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 signali
子宫内膜异位症是妇科常见病,且复发率高。本文从中医学阴阳理论为根本出发点,基于《黄帝内经》“阳化气,阴成形”理论,认为“阳化气,阴成形”功能失调是子宫内膜异位症的主要病机,其发病以脾肾阳虚、阳化气不足为本,阴成形,瘀血阻滞为标。治疗时谨守阳虚病机,兼化瘀消癥,以“补肾阳,温脾阳,化瘀血”三法作为子宫内膜异位症治疗的核心。从中医治未病思想,使阳化气功能正常,让机体达到阴阳相对平衡的状态,从而治疗子宫内膜异位症。Endometriosis is a common gynecological disease with a high recurrence rate. Starting from the yin-yang theory of traditional Chinese medicine (TCM), and basing on the theory of “yang transforms into qi, while yin constitutes form” in “Huangdi Neijing” (The Yellow Emperor’s Inner Classic),this paper considers that the dysfunction of “Yang transforming Qi and Yin forming” is the main pathogenesis of endometriosis, and suggests that the pathogenesis is based on the deficiency of spleen-kidney Yang and Yang transforming Qi at the root, Yin forming and blood stasis as the branch. The core of endometriosis treatment is “tonifying kidney Yang, warming spleen Yang, removing blood stasis” basing on the pathogenesis of Yang deficiency disease and dissipating stasis eliminating disease. This paper suggests that making the body to achieve a relative balance of Yin and Yang starting from the thought of preventive treatment of disease of TCM, so as to treat endometriosis.
