摘要
左归丸出自《景岳全书》,临床应用400余年,是治疗肾阴不足的经典用方,具有滋阴补肾,填精益髓的功效,广泛应用于骨质疏松症、膝骨关节炎等疾病的治疗。近年来,越来越多研究表明左归丸在卵巢早衰(Premature ovarian failure,POF)的治疗中有一定疗效。归纳整理近几年文献,从抑制细胞凋亡与自噬、改善性激素水平、调控生长分化因子-9(Growth differentiation factor 9,GDF-9)和骨形态发生蛋白-15(Bonemorphogenetic protein-15,BMP-15)的表达、上调连接蛋白37(Connexin37,Cx37)和连接蛋白43(Connexin43,Cx43)的表达、调节下丘脑-垂体-卵巢轴(hypothalamic-pituitary-ovarianaxis,HPOA)、改善卵巢血管生成、抗骨质疏松等方面总结左归丸治疗POF的作用机制,并参与调控PI3K/AKT/mTOR、GDF-9/Smad2信号通路,从分子机制上证实了左归丸具有治疗POF的作用;并通过对左归丸治疗用药进行总结,发现无论是单方治疗,还是联合西药或针灸治疗,均可明显改善患者症状,减轻不良反应,临床疗效确切,安全性较高,值得临床推广应用。通过基础研究及临床研究全面分析了左归丸治疗POF的现状,并对当今基础实验及临床研究提出了不足与改进,为今后本方的深入研究和临床应用以及治疗POF新型药物的研发提供相关依据。
Zuogui Pill(左归丸),from Jingyue Quanshu,has been used clinically for more than 400 years.It is a classic pre-scription for the treatment of kidney Yin deficiency.It has the effect of nourishing Yin and tonifying kidney,supplementing es-sence and replenishing marrow,and is widely used in the treatment of osteoporosis,knee osteoarthritis and other diseases.In re-cent years,more and more studies have shown its efficacy in the treatment of premature ovarian failure(POF).This article sum-marized the mechanism of the treatment of POF and the literature in recent years from the aspects of inhibiting cell apoptosis and autophagy,improving sex hormone levels,regulating the expressions of growth differentiation factor 9(GDF-9)and bone morpho-genetic protein-15(BMP-15),up-regulating the expressions of connexin37(Cx37)and Connexin43(Cx43),regulating the hypothalamic pituitary ovarian axis(HPOA),improving ovarian angiogenesis and anti osteoporosis.And it participated in regula-ting the PI3K/Akt/mTOR and GDF-9/Smad2 signaling pathways,confirming the therapeutic effect of Zuogui Pill on POF from a molecular mechanism perspective.And through the summary of Zuogui Pill,it is found that whether it is a single treatment,or combined with western medicine or acupuncture and moxibustion treatment,it can significantly improve the symptoms of patients,reduce adverse reactions,and has definite clinical efficacy and high safety,which is worthy of clinical promotion and application.This article comprehensively analyzed the current status of Zuogui Pill in the treatment of POF through basic and clinical re-search,and proposed shortcomings and improvements in current basic and clinical research,providing relevant basis for future in-depth research and clinical application of the formula,as well as the development of new drugs for the treatment of POF.
作者
王月
张骞文
潘可盈
赵帅
WANG Yue;ZHANG Qianwen;PAN Keying;ZHAO Shuai(First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;School of Acupuncture and Tuina,Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China)
出处
《中华中医药学刊》
北大核心
2025年第3期143-149,共7页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金青年科学基金项目(82104914)。
关键词
左归丸
卵巢早衰
作用机制
有效成分
临床应用
Zuogui Pill(左归丸)
premature ovarian failure
mechanism of action
active ingredient
clinical application
