基于巨噬细胞极化探讨中医治疗子宫腺肌病所致慢性盆腔痛  

Study on Traditional Chinese Medicine Treatment for Chronic Pelvic Pain Caused by Adenomyosis Based on Macrophage Polarization

作　　者：邵钰 程文秀 魏绍斌[2] SHAO Yu;CHENG Wenxiu;WEI Shaobin(Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan,China,610075;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan,China,610072)

机构地区：[1]成都中医药大学,四川成都610075 [2]成都中医药大学附属医院,四川成都610072

出　　处：《河南中医》2025年第3期337-342,共6页Henan Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81273796)。

摘　　要：中医药治疗子宫腺肌病的作用机制与调节免疫、改善炎症微环境有关。巨噬细胞是人体免疫细胞之一,参与人体免疫炎症反应,在环境等因素的诱导下进行表型转化即巨噬细胞极化,巨噬细胞极化是否失衡与子宫腺肌病所致慢性盆腔痛的发生密切相关。瘀阻胞宫是子宫腺肌病的中医基本病机,湿瘀互结是子宫腺肌病所致疼痛的主要中医病机,巨噬细胞极化产生的炎症因子与中医血瘀证密切相关,清湿化瘀法通过调控巨噬细胞极化分泌的相关因子及通路改善缺氧状态,延缓纤维化,降低致痛因子表达,减缓子宫腺肌病的发展,从而达到缓解疼痛的目的。血管内皮生长因子、雌激素、致痛因子等均与巨噬细胞极化有密切关系,清湿化瘀法治疗子宫腺肌病所致慢性盆腔痛的作用机制是否与上述因子有关是未来的研究方向。The therapeutic mechanism of TCM in treating adenomyosis is associated with immunomodulation and improvement of the inflammatory microenvironment.Macrophages,as one kind of key immune cells involved in inflammatory responses,undergo phenotype transformation(that is,macrophage polarization)under environmental stimuli.Dysregulated macrophage polarization is closely linked to the pathogenesis of chronic pelvic pain(CPP)secondary to adenomyosis.According to the related TCM theory,blood stasis in the uterine chamber is the fundamental pathogenesis of adenomyosis,while combined dampness-stasis serves as the core mechanism underlying pain manifestation.Inflammatory cytokines produced through macrophage polarization exhibit significant correlations with TCM blood stasis syndrome.The method of clearing dampness and resolving blood stasis alleviates pain by modulating macrophage polarization-related secretory factors and signaling pathways,thereby improving hypoxic conditions,delaying fibrosis,and suppressing algogenic factor expression to impede disease progression.Besides,factors such as vascular endothelial growth factor(VEGF),estrogen,and algogenic mediators,etc.are intricately involved in macrophage polarization.Whether the pain-relieving effects of the above factors are achieved by interfering with macrophage polarization is a direction worth further exploration in the treatment of CPP caused by adenomyosis with the method of clearing dampness and removing blood stasis in the future.

关 键 词：子宫腺肌病 慢性盆腔痛 清湿化瘀法 巨噬细胞极化 

分 类 号：R271.911.74[医药卫生—中西医结合]