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Роль Витекса священного (Vitex agnus castus) в гинекологической эндокринологии*
Роль Витекса священного (Vitex agnus castus) в гинекологической эндокринологии*
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Аннотация
Экстракты из сушеных плодов Витекса священного (Vitex agnus castus – VAC) содержат дофаминергические субстанции, которые ингибируют секрецию пролактина в гипофизе. Возникновение не только предменструальной мастодинии, но и, как доказано в последнее время, фиброзно-кистозной мастопатии, связаны с действием пролактина. Так, у многих пациенток, у которых в стрессовых ситуациях и в фазе глубокого сна происходит усиленный выброс пролактина, развиваются указанные состояния. Так называемая латентная гиперпролактинемия может также привести к лютеиновой недостаточности и бесплодию. В этих случаях терапия с помощью VAC может оказывать стимулирующее влияние на фертильность.
Ключевые слова: Витекс священный, Vitex agnus castus, мастодиния, предменструальный симптом, лютеиновая недостаточность, пролактин, дофамин.
Key words: chasteberry, Vitex agnus castus, mastodynia, premenstrual symptom, corpus luteum insufficiencty, prolactin, dopamine.
Ключевые слова: Витекс священный, Vitex agnus castus, мастодиния, предменструальный симптом, лютеиновая недостаточность, пролактин, дофамин.
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Key words: chasteberry, Vitex agnus castus, mastodynia, premenstrual symptom, corpus luteum insufficiencty, prolactin, dopamine.
Полный текст
Список литературы
1. Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Menopause 2006; 13: 185–96.
2. Wuttke W, Jarry H, Christoffel V et al. Chaste tree (Vitex agnus-castus) – pharmacology and clinical indications. Phytomedicine 2003; 10: 348–57.
3. Gorkow C, Wuttke W. Evidence of efficacy of Vitex agnus castus preparations. Phytopharmaka V 1999; p. 189–208.
4. Halaska M, Raus K, Beles P et al. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo. Ceska Gynekol 1998; 63: 388–92.
5. Wuttke W, Splitt G, Gorkow C et al. Behandlung zyklusabhängiger Brustschmerzen mit einem Agnus castus-haltigen Arzneimittel-Ergebnisse einer randomisierten, plazebokontrollierten Doppelblindstudie. Geburtsh u Frauenheilk 1997; 57: 569–74.
6. Kubista E, Muller G, Spona J. Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles. Rev Fr Gynecol Obstet 1987; 82: 221–7.
7. Kumar S, Mansel RE, Hughes LE et al. Prediction of response to endocrine therapy in pronounced cyclical mastalgia using dynamic tests of prolactin release. Clin Endocrinol (Oxf) 1985; 23: 699–704.
8. Suginami H, Ito T, Hamada K et al. Serum prolactin levels during sleep and in metoclopramide stimulation in normoprolactinemic anovulation and ovulation induction with bromocriptine. Nippon Sanka Fujinka Gakkai Zasshi 1986; 38: 728–34.
9. Wuttke W, Pitzel L, Seidlova-Wuttke D et al. LH pulses and the corpus luteum: the luteal phase deficiency LPD. Vitam Horm 2001; 63: 131–58.
10. Freeman ME, Kanyicska B, Lerant A et al. Prolactin: structure, function, and regulation of secretion. Physiol Rev 2000; 80: 1523–631.
11. Dogliotti L, Mansel RE. Bromocriptine treatment of cyclical mastalgia/fibrocystic breast disease: update on the European trial. Br J Clin Pract Suppl 1989; 68: 26–32; dis. 49–53.
12. Nazli K, Syed S, Mahmood MR et al. Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia. Br J Clin Pract 1989; 43: 322–7.
13. Schwibbe M BD, Wuttke W. EEG and psycho-logical effects of lisuride in women with premenstrueal tension. Lisurides and Other Dopmanine Agonists. Calne et al. 1983.
14. Milewicz A, Gejdel E, Sworen H et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993; 43: 752–6.
15. Wuttke W GC, Jarry H. Dopaminergic compounds in Vitex agnus castus. Phyto-Pharmaka-Forschung und klinische Anwendung 1995; p. 81–91.
16. Jarry H, Leonhardt S, Gorkow C et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994; 102: 448–54.
17. Ono M, Nagasawa Y, Ikeda T et al. Three new diterpenoids from the fruit of Vitex agnus castus. Chem Pharm Bull (Tokyo) 2009; 57: 1132–5.
18. Christoffel V, Spengler B, Jarry H et al. Prolactin inhibiting dopaminergic activity of diterpenes from Vitex agnus castus Phytopharmaka 1999; p. 209–14.
19. Artymuk NV. Vitex agnus castus extract administered for luteal-phase defect treatment. J Reproduktionsmed Endokrinol 2010; 7: 362.
