Research Progress of Traditional Chinese Medicine for Perimenopausal Emotional Disturbances from the Perspective of the Neuroendocrine-Immune Network

作者：婷 王 · 发表于：Journal of Clinical Personalized Medicine · 年份：2026 · DOI：10.12677/jcpm.2026.54271 · 研究领域：Traditional Chinese Medicine Studies、Menstrual Health and Disorders、Antioxidants, Aging, Portulaca oleracea

围绝经期情绪障碍，是指围绝经期伴随的焦虑、抑郁等情绪症状，主要依据经验证量表或临床评估识别，并非新增的独立精神科诊断；达到焦虑障碍或抑郁障碍诊断标准者仍应按相应疾病规范诊疗。卵巢功能波动与下丘脑–垂体–卵巢轴、下丘脑–垂体–肾上腺轴、单胺类神经递质、神经可塑性及炎症免疫信号共同作用，可形成神经–内分泌–免疫(NEI)网络失衡。现有研究提示中药、针刺及其联合常规治疗可能改善部分女性的焦虑、抑郁量表评分和围绝经期伴随症状，但证据受到样本量较小、盲法不足、结局异质性及随访偏短等限制。本文围绕概念界定、NEI病理基础、中医药临床证据和可能机制进行梳理，并纳入国内外关于二仙汤、逍遥散的代表性研究，辨析动物实验、网络药理学与临床外推的边界。当前证据支持将中医药作为个体化综合管理的潜在组成部分，但不能替代规范化精神心理评估及一线治疗。未来应统一生殖分期、情绪结局和证候标准，开展多中心、注册、充分报告安全性并长期随访的随机对照试验，同时通过逍遥散等重点案例，串联复方药理、代谢组学、肠道菌群–炎症免疫及临床症状改善证据，并提出基于NEI生物标志物分层的安慰剂对照随机试验框架，以增强机制论证的深度和研究建议的可操作性。In this review, perimenopausal emotional disturbances refer to anxiety and depressive symptoms accompanying perimenopause, identified mainly by validated scales or clinical assessment. The term is descriptive rather than a new psychiatric diagnosis; women meeting criteria for an anxiety or depressive disorder require diagnosis-specific management. Fluctuating ovarian function interacts with the hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes, monoaminergic neurotransmission, neuroplasticity, and inflammatory signaling, producing dysregulation of the neuroendocrine-immune (NEI) network. Existing studies suggest that Chinese herbal medicine, acupuncture, and integrative treatment may improve anxiety, depressive, and co-occurring menopausal symptoms in selected women. However, certainty is limited by small samples, inadequate blinding, heterogeneous outcomes, and short follow-up. This narrative review summarizes the conceptual scope, NEI basis, clinical evide...