Tian Sai-Nan, Tang Li, Wang Sheng-Yu, Chen Yao, Zeng Jing
the First Affiliated Hospital of Hunan University of Chinese Medicine Changsha 410007, China Hunan University of Chinese Medicine Changsha 401008, China.
the First Affiliated Hospital of Hunan University of Chinese Medicine Changsha 410007, China.
Zhongguo Zhong Yao Za Zhi. 2025 Jun;50(11):2969-2981. doi: 10.19540/j.cnki.cjcmm.20250228.501.
Premature ovarian insufficiency(POI) is a manifestation of ovarian aging, with a global incidence of 3.5%. If not addressed in time, POI can rapidly develop into premature ovarian failure(POF). The incidence of POI is mainly related to genetic factors, iatrogenic factors, autoimmunity, aging, infection, psychological factors, and other influences. POI not only causes menstrual disorders, amenorrhea, infertility, and dyspareunia but also tends to present with symptoms such as mood swings, insomnia, hot flashes, fatigue, as well as osteoporosis, coronary heart disease, diabetes, and other conditions, resulting in long-term psychological and physical health concerns for affected women. From traditional Chinese medicine(TCM)'s perspective, POI is primarily attributed to kidney Yin deficiency, with the main pathogenesis rooted in kidney deficiency, which affects the heart, liver, and spleen. It manifests in different syndrome types, including kidney deficiency with liver Qi stagnation, kidney deficiency with blood stasis, and spleen-kidney Yang deficiency. TCM employs a holistic view, utilizing multi-component TCM, multi-site acupuncture, and multi-target and multi-pathway interventions to treat POI. It offers unique advantages such as strong personalization, high safety, and good efficacy. In this paper, the animal and clinical research literature on the prevention and treatment of POI in the past 10 years was systematically summarized and reviewed. It is found that TCM mainly treats POI and alleviates POI-caused issues such as menstrual disorders, infertility, and emotional instability by regulating the neuroendocrine system(hypothalamic-pituitary-ovarian axis, HPOA) and related signaling pathways, improving ovarian function and antioxidant capacity, enhancing immune function, maintaining mitochondrial energy metabolism, inhibiting ferroptosis, and controlling endoplasmic reticulum stress.
卵巢早衰（POI）是卵巢衰老的一种表现，全球发病率为3.5%。若不及时治疗，POI可迅速发展为卵巢功能早衰（POF）。POI的发病率主要与遗传因素、医源性因素、自身免疫、衰老、感染、心理因素等有关。POI不仅会导致月经紊乱、闭经、不孕和性交困难，还常伴有情绪波动、失眠、潮热、疲劳等症状，以及骨质疏松、冠心病、糖尿病等疾病，给患病女性带来长期的身心健康问题。从中医学角度来看，POI主要归因于肾阴虚，其主要病机为肾虚，进而影响心、肝、脾。其表现为不同的证型，包括肾虚肝郁、肾虚血瘀、脾肾阳虚。中医采用整体观，运用中药多成分、针刺多穴位以及多靶点、多途径干预来治疗POI。它具有个性化强、安全性高、疗效好等独特优势。本文系统总结并回顾了过去10年中关于POI防治的动物和临床研究文献。研究发现，中医主要通过调节神经内分泌系统（下丘脑-垂体-卵巢轴，HPOA）及相关信号通路、改善卵巢功能和抗氧化能力、增强免疫功能、维持线粒体能量代谢、抑制铁死亡以及控制内质网应激等方式来治疗POI，并缓解POI所致的月经紊乱、不孕和情绪不稳定等问题。