20. Gerhard II, Patek A, Monga B et al. MastodynonR bei weiblicher Sterilitat. Forsch Komplementarmed 1998; 5: 272–8.
21. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001; 322: 134–7.
22. Prilepskaya VN. Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome. Maturitas 55S 2006; p. 55–63.
23. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003; 18: 191–5.
24. Bogorad RL, Courtillot C, Mestayer C et al. Identification of a gain-of-function mutation of the prolactin receptor in women with benign breast tumors. Proc Natl Acad Sci USA 2008; 105: 14533–8.
25. Courtillot C, Chakhtoura Z, Bogorad R et al. Characterization of two constitutively active prolactin receptor variants in a cohort of 95 women with multiple breast fibroadenomas. J Clin Endocrinol Metab 1995; p. 271–9.
26. Daniele C, Thompson Coon J, Pittler MH et al. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005; 28: 319–32.
2. Wuttke W, Jarry H, Christoffel V et al. Chaste tree (Vitex agnus-castus) – pharmacology and clinical indications. Phytomedicine 2003; 10: 348–57.
3. Gorkow C, Wuttke W. Evidence of efficacy of Vitex agnus castus preparations. Phytopharmaka V 1999; p. 189–208.
4. Halaska M, Raus K, Beles P et al. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo. Ceska Gynekol 1998; 63: 388–92.
5. Wuttke W, Splitt G, Gorkow C et al. Behandlung zyklusabhängiger Brustschmerzen mit einem Agnus castus-haltigen Arzneimittel-Ergebnisse einer randomisierten, plazebokontrollierten Doppelblindstudie. Geburtsh u Frauenheilk 1997; 57: 569–74.
6. Kubista E, Muller G, Spona J. Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles. Rev Fr Gynecol Obstet 1987; 82: 221–7.
7. Kumar S, Mansel RE, Hughes LE et al. Prediction of response to endocrine therapy in pronounced cyclical mastalgia using dynamic tests of prolactin release. Clin Endocrinol (Oxf) 1985; 23: 699–704.
8. Suginami H, Ito T, Hamada K et al. Serum prolactin levels during sleep and in metoclopramide stimulation in normoprolactinemic anovulation and ovulation induction with bromocriptine. Nippon Sanka Fujinka Gakkai Zasshi 1986; 38: 728–34.
9. Wuttke W, Pitzel L, Seidlova-Wuttke D et al. LH pulses and the corpus luteum: the luteal phase deficiency LPD. Vitam Horm 2001; 63: 131–58.
10. Freeman ME, Kanyicska B, Lerant A et al. Prolactin: structure, function, and regulation of secretion. Physiol Rev 2000; 80: 1523–631.
11. Dogliotti L, Mansel RE. Bromocriptine treatment of cyclical mastalgia/fibrocystic breast disease: update on the European trial. Br J Clin Pract Suppl 1989; 68: 26–32; dis. 49–53.
12. Nazli K, Syed S, Mahmood MR et al. Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia. Br J Clin Pract 1989; 43: 322–7.
13. Schwibbe M BD, Wuttke W. EEG and psycho-logical effects of lisuride in women with premenstrueal tension. Lisurides and Other Dopmanine Agonists. Calne et al. 1983.
14. Milewicz A, Gejdel E, Sworen H et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993; 43: 752–6.
15. Wuttke W GC, Jarry H. Dopaminergic compounds in Vitex agnus castus. Phyto-Pharmaka-Forschung und klinische Anwendung 1995; p. 81–91.
16. Jarry H, Leonhardt S, Gorkow C et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994; 102: 448–54.
17. Ono M, Nagasawa Y, Ikeda T et al. Three new diterpenoids from the fruit of Vitex agnus castus. Chem Pharm Bull (Tokyo) 2009; 57: 1132–5.
18. Christoffel V, Spengler B, Jarry H et al. Prolactin inhibiting dopaminergic activity of diterpenes from Vitex agnus castus Phytopharmaka 1999; p. 209–14.
19. Artymuk NV. Vitex agnus castus extract administered for luteal-phase defect treatment. J Reproduktionsmed Endokrinol 2010; 7: 362.
20. Gerhard II, Patek A, Monga B et al. MastodynonR bei weiblicher Sterilitat. Forsch Komplementarmed 1998; 5: 272–8.
21. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001; 322: 134–7.
22. Prilepskaya VN. Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome. Maturitas 55S 2006; p. 55–63.
23. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003; 18: 191–5.
24. Bogorad RL, Courtillot C, Mestayer C et al. Identification of a gain-of-function mutation of the prolactin receptor in women with benign breast tumors. Proc Natl Acad Sci USA 2008; 105: 14533–8.
25. Courtillot C, Chakhtoura Z, Bogorad R et al. Characterization of two constitutively active prolactin receptor variants in a cohort of 95 women with multiple breast fibroadenomas. J Clin Endocrinol Metab 1995; p. 271–9.
