【摘要】 产后缺乳是影响母婴健康及母乳喂养持续性的常见临床问题。本文聚焦于中药复方治疗产后缺乳，围绕临床应用证据、作用机制及研究瓶颈展开综述。当前中药复方治疗产后缺乳主要围绕气血亏虚、肝郁气滞和痰湿阻滞等证型展开，代表方包括参芪催乳汤、催乳汤、补血生乳颗粒、理气解毒通乳汤、苍附导痰丸等，在改善泌乳量、乳房充盈度、血清催乳素水平及母乳喂养等方面显示一定优势。现代研究提示，中药复方的促泌乳作用与调节下丘脑-垂体-乳腺轴、改善催乳素/雌孕激素失衡、激活Janus激酶2/信号转导及转录激活因子5(JAK2/STAT5)、磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白（PI3K/Akt/mTOR与Wnt/β-肌动蛋白（β-catenin）等信号通路、减轻炎症反应及促进乳腺组织修复有关。但现有研究仍存在证候诊断与纳排标准不统一、结局指标异质性大、高质量随机对照研究不足、复方物质基础与靶向机制阐释有限等问题。未来应从构建标准化临床评价体系、强化循证设计、结合网络药理学与多组学阐明复方关键活性成分及作用通路、推进标准化制剂开发等方面提升研究质量。本文可为产后缺乳的中医临床辨治及中药复方二次开发提供参考。更多还原

【Abstract】 Postpartum hypogalactia is a common clinical problem that affects maternal and infant health and the continuation of breastfeeding. This review narrows the topic to traditional Chinese medicine formulas for postpartum hypogalactia and summarizes evidence from clinical application, mechanistic studies, and unresolved research issues. Current formula-based interventions are mainly applied to qi-blood deficiency, liver-qi stagnation, and phlegm-dampness obstruction patterns. Representative prescriptions include Shenqi Cuiru decoction, Cuiru decoction, Buxue Shengru granules, Liqi Jiedu Tongru decoction, and Cangfu Daotan pills. These formulas may improve milk volume, breast fullness, serum prolactin, and breastfeeding outcomes. Modern studies suggest that the lactogenic effects are associated with regulation of the hypothalamus-pituitary-mammary axis, correction of estrogen-progesterone imbalance, activation of JAK2/STAT5, PI3K/Akt/mTOR, and Wnt/β-catenin signalling pathways, attenuation of inflammatory responses, and promotion of mammary tissue repair. However, existing studies still have problems such as non-uniform syndrome diagnosis and inclusion/exclusion criteria, high heterogeneity of outcome indicators, insufficient high-quality randomized controlled trials, and limited elucidation of the material basis and targeted mechanisms of compound formulas. Future research should focus on constructing standardized clinical evaluation systems, strengthening evidence-based designs, combining network pharmacology with multi-omics to elucidate key active components and mechanisms of compound formulas, and promoting the development of standardized formulations. This review may provide references for clinical syndrome differentiation and treatment of postpartum hypogalactia and secondary development of traditional Chinese medicine compound formulas.更多还原