中药通过影响细胞行为治疗子宫腺肌病的药理机制研究进展  

Research progress on the pharmacological mechanisms of traditional Chinese medicine in treating uterine adenomyosis by affecting cell behavior

作　　者：周寒雪 张娥[1] 李田雨 赵晴晴 李颖 ZHOU Hanxue;ZHANG E;LI Tianyu;ZHAO Qingqing;LI Ying(Obstetrics and Gynecology Department of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院妇产科,郑州450000 [2]河南中医药大学第一临床医学院 [3]河南省第二人民医院中西医结合妇科

出　　处：《环球中医药》2025年第3期615-621,共7页Global Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2022JDZX054)。

摘　　要：细胞行为在子宫腺肌病的发病机制中扮演着关键角色,主要包括侵袭迁移、凋亡、增殖和黏附等。中药可通过多种机制、多通路、多靶点地干预子宫腺肌病细胞的以上行为的异常。研究表明,在抑制细胞侵袭迁移方面,中药能够调控Ras同源基因-Rho相关螺旋卷曲蛋白激酶(Ras homologgene/a Rho-associated coiled coil-forming protein kinase,Rho/ROCK)信号通路,抑制上皮细胞—间充质转化(epithelial-mesenchymal transition,EMT)过程,干预基质金属蛋白酶及其抑制剂的表达,调控丝裂原活化蛋白激酶(mitogen activated protein kinase,MAPK)信号通路等,从而减缓病情发展。对于细胞增殖,中药能在抑制MAPK信号通路、抑制磷脂酰肌醇3-激酶/蛋白激酶B(phosphoinositide 3-kinase/protein kinase B,PI3K/Akt)信号通路、抑制MAPK/细胞外信号调节激酶信号通路(MAPK/extracellular regulated protein kinases,MAPK/ERK)信号通路、调控线粒体稳态、调整细胞周期等方面发挥作用。此外,中药还可通过下调B淋巴细胞瘤-2基因(B-cell lymphoma-2,Bcl-2)等抗凋亡基因的表达,上调Bcl-2关联X(Bcl-2 associated X,Bax)等促凋亡基因的表达,以及激活Fas/FasL信号通路、非受体酪氨酸激酶(janus kinase,JAK)2/信号转导子和转录激活子(signal transducer and activator of transcription,STAT)3通路、MAPK信号通路、PI3K/Akt信号通路等,促进细胞凋亡,从而在子宫腺肌病的治疗中发挥作用。本文对国内外应用中药干预细胞行为治疗子宫腺肌病的相关研究进行综述,并深入分析了其药理作用机制,以期为子宫腺肌病的治疗提供新的思路和方法。Cellular behaviors play a pivotal role in the pathogenesis of adenomyosis(AM),including invasion,migration,apoptosis,proliferation,and adhesion.Traditional Chinese Medicine(TCM)can intervene in the abnormal cellular behaviors of AM through multiple mechanisms,pathways,and targets.Studies have shown that in terms of inhibiting cell invasion and migration,TCM can regulate the Ras homolog gene/Rho-associated coiled coil-forming protein kinase(Rho/ROCK)signaling pathway,inhibit the Epithelial-Mesenchymal Transition(EMT)process,interfere with the expression of matrix metalloproteinases and their inhibitors,and regulate the mitogen-activated protein kinase(MAPK)signaling pathway,thereby slowing down disease progression.Regarding cell proliferation,TCM can inhibit MAPK,phosphoinositide 3-kinase/protein kinase B(PI3K/Akt),MAPK/extracellular regulated protein kinases(MAPK/ERK)signaling pathway,regulate mitochondrial homeostasis,and adjust cell cycle.Furthermore,TCM promotes cell apoptosis by down-regulating anti-apoptotic genes such as B-cell lymphoma-2(Bcl-2)and up-regulating pro-apoptotic genes like Bcl2-Associated X(Bax)protein,as well as activating Fas/FasL signaling pathway,Janus kinase 2(JAK2)/signal transducer and activator of transcription(STAT3),MAPK,and PI3K/Akt signaling pathway,thereby contributing to the treatment of AM.This paper reviews the relevant research on the application of TCM in intervening with cellular behaviors to treat AM both domestically and internationally,and deeply analyzes its pharmacological mechanisms,providing new ideas and methods for the treatment of AM.

关 键 词：子宫腺肌病 细胞行为 中药治疗 研究进展 药理作用机制 细胞侵袭迁移 细胞黏附 细胞增殖 细胞凋亡 

分 类 号：R286[医药卫生—中药学]