基于肠道菌群探讨从"土得木而达"论治早发性卵巢功能不全OA

Premature ovarian insufficiency(POI)is a common gynecologic endocrine disease characterized by ovarian dysfunction or loss under the age of 40.In recent years,influenced by multiple factors such as genetics,environment,and lifestyle,its incidence has increased significantly,which not only leads to reproductive system problems such as menstrual disorders and fertility decline,but also has a serious impact on the psychological state and overall quality of life of patients,and has become one of the major diseases threatening women's physical and mental health.As one of the core connotations of the theory of liver and spleen in traditional Chinese medicine(TCM),the"Earth attaining free flow through the regulation of Wood"profoundly explains the promoting effect of liver Qi(气)on the spleen function and the coordinated mechanism between the two to maintain the body fluid homeostasis and Qi regulation.According to the theory of TCM,the liver governs free flow of Qi and the spleen governs transportation and transformation.If the liver fails to govern the free flow of Qi,the Qi movement will be stagnant,and then the spleen's transportation and transformation function will be impaired.The dysfunction of the two can lead to the abnormalities in metabolism of blood,Qi,and body fluid,the loss of nourishment,and ultimately affect the normal physiological function of the ovary.In recent years,studies have shown that gut microbiota can directly or indirectly affect ovarian function through metabolically mediated,immune regulation,neuroendocrine signal transmission and other pathways.Based on the core pathogenesis of liver and spleen imbalance,this paper systematically elucidates the correlation mechanisms between gut microbiota disorder and POI from the perspective of TCM,aiming to provide new theoretical ideas and clinical reference for intervention in POI from the aspects of liver and spleen homology theory and gut microbiota regulation.