基于“不通则痛”探讨中医药治疗子宫内膜异位症痛经机制的研究进展

Mechanism of Traditional Chinese Medicine in Treating Dysmenorrhea Caused by Endometriosis Based on“Stagnation Leading to Pain”:A Review

子宫内膜异位症(EMT)是一种慢性雌激素依赖性疾病,痛经作为其最典型的临床症状,近年来发病率逐年升高,严重影响女性的生命质量。中医学认为不通则痛是EMT痛经的主要发病机制。现代医学发现,EMT发生与血管新生、上皮间质转化和免疫炎症等相关。最新研究文献发现,中医药可以从调节细胞自噬,发挥免疫、抗炎、抑制子宫平滑肌的收缩、改善子宫血液流变学、降低患者疼痛敏感性,抑制异位组织细胞的植入、粘连、黏附与侵袭而改善EMT痛经。在中医理论指导下,从中西医结合出发,总结现代医学理论中中医药治疗EMT痛经的作用机制,开拓中医药治疗EMT痛经的新思路与新方法。

Endometriosis(EMT)is a chronic estrogen-dependent disease,with dysmenorrhea being its most characteristic clinical symptom.The incidence of EMT has been rising annually in recent years,significantly affecting women′s quality of life.Traditional Chinese medicine(TCM)posits that“stagnation leading to pain”,identifying this as a primary mechanism for dysmenorrhea associated with EMT.Modern medicine has discovered that the occurrence of EMT is linked to processes such as angiogenesis,epithelial-mesenchymal transition,and immune inflammation.Recent literature indicates that TCM can improve dysmenorrhea associated with EMT by regulating autophagy,exerting immunomodulatory and anti-inflammatory effects,inhibiting uterine smooth muscle contractions,improving uterine blood rheology,reducing pain sensitivity,and suppressing the implantation,adhesion,and invasion of ectopic tissues.Guided by TCM theory and starting from the integration of TCM and Western medicine,this research summarized the mechanisms of TCM in treating dysmenorrhea in EMT in modern medical theory to explore new ideas and methods for TCM in addressing dysmenorrhea associated with EMT.