 ): 1371 .
SMITS M A J , SCHOMAKERS B V , VAN WEEGHEL M , et al . Human ovarian aging is characterized by oxidative damage and mitochondrial dysfunction [J ] . Hum Reprod , 2023 , 38 ( 11 ): 2208 - 2220 .
DING Z W , SHAO G B , LI M Y . Targeting autophagy in premature ovarian failure:therapeutic strategies from molecular pathways to clinical applications [J ] . Life Sci , 2025 , 366 / 367 : 123473 .
ZHAO J H , BRAULT J J , SCHILD A , et al . FoxO3 coordinately activates protein degradation by the autophagic/ lysosomal and proteasomal pathways in atrophying muscle cells [J ] . Cell Metab , 2007 , 6 ( 6 ): 472 - 483 .
KIM J , KUNDU M , VIOLLET B , et al . AMPK and mTOR regulate autophagy through direct phosphorylation of ULK1 [J ] . Nat Cell Biol , 2011 , 13 ( 2 ): 132 - 141 .
YAN Z J , DAI Y J , FU H L , et al . Curcumin exerts a protective effect against premature ovarian failure in mice [J ] . J Mol Endocrinol , 2018 , 60 ( 3 ): 261 - 271 .
HU F Y , ZHOU X W , JIANG Y J , et al . Effect of myrcene on Th17/Treg balance and endocrine function in autoimmune premature ovarian insufficiency mice through the MAPK signaling pathway [J ] . Protein Pept Lett , 2022 , 29 ( 11 ): 954 - 961 .
HU B B , ZHENG X S , ZHANG W . Resveratrol-βCD inhibited premature ovarian insufficiency progression by regulating granulosa cell autophagy [J ] . J Ovarian Res , 2024 , 17 ( 1 ): 18 .
刘小虎 , 赵志慧 , 周玥 , 等 . PI3K/Akt/mTOR自噬通路在人参皂苷Rg 1 延缓D-gal诱导的卵巢早衰小鼠模型卵巢早衰中的作用 [J ] . 中国中药杂志 , 2020 , 45 ( 24 ): 6036 - 6042 .
TAO F Y , ZHAI Q F , CAO Y Q , et al . Inhibition of p38 MAPK/NF-κB p65 signaling pathway activity by rare ginsenosides ameliorates cyclophosphamide-induced premature ovarian failure and KGN cell injury [J ] . J Ethnopharmacol , 2024 , 326 : 117944 .
LI N , WANG J , WANG X , et al . Icariin exerts a protective effect against D-galactose induced premature ovarian fai-lure via promoting DNA damage repair [J ] . Biomed Pharmacother , 2019 , 118 : 109218 .
CHEN H R , SONG L J , XU X F , et al . The effect of icariin on autoimmune premature ovarian insufficiency via modulation of Nrf2/HO-1/SIRT1 pathway in mice [J ] . Reprod Biol , 2022 , 22 ( 2 ): 100638 .
ZHENG S Y , MA M Y , CHEN Y X , et al . Effects of quercetin on ovarian function and regulation of the ovarian PI3K/Akt/FoxO3a signalling pathway and oxidative stress in a rat model of cyclophosphamide-induced premature ovarian failure [J ] . Basic Clin Pharmacol Toxicol , 2022 , 130 ( 2 ): 240 - 253 .
CHEN Y , ZHAO Y , MIAO C Y , et al . Quercetin alle-viates cyclophosphamide-induced premature ovarian insufficiency in mice by reducing mitochondrial oxidative stress and pyroptosis in granulosa cells [J ] . J Ovarian Res , 2022 , 15 ( 1 ): 138 .
HUANG Y P , CUI Y F , HUANG J , et al . Proanthocyanidins protects 3-NPA-induced ovarian function decline by activating Sestrin2-Nrf2-mediated oxidative stress in mice [J ] . Sci Rep , 2024 , 14 : 25643 .
WU W B , BAI M Y , HONG W L , et al . Proanthocyanidins delaying the premature ovarian insufficiency through regulatory SIRT1-p53-p21 signaling pathway in female germline stem cells [J ] . J Ovarian Res , 2025 , 18 ( 1 ): 97 .
ZHU L , LI J , XING N N , et al . American ginseng regulates gene expression to protect against premature ovarian failure in rats [J ] . Biomed Res Int , 2015 , 2015 : 767124 .
