中医外治法治疗寒凝血瘀型子宫内膜异位症的研究进展

Progress in the Treatment of Cold-Congealed Blood Stasis Type Endometriosis by External Treatment of Traditional Chinese Medicine

摘要: 中医外治法治疗寒凝血瘀型子宫内膜异位症以“温通化瘀、散寒止痛”为核心原则。针对寒凝血瘀病机，本文主要讨论三种特色外治法：针刺通过关元、三阴交等穴温通经络，结合电针或疗效更优的穴位埋线强化神经–内分泌调节，有效止痛；艾灸直击寒凝，如隔姜灸关元、神阙驱散寒邪，热敏灸子宫、次髎通过循经往返激发热感深达盆腔，显著降低PGE2、VEGF等炎症因子；中药灌肠则利用直肠–盆腔靶向给药优势，高浓度药物直达病灶，阻断VEGF通路及雌激素合成，规避肝毒性。外治法常联合西药或中药内服以增效。本文综述近年来关于中医外治法治疗寒凝血瘀型子宫内膜异位症的研究进展，旨在为临床应用提供参考。

Abstract: The core principle of the treatment of endometriosis with cold-congealed blood stasis in Chinese medicine is “warming and transforming blood stasis, dispersing cold and relieving pain”. To address the pathogenesis of cold condensation and blood stasis, this article mainly discusses three special external treatments: acupuncture through Guanyuan, Sanyinjiao and other points to warm the meridians, combined with electroacupuncture or more effective acupuncture point buried line to strengthen the neuroendocrine regulation, effective pain; moxibustion to directly attack the cold condensation, such as the ginger moxibustion Guanyuan, Shenque to dispel the cold evil, while heat-sensitive moxibustion on the uterus and Ciliao acupoints stimulates heat sensation through meridian circulation, penetrating deeply into the pelvic cavity and significantly reducing inflammatory factors such as PGE2 and VEGF; Chinese Herbal enemas utilize the rectum-pelvic cavity targeted to deliver high-concentration drugs directly to the affected area, blocking the VEGF pathway and estrogen synthesis, and avoiding hepatotoxicity. External treatments are often combined with Western medicine or internal administration of Chinese medicine to increase the efficacy. This article summarizes the research progress in recent years on the treatment of cold-congealed and blood-stasis type endometriosis by external treatment of Chinese medicine, aiming to provide reference for clinical application.