PCOS中的自噬异常及中医药靶向干预的研究进展  

Autophagy Abnormalities in PCOS and Targeted Treatment with Traditional Chinese Medicine:A Review

作　　者：杨鑫鑫 贾志诚 石梦雨 李永谦 王培璇 郭颖[2] YANG Xinxin;JIA Zhicheng;SHI Mengyu;LI Yongqian;WANG Peixuan;GUO Ying(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine(TCM),Jinan 250014,China;Affiliated Hospital of Shandong University of TCM,Jinan 250011,China)

机构地区：[1]山东中医药大学第一临床医学院,济南250014 [2]山东中医药大学附属医院,济南250011

出　　处：《中国实验方剂学杂志》2025年第3期313-322,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82374505);山东省自然科学基金项目(ZR2023MH219);济南市科技发展计划项目(202225005);泰山青年学者计划项目(202211353)。

摘　　要：多囊卵巢综合征(PCOS)是一种常见的妇科内分泌和生殖功能障碍性疾病,主要临床表现为排卵障碍、胰岛素抵抗、高雄激素血症、肥胖等,该病的发生发展与细胞凋亡、自噬、氧化应激、炎症反应等生物调控过程密切相关。自噬作为一种维持细胞稳态的清除机制,在维持卵母细胞生长、发育和成熟过程中发挥着关键作用,探究疾病发生发展过程中的自噬机制,有助于设计通过调控自噬干预PCOS的治疗方法。现有研究表明,自噬在PCOS的发病过程中起着重要作用,能够多层次、多途径、多靶点影响疾病进展。中医药通过靶向自噬信号通路、调控因子及非编码单链RNA分子的表达,来调控PCOS患者卵巢颗粒细胞自噬或子宫内膜自噬,从而缓解炎症、调节PCOS代谢障碍、平衡激素水平,有效改善PCOS胰岛素抵抗、高雄激素血症、排卵障碍等病理状态。该文章对治疗PCOS的中药复方和中药提取物及涉及的主要自噬通路和调控因子进行归纳总结,以期从中医药调控自噬的角度为今后PCOS的治疗提供相关参考和建议。Polycystic ovary syndrome(PCOS)is a common gynecological endocrine and reproductive disorder,with the main clinical manifestations including ovulation failure,insulin resistance,hyperandrogenism,and obesity.Its occurrence and development are closely related to cellular regulatory mechanisms such as apoptosis,autophagy,oxidative stress,and inflammatory response.Autophagy,as a clearance mechanism that maintains cellular homeostasis,plays a crucial role in maintaining the growth,development,and maturation of oocytes.Exploring the mechanism of autophagy during the occurrence and development of diseases can help develop treatment methods for PCOS by regulating autophagy.Studies have shown that autophagy plays an important role in the pathogenesis of PCOS,and it can affect the occurrence and development of PCOS through multiple pathways,levels,and targets.Traditional Chinese medicine(TCM)regulates autophagy in ovarian granulosa cells or endometrium of patients with PCOS by targeting the expression of autophagy signaling pathways,regulatory factors,and non-coding single-stranded RNA molecules,thereby alleviating inflammation,regulating metabolism disorders,and balancing hormone levels in PCOS.Accordingly,TCM can ameliorate pathological conditions such as insulin resistance,hyperandrogenism,and ovulation failure in PCOS.This article summarizes the TCM formulas and extracts for the treatment of PCOS,as well as the main autophagy pathways and regulatory factors involved,aiming to provide reference and suggestions for the future treatment of PCOS with TCM by regulating autophagy.

关 键 词：多囊卵巢综合征 自噬 信号通路 调控因子 机制 中药复方 中药提取物 

分 类 号：R259[医药卫生—中西医结合] R588.6[医药卫生—中医内科学] R711.75[医药卫生—中医学]