肠道微生态介导多囊卵巢综合征发病的机制及中医药干预研究进展
Research Progress on the Mechanism of Gut Microecology Mediating the Pathogenesis of Polycystic Ovary Syndrome and Traditional Chinese Medicine Intervention
DOI: 10.12677/tcm.2026.1510575, PDF,   
作者: 王钰德, 张 明, 任萌琳：黑龙江中医药大学研究生院，黑龙江 哈尔滨；匡洪影*：黑龙江中医药大学附属第一医院妇科二科，黑龙江 哈尔滨
关键词: 肠道微生态；多囊卵巢综合征；中医药干预；菌群失调；短链脂肪酸；肠–卵巢轴；Gut Microecology； Polycystic Ovary Syndrome； Traditional Chinese Medicine Intervention； Gut Microbiota Dysbiosis； Short-Chain Fatty Acids； Gut-Ovary Axis
摘要: 多囊卵巢综合征(PCOS)作为育龄期女性最常见的内分泌代谢性疾病，其发病机制复杂且尚未完全阐明。近年来，肠道微生态失调被证实可通过代谢紊乱、内分泌失衡及免疫炎症等多条途径参与PCOS的发生发展。本文系统综述了肠道菌群及其代谢物在PCOS病理进程中的核心作用，重点剖析短链脂肪酸异常、内毒素易位、雌激素肠肝循环障碍及Treg/Th17失衡等关键机制环节，并深入归纳了中药复方及单味药活性成分通过重塑肠道菌群结构、修复肠道屏障、恢复代谢–内分泌–免疫网络稳态的干预策略。此外，本文整合了“肠–脑轴”“肠–肝轴”“肠–卵巢轴”多通路协同调控的整合机制框架，以期为PCOS的精准诊疗提供新思路。
Abstract: Polycystic ovary syndrome (PCOS), as the most common endocrine and metabolic disorder in women of reproductive age, has a complex pathogenesis that remains not fully elucidated. In recent years, gut microbiota dysbiosis has been confirmed to participate in the onset and progression of PCOS through multiple pathways, including metabolic disturbances, endocrine imbalance, and immune inflammation. This article systematically reviews the core role of gut microbiota and its metabolites in the pathological process of PCOS, focusing on key mechanistic links such as short-chain fatty acid abnormalities, endotoxin translocation, impaired estrogen enterohepatic circulation, and Treg/Th17 imbalance. Furthermore, it comprehensively summarizes intervention strategies involving traditional Chinese medicine formulas and active ingredients from single herbs that act by reshaping gut microbiota structure, repairing the intestinal barrier, and restoring homeostasis of the metabolic-endocrine-immune network. Additionally, this paper integrates a framework of synergistic regulatory mechanisms across multiple axes, including the “gut-brain axis,” “gut-liver axis,” and “gut-ovary axis,” aiming to provide new insights for the precision diagnosis and treatment of PCOS.
文章引用：王钰德, 张明, 任萌琳, 匡洪影. 肠道微生态介导多囊卵巢综合征发病的机制及中医药干预研究进展[J]. 中医学, 2026, 15(10): 422-429. https://doi.org/10.12677/tcm.2026.1510575

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