多囊卵巢综合征肠道微生物组学研究及中医药治疗的研究进展

doi:10.12280/gjszjk.20260177

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者肠道微生物呈现显著失调，细菌层面表现为α多样性降低，有益菌属（如双歧杆菌属、阿克曼菌属）丰度减少，而条件致病菌属（如拟杆菌属、大肠杆菌属）显著富集；真菌层面表现为酵母菌属丰度减少、念珠菌属丰度增加。肠道微生物通过多重途径参与PCOS的发生发展：短链脂肪酸减少；胆汁酸代谢异常致法尼酯X受体/G蛋白偶联胆汁酸受体5通路受损；支链氨基酸升高激活哺乳动物雷帕霉素靶蛋白复合物1；肠道通透性增加导致脂多糖入血引发慢性低度炎症；脑-肠轴紊乱致激素分泌异常等。中医药通过调节肠道微生物改善PCOS症状具有显著效果。桂枝茯苓丸、补肾化浊方等复方可调节菌群结构、改善胰岛素抵抗；毓麟通补方、王氏益经汤等能纠正激素代谢紊乱；芍药甘草汤、百令胶囊、归肾丸加味等可抑制炎症反应、修复肠道屏障。未来研究应继续探讨肠道微生物影响PCOS的具体作用机制，系统解析中医药靶向肠道微生物治疗PCOS的潜力，为PCOS的预防和治疗提供更充分的科学依据。

关键词: 胃肠道微生物组, 多囊卵巢综合征, 脑-肠轴, 中药, 治疗

Abstract:

Patients with polycystic ovary syndrome (PCOS) exhibit significant dysbiosis of the gut microbiome. At the bacterial level, the α-diversity is reduced, with the decreased abundance of beneficial genera such as Bifidobacterium and Akkermansia, and the increased enrichment of opportunistic pathogens including Bacteroides and Escherichia coli. At the fungal level, there is a reduction in abundance of Saccharomyces and an increase in abundance of Candida. Gut microbiota participate in the pathogenesis of PCOS through multiple pathways: the reduction of short-chain fatty acids (SCFA); bile acid metabolism disorders leading to impaired FXR/TGR5 signaling; the elevated branched-chain amino acids (BCAAs) activating mTORC1; the increased intestinal permeability allowing lipopolysaccharide (LPS) translocation into the circulation and triggering chronic low-grade inflammation; and the gut-brain axis dysregulation resulting in aberrant hormone secretion. Traditional Chinese Medicine (TCM) has demonstrated significant efficacy in improving PCOS symptoms through the regulation of gut microbiota. Formulations such as Guizhi Fuling Pill and Bushen Huazhuo Formula can modulate microbial community structure and ameliorate insulin resistance; Yulin Tongbu Formula and Wangshi Yijing Decoction can correct hormonal metabolic disturbances; and Shaoyao Gancao Decoction, Bailing Capsule, and Guishen Pill Jiawei can suppress inflammatory responses and restore intestinal barrier integrity. Future studies should continue to explore the specific mechanisms underlying the influence of gut microbiota on PCOS, systematically dissect the potential of TCM in targeting gut microbiota for PCOS therapy, and thus provide more robust scientific evidence for the prevention and treatment of PCOS.

Key words: Gastrointestinal microbiome, Polycystic ovary syndrome, Brain-gut axis, Traditional Chinese drugs, Therapy

秦文静, 李安琪, 吴效科. 多囊卵巢综合征肠道微生物组学研究及中医药治疗的研究进展[J]. 国际生殖健康/计划生育杂志, 2026, 45(5): 434-440.

QIN Wen-jing, LI An-qi, WU Xiao-ke. Research Progress of Gut Microbiota in the Pathogenesis and Traditional Chinese Medicine Treatment of Polycystic Ovary Syndrome[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(5): 434-440.

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