26. Daniele C, Thompson Coon J, Pittler MH et al. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005; 28: 319–32.
2. Wuttke W, Jarry H, Christoffel V et al. Chaste tree (Vitex agnus-castus) – pharmacology and clinical indications. Phytomedicine 2003; 10: 348–57.
3. Gorkow C, Wuttke W. Evidence of efficacy of Vitex agnus castus preparations. Phytopharmaka V 1999; p. 189–208.
4. Halaska M, Raus K, Beles P et al. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo. Ceska Gynekol 1998; 63: 388–92.
5. Wuttke W, Splitt G, Gorkow C et al. Behandlung zyklusabhängiger Brustschmerzen mit einem Agnus castus-haltigen Arzneimittel-Ergebnisse einer randomisierten, plazebokontrollierten Doppelblindstudie. Geburtsh u Frauenheilk 1997; 57: 569–74.
6. Kubista E, Muller G, Spona J. Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles. Rev Fr Gynecol Obstet 1987; 82: 221–7.
7. Kumar S, Mansel RE, Hughes LE et al. Prediction of response to endocrine therapy in pronounced cyclical mastalgia using dynamic tests of prolactin release. Clin Endocrinol (Oxf) 1985; 23: 699–704.
8. Suginami H, Ito T, Hamada K et al. Serum prolactin levels during sleep and in metoclopramide stimulation in normoprolactinemic anovulation and ovulation induction with bromocriptine. Nippon Sanka Fujinka Gakkai Zasshi 1986; 38: 728–34.
9. Wuttke W, Pitzel L, Seidlova-Wuttke D et al. LH pulses and the corpus luteum: the luteal phase deficiency LPD. Vitam Horm 2001; 63: 131–58.
10. Freeman ME, Kanyicska B, Lerant A et al. Prolactin: structure, function, and regulation of secretion. Physiol Rev 2000; 80: 1523–631.
11. Dogliotti L, Mansel RE. Bromocriptine treatment of cyclical mastalgia/fibrocystic breast disease: update on the European trial. Br J Clin Pract Suppl 1989; 68: 26–32; dis. 49–53.
12. Nazli K, Syed S, Mahmood MR et al. Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia. Br J Clin Pract 1989; 43: 322–7.
13. Schwibbe M BD, Wuttke W. EEG and psycho-logical effects of lisuride in women with premenstrueal tension. Lisurides and Other Dopmanine Agonists. Calne et al. 1983.
14. Milewicz A, Gejdel E, Sworen H et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993; 43: 752–6.
15. Wuttke W GC, Jarry H. Dopaminergic compounds in Vitex agnus castus. Phyto-Pharmaka-Forschung und klinische Anwendung 1995; p. 81–91.
16. Jarry H, Leonhardt S, Gorkow C et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994; 102: 448–54.
17. Ono M, Nagasawa Y, Ikeda T et al. Three new diterpenoids from the fruit of Vitex agnus castus. Chem Pharm Bull (Tokyo) 2009; 57: 1132–5.
18. Christoffel V, Spengler B, Jarry H et al. Prolactin inhibiting dopaminergic activity of diterpenes from Vitex agnus castus Phytopharmaka 1999; p. 209–14.
19. Artymuk NV. Vitex agnus castus extract administered for luteal-phase defect treatment. J Reproduktionsmed Endokrinol 2010; 7: 362.
20. Gerhard II, Patek A, Monga B et al. MastodynonR bei weiblicher Sterilitat. Forsch Komplementarmed 1998; 5: 272–8.
21. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001; 322: 134–7.
22. Prilepskaya VN. Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome. Maturitas 55S 2006; p. 55–63.
23. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003; 18: 191–5.
24. Bogorad RL, Courtillot C, Mestayer C et al. Identification of a gain-of-function mutation of the prolactin receptor in women with benign breast tumors. Proc Natl Acad Sci USA 2008; 105: 14533–8.
25. Courtillot C, Chakhtoura Z, Bogorad R et al. Characterization of two constitutively active prolactin receptor variants in a cohort of 95 women with multiple breast fibroadenomas. J Clin Endocrinol Metab 1995; p. 271–9.
26. Daniele C, Thompson Coon J, Pittler MH et al. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005; 28: 319–32.
________________________________________________
2. Wuttke W, Jarry H, Christoffel V et al. Chaste tree (Vitex agnus-castus) – pharmacology and clinical indications. Phytomedicine 2003; 10: 348–57.
3. Gorkow C, Wuttke W. Evidence of efficacy of Vitex agnus castus preparations. Phytopharmaka V 1999; p. 189–208.
4. Halaska M, Raus K, Beles P et al. Treatment of cyclical mastodynia using an extract of Vitex agnus castus: results of a double-blind comparison with a placebo. Ceska Gynekol 1998; 63: 388–92.
