中医临床研究2025，Vol.17Issue(24)：60-68,9.DOI:10.3969/j.issn.1674-7860.2025.24.010
中医药干预细胞自噬治疗子宫内膜异位症机制研究进展
Research progress on the mechanism of traditional Chinese medicine intervention in autophagy in the treatment of endometriosis
摘要
Abstract
Endometriosis(EMs)is a prevalent complex gynecological disorder among women of reproductive age,characterized by abnormal proliferation,invasion,and angiogenesis of ectopic endometrial cells.With a global prevalence of 10%-15%,it stands as one of the primary causes of infertility in reproductive-aged women.The pathogenesis of EMs is intricate,and the disease is prone to recurrence after treatment.While Western medicine can alleviate symptoms in the short term,long-term use is likely to induce adverse reactions related to low estrogen levels,restricting its clinical application.Autophagy,a core mechanism for maintaining cellular homeostasis,exerts a dual regulatory role in the pathological progression of EMs.Basal autophagy inhibits the survival of ectopic cells by clearing damaged organelles,whereas abnormal autophagy may promote lesion progression by maintaining metabolic homeostasis.Based on the pathogenic theory of blood stasis,deficiency,and Qi stagnation(气滞),traditional Chinese medicine(TCM)has demonstrated unique advantages in treating EMs.Studies have confirmed that various TCM monomers and compound prescriptions can exert therapeutic effects by regulating autophagic pathways through multiple targets.Triptolide can inhibit the Phosphatidylinositol 3-kinase(PI3K)/Protein kinase B(Akt)/Mammalian target of rapamycin(mTOR)pathway,activate autophagy in EMs stromal cells,promote the degradation of damaged organelles,and reduce the release of inflammatory factors such as interleukin-6(IL-6).Ginsenoside Rg3 relieves the inhibition of autophagy by regulating the balance between estrogen and progesterone receptors,promotes the expression of autophagy-related gene 5(ATG5)and microtubule-associated protein 1 light chain 3-II(LC3-II),and activates mitophagy to alleviate oxidative stress.The Guizhi Fuling pills(桂枝茯苓丸)can inhibit the PI3K/Akt/mTOR pathway,induce autophagic death of ectopic endometrial cells,and activate the mitochondrial apoptotic pathway.The active components paeoniflorin and ligustrazine in the Shaofu Zhuyu decoction(少腹逐瘀汤)regulate the phosphorylation balance of the Adenosine 5'-monophosphate-activated protein kinase(AMPK)/mTOR pathway.Through regulating autophagy,these TCM interventions synergistically inhibit inflammatory responses,oxidative stress,and angiogenesis,thereby inducing autophagic death of ectopic cells.This study innovatively integrates the TCM complex pathogenesis of blood stasis,deficiency,and Qi stagnation with the autophagy regulatory network,revealing the scientific connotation of TCM holistic regulation and syndrome differentiation-based treatment.Specifically,blood-activating and stasis-resolving drugs restore autophagic clearance function,Qi-tonifying and deficiency-nourishing drugs maintain autophagic energy homeostasis,and Qi-regulating and stagnation-relieving drugs improve autophagic signal transduction.These findings provide a modern molecular mechanism basis for TCM in treating EMs,suggesting that targeting autophagy may become an innovative strategy for TCM-based treatment of EMs,laying a foundation for overcoming the challenge of EMs recurrence and developing new therapeutic approaches.关键词
子宫内膜异位症/自噬/中医药/研究进展Key words
Endometriosis/Autophagy/Traditional Chinese Medicine/Research progress分类
医药卫生引用本文复制引用
段疏团,张亚嘉..中医药干预细胞自噬治疗子宫内膜异位症机制研究进展[J].中医临床研究,2025,17(24):60-68,9.基金项目
云南省科技厅——云南中医学院中医联合专项(202401AZ070001-056). （202401AZ070001-056）
