Review Article

Research Progress on the Effect of Traditional Chinese Medicine on Signal Pathway Related to Premature Ovarian Insufficiency

Table 2

The regulatory effects of Chinese herbal formula on signal pathways related to POI

RecipeCompositionsClassificationEfficaciesPathwaysTargetsExperimental modelRoles

Yulinzhu [6]Radix Angelicae Sinensis, Radix Rehmanniae Praeparata, Semen Cuscutae, ginseng, branched Atractylodes macrocephala, Poria, Radix Paeoniae Alba, Cortex Eucommiae, Zanthoxylum piperitum. Rhizoma Ligustici, Radix GlycyrrhizaeTonic prescriptionsWarming the kidneys and strengthening the spleen to produce essencePI3K/Akt/mTOR signaling pathwaysTSC1↓, TSC2↓, Rheb↑, P-s6k1↑, P-4e-bp1SPF BALB/c female mice with normal motility cycles at 6 to 8 weeks of age.It can inhibit microenvironmental oxidative stress.

Jiajian Guishen pill [8]Semen Cuscutae, semen spleen, Radix Rehmanniae, Radix Rehmanniae, Radix Angelicae Sinensis, Radix Paeoniae Alba, Salviae miltiorrhizaTonic prescriptionsTonifying the kidney, strengthening the spleen, tonifying the liver, and invigorating the bloodPI3K/Akt/mTOR signaling pathwayPI3K↑, Akt↑, mTOR mRNA↑SPF ICR female mice.Improve ovarian reserve function and increase the number of follicles.

Xianzi Yizhen capsule [9]Radix Rehmanniae Praeparata, Radix et Rhizoma Polygonati, Radix et Rhizoma Drynariae, Radix et Rhizoma Continuum, Semen Cuscutae, semen spleenTonic prescriptionsTonifying the kidney and filling the essencePI3K/Akt/mTOR signaling pathwaysKi67↑, Akt↑, PI3K↑SPF female C57BL/6J type mice.Increase the content of primordial follicles, secondary follicles and sinus follicles, and decrease the content of atretic follicles.

Guiluo's Anzang decoction [12]Radix Rehmanniae Praeparata, Fructus Fritillariae, Semen Cuscutae, Radix et Rhizoma Polygoni, Paeoniae AlbaTonic prescriptionsNourishing Yin, tonifying the kidneys, calming the mind, and relieving irritabilityBax/CytC/Caspase-3 signaling pathwaysBcl-2↑, Bax↓SPF healthy female SD ratsReduce granulocyte apoptosis and increase granulocyte secretion.

Kuntai capsule [14, 38, 39, 46, 47, 57]Radix Rehmanniae Praeparata, Rhizoma Polygonati, Radix Paeoniae Alba, Radix Scutellariae Praeparata, Radix Aconiti, PoriaTonic prescriptionsNourishing Yin, clearing heat, calming the mind, and relieving irritabilityBax/CytC/Caspase-3 signaling pathways, p-38/Fas/FasL signaling pathways, TGF-β/Smads signaling pathways, NF-kB signaling pathwaysBcl-2↑, Bcl-xl↑, Bax↓, Bad↓, Fas mRNA↑, FasL mRNA↓, GDF-9↑, EGR-1↑, Smad7↓, VEGF↑, bFGF↑SPF healthy female SD ratsMaintain the balance between pro-apoptotic and anti-apoptotic proteins and improve ovarian reserve function; improve ovarian blood supply, promote follicle development, reduce follicular atresia and increase the number of mature follicles present in rats.

Yangyin Shugan granule [15]Radix Bupleurum, Radix Paeoniae Alba, etc.Mediative formulasNourishing Yin and soothing the liverBax/CytC/Caspase-3 signaling pathwaysBcl-2↑, Bax↓, Caspase-3↓, FOXO3a↓SPF healthy female SD ratsIt can inhibit apoptosis.

Zuogui pill [17, 18, 21, 41, 48, 64]Radix Rehmanniae Praeparata, Rhizoma Dioscoreae, Fructus Lycii, Cornu Cervi Pantotrichum, Radix Achyranthes Bidentatae, Semen Cuscutae, antler gum, turtle board gumTonic prescriptionsNourishing Yin, tonifying the kidney, and nourishing the bloodBax/CytC/Caspase-3 signaling pathways, FOXO3, SCF, TGF-β/Smads signaling pathwaysBcl-2 mRNA↑, Bax↓, FOXO3a↓, CTX↑, Cx43 mRNA↑, Smad2↑, GDF-9↑Human ovarian granulosa cells; SPF 8-week-old BALB/c female miceIt can inhibit chemotherapy-induced granulosa cell apoptosis and protect ovarian function; improve suture junctions; promote recruitment of initiating follicles, promote follicular development, inhibit follicular atresia, and regulate ovarian function.