NAM E Y , KIM S A , KIM H , et al . Akt activation by Euodiae Fructus extract protects ovary against 4-vinylcyclohexene diepoxide-induced ovotoxicity [J ] . J Ethnopharmacol , 2016 , 194 : 733 - 739 .
HAN S Y , LI H X , LU R , et al . Effect and mechanism of pearl on ovarian function of rats with premature ovarian failure induced by Tripterygium glycosides [J ] . J Tradit Complement Med , 2023 , 13 ( 4 ): 368 - 378 .
LIANG Y S , SHI Y , GUO R , et al . Wine- and stir-frying processing of Cuscutae Seme n enhance its ability to alle-viate oxidative stress and apoptosis via the Keap 1-Nrf2/HO-1 and PI3K/Akt pathways in H 2 O 2 -challenged KGN human granulosa cell line [J ] . BMC Complement Med Ther , 2024 , 24 ( 1 ): 189 .
谢颖 , 萧闵 , 江晓翠 , 等 . 基于脂质与动脉粥样硬化通路探讨菟丝子防治卵巢早衰的作用机制 [J ] . 中国实验方剂学杂志 , 2024 , 30 ( 6 ): 109 - 118 .
刘涛 , 殷松娜 , 栾昕 . 肉苁蓉对卵巢早衰大鼠免疫因子和凋亡相关蛋白的影响 [J ] . 中国临床药理学杂志 , 2019 , 35 ( 23 ): 3084 - 3087 .
GAO R R , WU Y K , TANG Y Q , et al . Yijing decoction improves premature ovarian failure in rats by activating VEGF/VEGFR-2/FAK pathway [J ] . J Ovarian Res , 2025 , 18 ( 1 ): 87 .
ZHOU F R , SONG Y F , LIU X , et al . Si-wu-tang facilitates ovarian function through improving ovarian microenvironment and angiogenesis in a mouse model of premature ovarian failure [J ] . J Ethnopharmacol , 2021 , 280 : 114431 .
HUANG Y J , HU R N , LIU Z , et al . Bushen huoxue recipe ameliorates ovarian function via promoting BMSCs proliferation and homing to ovaries in POI mice [J ] . Phytomedicine , 2024 , 129 : 155630 .
LI T , WEI Y , JIAO B B , et al . Bushen huoxue formula attenuates lipid accumulation evoking excessive autophagy in premature ovarian insufficiency rats and palmitic acid-challenged KGN cells by modulating lipid metabolism [J ] . Front Pharmacol , 2024 , 15 : 1425844 .
张兵 , 王丽 , 左瑾楠 , 等 . 补肾养精颗粒调控HIF-1α/VEGF信号通路干预早发性卵巢功能不全模型大鼠的机制 [J ] . 中华中医药杂志 , 2023 , 38 ( 9 ): 4148 - 4153 .
HOU J R , HUANG X C , CAO X J , et al . Yangyin shugan capsule ameliorates premature ovarian insufficiency via dual receptor-mediated cascade in rats [J ] . Phytomedicine , 2025 , 147 : 157139 .
XIE L , WU S N , CAO D D , et al . Huyang yangkun formula protects against 4-vinylcyclohexene diepoxide-induced premature ovarian insufficiency in rats via the Hippo-JAK2/STAT3 signaling pathway [J ] . Biomed Pharmacother , 2019 , 116 : 109008 .
LI Y , WANG L D , LIU J , et al . Huyang yangkun formula regulates the mitochondria pathway of ovarian granulosa cell apoptosis through FTO/M6A-p53 pathway [J ] . Front Pharmacol , 2024 , 15 : 1491546 .
WANG L D , LI M F , LIU J , et al . Protective effect of Huyang yangkun formula on ovarian function in premature ovarian insufficiency rats based on apoptotic mechanism [J ] . J Ethnopharmacol , 2021 , 280 : 114477 .
LI Y , PENG Y , NIE G N , et al . Huyang yangkun formula enhances ovarian function and delays reproductive aging by influencing hypothalamic GnRH/LH pulse release through GAT-1/GABA/GABAAR2 [J ] . Drug Des Devel Ther , 2025 , 19 : 2677 - 2691 .
PENG H J , ZENG L H , ZHU L , et al . Zuogui pills inhibit mitochondria-dependent apoptosis of follicles in a rat model of premature ovarian failure [J ] . J Ethnopharmacol , 2019 , 238 : 111855 .
