Research Advances on Modified Yulinzhu Decoction in Clinical Applications and Fundamental Studies of Gynecological Diseases

Abstract

Yulinzhu Decoction, originally documented in Jingyue’s Complete Works by the Ming Dynasty physician Zhang Jingyue, is renowned for its dual capacity to “tonify Yang within Yin”, reinforce Kidney Qi, and regulate menstruation by nourishing Blood. Designed for women with concurrent Qi-Blood deficiency, menstrual irregularities, and infertility, this formula has been extolled by later physicians as the quintessential prescription for menstrual regulation and fertility enhancement. Recent advancements in modern research methodologies have expanded its therapeutic scope in gynecological disorders. This review systematically summarizes clinical progress in applying Yulinzhu for reproductive endocrine diseases, including hypomenorrhea, amenorrhea, polycystic ovary syndrome (PCOS), and premature ovarian insufficiency (POI). From a mechanistic perspective integrating network pharmacology predictions and experimental validation, we elucidate its modulation of multiple signaling pathways—HIF-1, SIRT1/TERT, mTOR, FOXO3a, and SIRT1-FoxO1—to improve ovarian microenvironment, delay ovarian aging, and mitigate oxidative stress damage. Evidence indicates that Yulinzhu exerts therapeutic effects via a “multi-component, multi-target, multi-pathway” regulatory network. Future studies should prioritize high-quality clinical trials to further delineate its pharmacodynamic material basis and molecular mechanisms, thereby facilitating the modernization and clinical translation of this classical formula.