中医药治疗月经先期作用机制分析  

An analysis on the mechanism of TCM in treating premenstruation

作　　者：卢利歌 袁温鲜 张多加[1,2] 吴效科[1,2] LU Lige;YUAN Wenxian;ZHANG Duojia;WU Xiaoke

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中医临床研究》2023年第27期131-135,共5页Clinical Journal Of Chinese Medicine

基　　金：国家重点研发计划项目(2019YFC1709500);国家重大疑难疾病中西医临床协作试点项目(国中医药办医政发[2018]3号);黑龙江省“头雁”团队-中西医结合妇科特色技术创新团队[黑龙江省“头雁”行动方案(黑政规[2019]2号)];黑龙江省中医药经典普及化专项课题项目(ZYW2023-130)。

摘　　要：中医药作为一种传统的医学体系,拥有着几千年的临床实践经验。在许多疾病的治疗中,特别是女性月经不规律等妇科疾病的治疗方面,中医药具有显著的疗效。文章将从现代药理学研究的角度,探讨经典中医方剂如何治疗月经先期,并结合临床实践分析总结其作用机制。首先,中医药对月经先期的治疗主要通过作用于磷脂酰肌醇3-激酶/蛋白激酶B、促分裂素原活化蛋白激酶、p38蛋白激酶/c-Jun氨基末端激酶、核转录因子-κB及Toll样受体4等信号通路,对卵巢卵泡的发育与成熟、卵泡数量与质量以及卵巢微环境的改善产生影响。这些信号通路在内分泌调节、炎症反应、免疫系统及细胞生长和凋亡等方面具有关键作用,从而达到调整月经周期的目的。其次,中药的有效成分还可以通过改善卵巢动脉血供、性激素水平、子宫内膜容受性等方面,对全身内分泌、血液循环和免疫系统产生积极影响。这将为卵巢提供一个良好的微环境,促使卵巢正常发育和排卵,进而帮助患者恢复正常月经规律。总之,在临床实践中,中医药能够根据患者的具体症状进行辨证施治,个性化治疗,使患者病情在短期内得到明显的改善,远期疗效也十分显著。因此,中医药治疗月经先期值得进一步研究和推广。As a traditional medical system,TCM has thousands of years of clinical practice experience.In the treatment of many diseases,especially in the treatment of gynecological diseases such as irregular menstruation,traditional Chinese medicine has remarkable curative effect.From the perspective of modern pharmacological research,this paper discusses how to treat premenstruation with classical TCM prescriptions,and analyzes and summarizes its mechanism of action in combination with clinical practice.Firstly,the treatment of premenstruation in TCM mainly affects the development and maturation of ovarian follicles,the quantity and quality of follicles and the improvement of the ovarian microenvironment by acting on signalling pathways such as phosphatidylinositol 3-kinase/protein kinase B,mitogen-activated protein kinase,p38 protein kinase/c-Jun amino-terminal kinase,nuclear transcription factor-κB and Toll-like receptor 4.These signalling pathways play key roles in endocrine regulation,inflammatory response,the immune system,and cell growth and apoptosis,thus achieving the purpose of regulating the menstrual cycle.Secondly,the effective ingredients of TCM medicine can also have a positive impact on the systemic endocrine,blood circulation and immune system of the whole body by improving the blood supply of ovarian arteries,sex hormone levels,endometrial receptivity and other aspects.This will provide a favourable microenvironment for the ovaries to develop and ovulate normally,which in turn helps the patient to return to normal menstruation.In short,in clinical practice,traditional Chinese medicine is able to differentiate and treat diseases according to the specific symptoms of patients and apply personalized treatment,so that patients can get significant improvement in the short term,and the long-term effect is also very significant.Therefore,TCM treatment of premenstruation is worth further research and promotion.

关 键 词：月经先期 中医药 药理机制 作用通路 

分 类 号：R271.11[医药卫生—中医妇科学]