Exploration of the Clinical Applications in Gynecology and Mechanism of Action of Yimucao Granules

益母草颗粒源自妇科经典名方，以益母草为主药，辅以当归、川芎、白芍、熟地黄等活血养血之品，佐入香附、延胡索理气止痛，兼配党参、白术护胃和中。全方以“化瘀调经、行气养血”为纲，顺应女性“血常不足，气易壅滞”的生理特性。本文聚焦其治疗妇科内分泌及月经失调疾病的应用与机制。该制剂通过多环节干预起效：调节性激素水平、改善子宫微循环、抑制异常宫缩、平衡凝血功能及减轻炎性反应。临床适用于月经不调、痛经、产后瘀阻、流产后宫腔修复等病症。研究表明，其联合西医治疗可降低血液黏度，促进产后子宫复旧，缩短药流后出血时间；通过调控前列腺素合成缓解痛经，双向调节雌激素/孕激素比值以改善黄体功能。独特之处在于既能缓解子宫过度收缩导致的痛经，又可增强宫缩乏力者的肌力，兼具“通”“补”双重特性。实验证实其活性成分可抑制氧化应激损伤，调控TLR4/NF-κB通路抗炎，促进内膜修复。长期应用显示其可减少宫腔粘连风险，且无显著肝肾毒性，安全性良好。作为妇科经典中成药，益母草颗粒在生殖系统调理与内分泌平衡领域具有重要临床价值。Yimucao Granules, derived from a classic traditional Chinese medicine (TCM) formula for gynecological disorders, are formulated with Leonurus cardiaca as the principal component. The formulation is complemented by blood-activating and tonifying herbs such as Angelica sinensis, Ligusticum chuanxiong, Paeonia lactiflora, and Rehmannia glutinosa, augmented with Cyperus rotundus and Corydalis yanhusuo for regulating qi and relieving pain, and further combined with Codonopsis pilosula and Atractylodes macrocephala to protect the stomach and strengthen the spleen. The entire formula adheres to the principle of “dispelling stasis to regulate menses, promoting qi flow to nourish blood”, aligning with women’s physiological characteristics of frequent blood deficiency and proneness to qi stagnation. This paper focuses on its clinical applications and mechanisms in treating endocrinological and menstrual disorders. The granules exert multifaceted therapeutic effects, including modulation of sex hormone levels, enhancement of uterine microcirculation, inhibition of abnormal uterine contractions, regulation of coagulation function, and attenuation of inflammatory responses. Clinically, it is indicated for irregular menstruation, dysmenorrhea, postpartum lochiostasis, and endometrial repair following abortion. Studies demonstrate that when used in conjunction with conventional Western treatments, Yimucao Granules reduce blood viscosity, accelerate postpartum uterine involution, and shorten bleeding duration after medical abortion. By modulating prostaglandin synthesis, it alleviates primary dysmenorrhea, while bidirectionally adjusting estrogen/progesterone ratios to improve corpus luteum function. Notably, it exhibits dual properties: relaxing excessive uterine contractions to relieve pain and enhancing myometrial tension in cases of insufficient contraction. Experimental evidence reveals its active components inhibit oxidative stress-induced damage, regulate the TLR4/NF-κB pathway to suppress inflammation, and promote endometrial repair. Long-term use shows reduced risks of intrauterine adhesions without significant hepatotoxicity or nephrotoxicity, underscoring its safety and tolerability. As a quintessential TCM preparation, Yimucao Granules hold significant clinical value in reproductive system regulation and endocrine balance.