摘要
多囊卵巢综合征(Polycystic ovary syndrome,PCOS)是一组生殖内分泌代谢紊乱的综合征,临床以稀发排卵、高雄激素体征、胰岛素抵抗为主要特征,其中育龄期发病率高,对女性生育力造成严重不良影响。PCOS的发生发展涉及多种信号通路,腺苷酸活化蛋白激酶(AMP-activated protein kinase,AMPK)及哺乳动物雷帕霉素靶蛋白(Mammalian target of rapamycin,mTOR)作为细胞能量感受器是其中两个关键靶点。二者在PCOS各个发病部位包括下丘脑-垂体-卵巢轴、子宫内膜、脂肪与骨骼肌中发挥重要的调节作用,通过影响细胞自噬、氧化应激、炎症、线粒体功能、葡萄糖摄取等,促进卵泡的发育和成熟,改善胰岛素抵抗。近年来,中医药因其成分多样、靶点众多等优势广泛应用于临床,研究人员已对PCOS的发病以及中药治疗及改善PCOS的机制进行了大量研究,结果提示AMPK与mTOR相关通路在其中发挥关键作用。通过总结中药干预AMPK与mTOR及其相关通路治疗PCOS的研究结果,为临床治疗及基础研究提供参考。
Polycystic ovary syndrome(PCOS)is a group of symptoms of reproductive endocrine and metabolic disorders.Rare ovulation,hyperandrogenism and insulin resistance are the main clinical features of PCOS which has a high incidence of childbearing age and a serious impact on female fertility.Numerous signaling pathways are involved in the occurrence and development of PCOS,AMP-activated protein kinase(AMPK)and mammalian target of rapamycin(mTOR)as cellular energy receptors are two of the key targets,both of which play important regulatory roles in different sites of PCOS pathogenesis including the hypothalamus-pituitary-ovarian axis,endometrium,adipose and skeletal muscle,by affecting autophagy,oxidative stress,inflammation,mitochondrial function and glucose uptake to promote follicular maturation and improve insulin resistance.In recent years,Chinese medicine has been widely used in clinical practice due to its complex components and numerous targets.Researchers have conducted a lot of researches on the pathogenesis of PCOS and the mechanism of Chinese medicine for treating PCOS.The results suggest that AMPK and mTOR-related pathways play a key role in it.This article summarized the results of Chinese medicine intervention in AMPK or mTOR and its related pathways in the treatment of PCOS,expounded its key role in the pathogenesis of PCOS and provided references for clinical treatment and mechanism research.
作者
马桦
齐大河
陈雯玥
司雨
任青玲
MA Hua;QI Dahe;CHEN Wenyue;SI Yu;REN Qinging(The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中华中医药学刊》
CAS
北大核心
2024年第2期164-170,共7页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金项目(82104904)
江苏省中医妇产生殖临床医学创新中心项目(ZX202102)
江苏省研究生实践创新计划项目(SJCX22-0770)。
作者简介
马桦(1998-),女,河南郑州人,硕士在读,研究方向:中医治疗妇科生殖内分泌疾病;通讯作者:任青玲(1969-),女,江苏句容人,教授、主任医师,博士研究生导师,博士,研究方向:中医药防治多囊卵巢综合征及宫颈病变。E-mail:yfy0047@niucm.edu.cn。