Erxian decoction [20, 52]Herba dipteris, Epimedium herba, Phellodendron phellodendron, Euphorbia officinalis, Angelica, Anemone anemoneTonic prescriptionsWarming kidney Yang, tonifying kidney essence, and dipping kidney fireFOXO3 transcription factor -P27/BimFOXO3↓, P27KiPi↓, Bim↓Clean-grade SD healthy female ratsPromote granulosa cell proliferation and inhibit granulosa cell regulation; promote the secretion of vascular growth factor associated with premature ovarian failure in rats, and enhance ovarian reserve function.
Bushen Jianpi decoction [29, 30]Polygonatum officinale, Radix et Rhizoma Polygonatum, Radix et Rhizoma Polygonatum, Fructus Lycii, Atractylodes Macrocephala, PoriaTonic prescriptionsTonifying the kidneys and strengthening the spleenER/c-myc/TERT signaling pathwaysc-Myc↑, TERT↑B6AF1 female miceIt can promote the proliferation and development of ovarian granulosa cells and the maturation of oocytes.

Bushen Tiaochong decoction [33, 42, 55]Cuscuta seed, Euphorbia officinalis, Ripe Rehmannia, Cistanche, yellow essence, amethyst, Schisandra fruit, Angelica, Ligusticum wallichii, etcTonic prescriptionsTonifying the kidneys and regulating the flushing processP53, SCF, NF-kB signaling pathwaysP53↓, GnRHR↑, Cx-37↑, SCF↓, VEGF↑, bFGF↑, TNF-α↓, IFN-γClean-grade female SD ratsProlong the time of apoptosis, reduce the occurrence of follicular atresia, improve the reserve capacity of ovarian receptors and thus coordinate ovarian function; promote the growth and development of early follicles, improve the function of ovarian tissue gap junctions and thus repair ovarian function damage in rats.

Bushen Huoxue decoction [36, 50]Herba epimedium, Semen Cuscutae, Fructus Lycii, Fructus Lycii, Fructus Morindae, mulberry, raspberry, yam, Radix Codonopsis, Radix Astragali, Radix Paeoniae Alba, Fructus Ulmoides, bark, Salviae Miltiorrhiza, Radix Angelicae Sinensis, Radix Angelicae SinensisTonic prescriptionsTonifying the kidney and invigorating the bloodKi67/ERKp-ERK1/2↑, ERK1/2↑Mouse intrasinus follicular granulosa cellsIt can improve follicular development and increase the proliferation of follicular granulosa cells and granulosa cells of the oocyte complex in mice with reduced ovarian reserve function at an advanced age.

Gui Zhi Fu Ling capsule [40]Cassia twig, Poria cocos, peony bark, peony root, peach kernelBlood-regulating formulaPromoting blood circulation, removing blood stasis, and eliminating symptomsp-38/Fas/FasLFas/FasL↓SPF female Wistar ratsReduce ovarian apoptosis.

Kun Bao pill [43]Chasteberry, raspberry, Cuscuta, etc.Tonic prescriptionsNourishing the liver and kidneys, calming and tranquilizing the mind, nourishing the blood, and opening the meridiansSCF, TGF-βCTGF↓, TGF-β1↓, SCF↓SPF healthy female SD ratsReduce ovarian fibrosis.

Siwu mixture [45]Radix Rehmanniae Praeparata, Radix Angelicae Sinensis, Radix Paeoniae Alba, Ligustici wallichiiTonic prescriptionsNourishing Yin and replenishing bloodTGF-β/Smads signaling pathwaysSmad2/3↑, Cyp19a1↑Healthy female SD ratsIt can promote follicular growth and development and slow down follicular atresia.

Yiqi Yangrong Fujing formula [54]Astragalus, Bacopa monnieri, Dendrobium Ferrugineum, Rhizoma PolygonatumTonic prescriptionsBenefiting Qi, warming Yang, nourishing Yin, and restoring essenceNF-kB signaling pathwaysIL-2↑, TNF-αHealthy female C57BL/6 miceInhibit the apoptosis of ovarian granulosa cells, restore ovarian function, and enhance ovarian reserve capacity.

Bushen Culuan formula [61]Radix chasteberry, Semen Cuscutae, Fructus Lycii, Radix et Rhizoma mulberry, Radix et Rhizoma Sequoiae, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix ZeleniumTonic prescriptionsTonifies the kidneys and enhances the essenceBax/CytC/Caspase-3 signaling pathways, Keap1/Nrf2/ARE signaling pathwaysAkt↓, mTOR mRNA↓, PI3K mRNA↓, Bcl-2↑, Keap1↓, Bach1↓SPF 8-week-old female BALB/c miceReverse excessive apoptosis of granulosa cells, reduce follicular atresia, reduce excessive activation of primordial follicles, and protect ovarian reserve; reduce ovarian oxidative damage.

Yiguan Jian decoction [62]Raw Rehmanniae, Radix Aristophanae, Angelica, Wolfberry, chinaberryTonic prescriptionsNourishing Yin and softening the liverKeap1/Nrf2/ARE signaling pathwaysT-SOD↑, CAT↑, MDA↓, Caspase-3↓SPF healthy female SD ratsProtect normal ovarian cells.