5. Wuttke W, Splitt G, Gorkow C et al. Behandlung zyklusabhängiger Brustschmerzen mit einem Agnus castus-haltigen Arzneimittel-Ergebnisse einer randomisierten, plazebokontrollierten Doppelblindstudie. Geburtsh u Frauenheilk 1997; 57: 569–74.
6. Kubista E, Muller G, Spona J. Treatment of mastopathies with cyclic mastodynia. Clinical results and hormonal profiles. Rev Fr Gynecol Obstet 1987; 82: 221–7.
7. Kumar S, Mansel RE, Hughes LE et al. Prediction of response to endocrine therapy in pronounced cyclical mastalgia using dynamic tests of prolactin release. Clin Endocrinol (Oxf) 1985; 23: 699–704.
8. Suginami H, Ito T, Hamada K et al. Serum prolactin levels during sleep and in metoclopramide stimulation in normoprolactinemic anovulation and ovulation induction with bromocriptine. Nippon Sanka Fujinka Gakkai Zasshi 1986; 38: 728–34.
9. Wuttke W, Pitzel L, Seidlova-Wuttke D et al. LH pulses and the corpus luteum: the luteal phase deficiency LPD. Vitam Horm 2001; 63: 131–58.
10. Freeman ME, Kanyicska B, Lerant A et al. Prolactin: structure, function, and regulation of secretion. Physiol Rev 2000; 80: 1523–631.
11. Dogliotti L, Mansel RE. Bromocriptine treatment of cyclical mastalgia/fibrocystic breast disease: update on the European trial. Br J Clin Pract Suppl 1989; 68: 26–32; dis. 49–53.
12. Nazli K, Syed S, Mahmood MR et al. Controlled trial of the prolactin inhibitor bromocriptine (Parlodel) in the treatment of severe cyclical mastalgia. Br J Clin Pract 1989; 43: 322–7.
13. Schwibbe M BD, Wuttke W. EEG and psycho-logical effects of lisuride in women with premenstrueal tension. Lisurides and Other Dopmanine Agonists. Calne et al. 1983.
14. Milewicz A, Gejdel E, Sworen H et al. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 1993; 43: 752–6.
15. Wuttke W GC, Jarry H. Dopaminergic compounds in Vitex agnus castus. Phyto-Pharmaka-Forschung und klinische Anwendung 1995; p. 81–91.
16. Jarry H, Leonhardt S, Gorkow C et al. In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Exp Clin Endocrinol 1994; 102: 448–54.
17. Ono M, Nagasawa Y, Ikeda T et al. Three new diterpenoids from the fruit of Vitex agnus castus. Chem Pharm Bull (Tokyo) 2009; 57: 1132–5.
18. Christoffel V, Spengler B, Jarry H et al. Prolactin inhibiting dopaminergic activity of diterpenes from Vitex agnus castus Phytopharmaka 1999; p. 209–14.
19. Artymuk NV. Vitex agnus castus extract administered for luteal-phase defect treatment. J Reproduktionsmed Endokrinol 2010; 7: 362.
20. Gerhard II, Patek A, Monga B et al. MastodynonR bei weiblicher Sterilitat. Forsch Komplementarmed 1998; 5: 272–8.
21. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ 2001; 322: 134–7.
22. Prilepskaya VN. Vitex agnus castus: Successful treatment of moderate to severe premenstrual syndrome. Maturitas 55S 2006; p. 55–63.
23. Atmaca M, Kumru S, Tezcan E. Fluoxetine versus Vitex agnus castus extract in the treatment of premenstrual dysphoric disorder. Hum Psychopharmacol 2003; 18: 191–5.
24. Bogorad RL, Courtillot C, Mestayer C et al. Identification of a gain-of-function mutation of the prolactin receptor in women with benign breast tumors. Proc Natl Acad Sci USA 2008; 105: 14533–8.
25. Courtillot C, Chakhtoura Z, Bogorad R et al. Characterization of two constitutively active prolactin receptor variants in a cohort of 95 women with multiple breast fibroadenomas. J Clin Endocrinol Metab 1995; p. 271–9.
26. Daniele C, Thompson Coon J, Pittler MH et al. Vitex agnus castus: a systematic review of adverse events. Drug Saf 2005; 28: 319–32.
Авторы
В.Вуттке1, Д.Зайдлова-Вуттке1, Г.Ярри1, Н.Артымук2
1. Кафедра эндокринологии Университета Геттингена, Германия;
2. ГБОУ ВПО Кемеровская государственная медицинская академия Минздравсоцразвития РФ
1. Кафедра эндокринологии Университета Геттингена, Германия;
2. ГБОУ ВПО Кемеровская государственная медицинская академия Минздравсоцразвития РФ
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