LI Z A , LIANG Y Y , WANG Y X , et al . Zuogui pills alleviate cyclophosphamide-induced ovarian aging by reducing oxidative stress and restoring the stemness of oogonial stem cells through the Nrf2/HO-1 signaling pathway [J ] . J Ethnopharmacol , 2024 , 333 : 118505 .
CHEN H M , ZHANG G Y , PENG Y , et al . Danggui shaoyao san protects cyclophosphamide-induced premature ovarian failure by inhibiting apoptosis and oxidative stress through the regulation of the SIRT1/p53 signaling pathway [J ] . J Ethnopharmacol , 2024 , 323 : 117718 .
杨珍 , 魏茂林 , 董晓英 . 毓麟珠通过调控FOXO3a通路影响免疫性POI小鼠卵巢功能的机制研究 [J ] . 中华中医药杂志 , 2022 , 37 ( 10 ): 6026 - 6030 .
RUAN X , WANG P X , WEI M L , et al . Yu linzhu alleviates primary ovarian insufficiency in a rat model by improving proliferation and energy metabolism of granulosa cells through HIF1α/CX43 pathway [J ] . J Ovarian Res , 2024 , 17 ( 1 ): 89 .
HUANG Y , ZHANG Q , SHEN D , et al . Mechanisms of He shi yu lin formula in treating premature ovarian insufficiency:insights from network pharmacology and animal experiments [J ] . J Ovarian Res , 2024 , 17 ( 1 ): 254 .
王如烨 , 章勤 , 方晓红 . 何氏育麟方通过调控PI3K/Akt信号通路对卵巢储备功能下降大鼠颗粒细胞的影响 [J ] . 中成药 , 2024 , 46 ( 7 ): 2382 - 2389 .
XIU Z , TANG S L , KONG P , et al . Zigui-yichong-fang protects against cyclophosphamide-induced premature ovarian insufficiency via the SIRT1/FoxO3a pathway [J ] . J Ethnopharmacol , 2023 , 314 : 116608 .
刘雪平 , 宿滋 , 李荣霞 , 等 . 基于线粒体能量代谢途径探讨资癸益冲方改善早发性卵巢功能不全小鼠卵巢功能的作用机制 [J ] . 中华中医药杂志 , 2023 , 38 ( 5 ): 2361 - 2366 .
张新苗 , 刘雪平 , 郗红燕 , 等 . 资癸益冲方通过糖酵解代谢途径对小鼠早发性卵巢功能不全的影响 [J ] . 中国药房 , 2024 , 35 ( 20 ): 2460 - 2465 .
仲佳雯 , 姜波 , 张文燕 , 等 . 六味地黄丸对卵巢早衰小鼠激素水平、氧化应激、颗粒细胞自噬的影响及机制 [J ] . 世界中医药 , 2025 , 20 ( 4 ): 574 - 582,592 .
ZHONG J W , LAN G X , MA X Q , et al . Mechanism study on the regulation of autophagy and oxidative stress through SIRT1/PI3K/AKT pathway by Liuwei dihuang pill to improve ovarian function [J ] . J Ovarian Res , 2025 , 18 ( 1 ): 118 .
仲佳雯 , 姜波 , 张文燕 , 等 . 六味地黄丸对卵巢早衰小鼠激素水平、氧化应激、颗粒细胞自噬的影响及机制 [J ] . 世界中医药 , 2025 , 20 ( 4 ): 574 - 582,592 .
仲佳雯 , 姜波 , 张文燕 , 等 . 六味地黄丸调节肠道微生物组平衡抑制卵巢早衰小鼠的氧化应激 [J ] . 中国组织工程研究 , 2025 , 29 ( 11 ): 2285 - 2293 .
YE X M , CHEN M , ZHONG J J , et al . Kuntai capsules improve premature ovarian failure by regulating AMPK-mediated autophagy [J ] . Reprod Sci , 2025 , 32 ( 9 ): 2970 - 2984 .
GONG L L , HOU J L , YANG H J , et al . Kuntai capsule attenuates premature ovarian insufficiency by activating the FOXO3/SIRT5 signaling pathway in mice:a comprehensive study using UHPLC-LTQ-Orbitrap and integrated pharmacology [J ] . J Ethnopharmacol , 2024 , 322 : 117625 .
DOU X Q , JIN X , CHEN X B , et al . Bu-shen-ning-xin decoction alleviates premature ovarian insufficiency(POI)by regulating autophagy of granule cells through acti-vating PI3K/Akt/mTOR pathway [J ] . Gynecol Endocrinol , 2022 , 38 ( 9 ): 754 - 764 .
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