多囊卵巢综合征（PCOS）患者的临床表现为胰岛素抵抗、排卵功能障碍及高雄激素血症，常伴有肥胖、2型糖尿病和血 脂代谢异常等。对近年来中药（包括中药复方与中药单体）干预 PCOS 的相关研究的综述显示，中药复方及中药单体均对 PCOS 具有改善作用，中药干预 PCOS 具有多靶点和个性化治疗的优势。中药复方可分为补肾类（如安胎防漏汤、归术益坤 方、六味地黄丸、 补肾化瘀方）、化痰类（如苍附导痰汤、二陈汤）、疏肝类（如逍遥散、 芍药甘草汤）、活血类（如加味芍药 甘草汤、 膈下逐瘀汤、 化瘀消癥汤），分别具有补肾填精、疏肝解郁、活血化瘀等主要功效，与PCOS的中医病因病机相契 合。中药单体成分主要包括黄酮类、生物碱类、萜类、多酚类，中药提取物通过抑制卵巢炎症反应、改善高雄激素血症与 胰岛素抵抗，从而发挥治疗PCOS的作用。中药干预PCOS涉及的主要信号通路包括PI3K/AKT/mTOR、SIRT1/AMPK、TLR4/ NF-κB、IRS1/PI3K/GLUT4、RIP1/RIP3/MLKL、HMGB1/RAGE及Hippo-YAP等。该文对近年来干预PCOS的中药复方及中药 单体及其作用机制进行总结，可为拓展PCOS的临床诊疗及新药研发提供参考。

Polycystic ovary syndrome （PCOS） is clinically characterized by insulin resistance，ovulatory dysfunction and hyperandrogenemia，often accompanied by obesity，type 2 diabetes，and dyslipidemia. This article reviews the recent studies on the intervention of PCOS with herbal medicines， including traditional Chinese medicine （TCM） compound formulas and single active compounds. The results demonstrate that both TCM compound formulas and single active compounds are effective on improving PCOS symptoms，with the advantages of multitarget actions and personalized treatment. TCM compound formulas for PCOS can be categorized into kidneytonifying formulas （e. g.， Antai Fanglou Decoction， Gui Zhu Yikun Formula， Liuwei Dihuang Pills， Bushen Huayu Formula）， phlegm-resolving formulas （e. g.， Cang Fu Daotan Decoction， Erchen Decoction）， liversoothing formulas （e.g.，Xiaoyao San，Shaoyao Gancao Decoction），and blood-activating formulas （e.g.，Jiawei Shaoyao Gancao Decoction， Gexia Zhuyu Decoction， Huayu Xiaozheng Decoction）. These compound formulas separately exhibit actions of tonifying kidney essence， soothing liver and relieving depression， and activating blood circulation to resolve stasis， which are aligned with the TCM etiology and pathogenesis of PCOS. Single active compounds from herbal medicine primarily include flavonoids， alkaloids， terpenoids and polyphenols. Extractives from herbal medicines exert therapeutic effects by inhibiting ovarian inflammatory responses and relieveing hyperandrogenemia insulin resistance. Key signaling pathways for the intervention of PCOS with TCM include PI3K/AKT/mTOR， SIRT1/AMPK， TLR4/NF- κB， IRS1/PI3K/GLUT4， RIP1/RIP3/MLKL， HMGB1/RAGE，and Hippo-YAP. The review of recent advances in TCM formulas and single active compounds for the treatment of PCOS along with their underlying mechanisms will provide valuable insights for clinical management and new drug development for PCOS.

R271.9

国家重点研发计划项目（编号：2023YFC2705400）；广东省科技计划项目（编号：2023B1212060062，2023B1212060063）；广州市 科技局项目（编号：2024A04J9997，2025A03J4085，2023A03J0240）