中医药调控Nrf2信号通路治疗早发性卵巢功能不全的研究进展*
作者：史力卉，王艳辉，雷 磊
单位：湖南中医药大学中西医结合学院，湖南 长沙 410208
引用：引用：史力卉，王艳辉，雷磊.中医药调控Nrf2信号通路治疗早发性卵巢功能不全的研究进展[J].中医药导报,2026,32(4):144-152.
DOI：10.13862/j.cn43-1446/r.2026.04.023
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摘要：早发性卵巢功能不全（POI）是一种卵巢活性过早丧失、会诱发40岁以下女性出现低雌激素状态的生殖内分泌疾病，严重影响女性心理健康和生活质量。目前西医治疗POI以激素替代疗法（HRT）为主，虽可取得较好的临床疗效，但易出现消化道不良反应，且长期使用会增加女性罹患血栓栓塞症、子宫内膜增生、子宫内膜癌等疾病的风险。近年来，中医药在POI的治疗中展现出了疗效佳、不良反应小、治疗系统性强等特点，得到了广泛的关注和研究。POI发病机制较为复杂，目前研究发现其主要与氧化应激、炎症反应和细胞凋亡等方面关系密切。核因子红系2相关因子2（Nrf2）信号通路是细胞应对氧化应激和维持细胞稳态的重要调节通路，它主要参与抗氧化、抗炎、增强解毒酶活性等保护性生物学过程。近期有关研究指出，中医药可通过Nrf2信号通路抑制氧化应激、炎症反应、颗粒细胞（GCs）凋亡并减轻细胞铁死亡强度，从而改善卵巢功能。基于此，本文从Nrf2信号通路概况、Nrf2信号通路在POI中的作用、中医药通过Nrf2信号通路治疗POI等方面对近年来中医药通过Nrf2信号通路治疗POI的相关研究报道进行综述，以期为临床治疗POI提供新的切入点。
关键词：早发性卵巢功能不全；核因子红系2相关因子2（Nrf2）信号通路；中医药；氧化应激；研究进展
Abstract：Premature ovarian insufficiency (POI) is a reproductive endocrine disorder characterized by premature loss of ovarian activity, resulting in a hypoestrogenic state in women under 40 years of age, which severely affects their mental health and quality of life. Current Western medical treatment for POI is mainly hormone replacement therapy (HRT). Although HRT can achieve favorable clinical outcomes, it is prone to gastrointestinal adverse reactions, and long-term use increases the risk of thromboembolism, endometrial hyperplasia, endometrial cancer, and other diseases. In recent years, traditional Chinese medicine (TCM) has gained widespread attention and research interest for its advantages in the treatment of POI, including good efficacy, low side effects, and a systematic therapeutic approach. The pathogenesis of POI is complex, and current studies have found that it is closely related to oxidative stress, inflammatory responses, and apoptosis. The nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway is a key regulatory pathway for cellular responses to oxidative stress and maintenance of cellular homeostasis, primarily involved in protective biological processes such as antioxidation, anti-inflammation, and enhancement of detoxifying enzyme activity. Recent studies have indicated that TCM can inhibit oxidative stress, inflammatory responses, and granulosa cell (GC) apoptosis, as well as attenuate the intensity of ferroptosis through the Nrf2 signaling pathway, thereby improving ovarian function. Based on these findings, this article reviews recent research reports on the treatment of POI with TCM via the Nrf2 signaling pathway, covering an overview of the Nrf2 signaling pathway, its role in POI, and the application of TCM in treating POI through this pathway, aiming to provide new insights for clinical treatment of POI.
Key words：premature ovarian insufficiency (POI); nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway; traditional Chinese medicine; oxidative stress; research progress
发布时间：2026-04-26
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