基于信号通路的中医药治疗原发性痛经机制研究进展

Research Progress on the Mechanism of Traditional Chinese Medicine in the Treatment of Primary Dysmenorrhea Based on Signaling Pathways

原发性痛经是妇科常见疾病,其特点是周期性的下腹部疼痛,或伴有腰骶酸痛、恶心呕吐等症状,给患者身心健康及生活质量带来严重负面影响。药物治疗是应对原发性痛经的主要干预措施,但非甾体抗炎药存在副作用大、停药易反复等缺点。原发性痛经属于中医“经行腹痛”范畴,祖国医学在治疗原发性痛经方面积累了丰富的经验,包括内服法和外治法,疗效显著且毒副作用小。近年来,大量动物或组织细胞模型实验研究发现,中医药防治原发性痛经发生进展的作用机制与多信号通路密切相关,包括MAPK/ERK、PI3K/Akt/mTOR、TLR4/MyD88/NF-κB、COX-2/PGF2a、EP2/NLRP3/caspase-1等信号通路,中医药的调控作用已成为大量研究的焦点,本文综述近年来的研究成果,以期为原发性痛经的临床治疗及中医药防治原发性痛经的作用机制提供思路和参考。Primary dysmenorrhea is a common gynecological disease, which is characterized by periodic lower abdominal pain, or accompanied by lumbosacral pain, nausea and vomiting and other symptoms, which has a serious negative impact on the physical and mental health and quality of life of patients. Drug therapy is the main intervention for primary dysmenorrhea, but NSAIDs have the disadvantages of large side effects and easy recurrence of drug withdrawal. Primary dysmenorrhea belongs to the category of “menstrual abdominal pain” in traditional Chinese medicine, and Chinese medicine has accumulated rich experience in the treatment of primary dysmenorrhea, including internal and external treatment, with significant efficacy and few toxic side effects. In recent years, a large number of experimental studies in animal or tissue cell models have found that the mechanism of action of TCM in the prevention and treatment of the progression of primary dysmenorrhea is closely related to multiple signaling pathways, including MAPK/ERK, PI3K/Akt/mTOR, TLR4/MyD88/NF-κB, COX-2/PGF2a and other signaling pathways, the regulatory role of traditional Chinese medicine has become the focus of a large number of researches. This article reviews the research results in recent years, in order to provide ideas and references for the clinical treatment of primary dysmenorrhea and the mechanism of action of traditional Chinese medicine in the prevention and treatment of primary dysmenorrhea.