微生物群参与子宫内膜异位症发病机制的研究现况  

Advances of Microbiome Involvement in Pathogenesis of Endometriosis

作　　者：邱天 张婷婷[2] 庄梦斐[2] QIU Tian;ZHANG Tingting;ZHUANG Mengfei(Shanghai TCM-integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200082,China;Yueyang Hospital of Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属上海市中西医结合医院,上海200082 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中华中医药学刊》2025年第3期47-55,共9页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82374499,82074475);国家自然科学基金青年科学基金项目(82104906);海派中医流派传承创新团队建设项目(2021LPTD-002);上海市进一步加快中医药传承创新发展三年行动计划项目(ZY[2021-2023]0302)。

摘　　要：子宫内膜异位症(endometriosis,EM)作为妇科常见病和多发病,是引起女性慢性盆腔疼痛和不孕的重要原因,发病机制至今尚未明确,具有易侵袭和易复发的特点。近年来越来越多的研究证据表明,EM患者的肠道微生物群、女性生殖道微生物群和腹膜微生物群与健康女性存在显著差异,提示EM发病与体内微生物群失调之间存在密切的相关性。研究认为微生物群可能通过免疫炎症途径以及代谢途径(雌激素代谢增强、脂质代谢异常等)影响EM的发生和进展。目前针对EM相关微生物群的研究已发现一些可能的特异性菌种,有望成为早期无创诊断EM的生物标志物;同时通过饮食干预、补充益生菌或益生元以及微生物移植等方法可以有助于预防和缓解EM症状,提供潜在的治疗方法。研究表明中药的寒热性质与其对肠道微生物群的调节作用之间存在潜在关系;活血化瘀类中药及中药复方在改善肠道菌群结构及保护肠道屏障功能方面具有明显作用。就现有微生物群参与EM的发病机制的研究进展做一综述,并展望未来通过微生物途径诊治EM的潜在方法。As a common and frequently-occurring gynecological disease,endometriosis(EM)is an important cause of chro-nic pelvic pain and infertility in women,which seriously troubles many women of childbearing age.Because of its unknown etiolo-gy,extensive lesions,extremely invasive and easy to relapse characteristics,EM is also an intractable disease.More and more re-search evidence in recent years has shown that the intestinal microbiota,female reproductive tract microbiota and peritoneal micro-biota of EM patients are significantly different from those of healthy women,indicating that there is a close correlation between the etiology of EM and the disorder of the microbiome in vivo.It is suggested that the microbiota may affect the occurrence and pro-gression of EM through immune-inflammatory pathways and metabolic pathways(enhanced estrogen metabolism,abnormal lipid metabolism,etc.).To date,studies on EM-related microbiotm have found some possible specific strains,which are expected to be biomarkers for early non-invasive diagnosis of EM.At the same time,dietary intervention,supplementation with probiotics or prebiotics and microbial transplantation can help to prevent and alleviate EM symptoms and provide potential treatments.Studies showed that there was a potential relationship between the cold-heat nature of TCMs and its modulation effects on gut microbio-ta.The TCM and its compounds which can promote blood circulation and removing blood stasis have obvious effects on modula-ting gut microbiota structure and protecting intestinal barrier function.In this paper,it reviewed the current research progress of microbiota involvement in the pathogenesis of EM,and looked forward to the potential treatment of EM through microbial approach in the future.

关 键 词：子宫内膜异位症 微生物群 发病机制 

分 类 号：R271.1[医药卫生—中医妇科学]