中医药治疗子宫腺肌病相关信号通路研究进展
Research Progress of Traditional Chinese Medicine in the Treatment of Adenomyosis-Related Signaling Pathways
DOI: 10.12677/tcm.2026.151052, PDF,    科研立项经费支持
作者: 刘建宇:黑龙江中医药大学第一临床医学院,黑龙江 哈尔滨;韩凤娟*:黑龙江中医药大学附属第一医院妇科三科,黑龙江 哈尔滨
关键词: 子宫腺肌病中医药信号通路研究进展Adenomyosis Traditional Chinese Medicine Signaling Pathways Research Advances
摘要: 子宫腺肌病作为一种常见且复杂的妇科疾病,严重影响女性的生活质量和生育功能,其发病机制涉及多种分子信号通路的异常调控。近年来,随着分子生物学技术的不断进步,相关信号通路在子宫腺肌病发病中的作用逐渐被揭示,尤其是炎症反应、细胞凋亡、细胞增殖及纤维化等路径的研究取得显著成果。中医药作为传统治疗体系,凭借其多靶点、多成分的特点,在调节这些关键通路方面表现出独特优势。本文系统综述了中医药对子宫腺肌病相关信号通路的调控机制,重点分析了中药复方、中药单体及中药药对对炎症、细胞凋亡及组织纤维化信号通路的影响,探讨其潜在的分子靶点及作用机制,为中医药治疗子宫腺肌病提供科学依据,并为未来中医药新药研发和临床应用指明方向。
Abstract: As a common and complex gynecological disease, adenomyosis seriously affects women’s quality of life and reproductive function. Its pathogenesis involves abnormal regulation of multiple molecular signaling pathways. In recent years, with the continuous progress of molecular biology technology, the role of related signaling pathways in the pathogenesis of adenomyosis has been gradually revealed, especially the research on inflammatory response, apoptosis, cell proliferation, and fibrosis has achieved remarkable results. As a traditional treatment system, traditional Chinese medicine has unique advantages in regulating these key pathways by virtue of its multi-target and multi-component characteristics. This paper systematically reviews the regulatory mechanism of traditional Chinese medicine on adenomyosis-related signaling pathways, focusing on the analysis of the effects of traditional Chinese medicine compounds, traditional Chinese medicine monomer and traditional Chinese medicine combination on inflammation, apoptosis, and tissue fibrosis signaling pathways, and exploring its potential molecular targets and mechanism of action. It provides a scientific basis for the treatment of adenomyosis with traditional Chinese medicine and points out the direction for the future development and clinical application of new drugs in traditional Chinese medicine.
文章引用:刘建宇, 韩凤娟. 中医药治疗子宫腺肌病相关信号通路研究进展[J]. 中医学, 2026, 15(1): 372-380. https://doi.org/10.12677/tcm.2026.151052

参考文献

[1] Chu, L., Liao, C., Liew, P., Chen, C., Su, P., Wen, K., et al. (2022) Epigenomic Analysis Reveals the KCNK9 Potassium Channel as a Potential Therapeutic Target for Adenomyosis. International Journal of Molecular Sciences, 23, Article 5973. [Google Scholar] [CrossRef] [PubMed]
[2] Jiang, X. and Chen, X. (2023) Endometrial Cell-Derived Exosomes Facilitate the Development of Adenomyosis via the IL-6/JAK2/STAT3 Pathway. Experimental and Therapeutic Medicine, 26, Article No. 526. [Google Scholar] [CrossRef] [PubMed]
[3] Bourdon, M., Santulli, P., Jeljeli, M., Vannuccini, S., Marcellin, L., Doridot, L., et al. (2021) Immunological Changes Associated with Adenomyosis: A Systematic Review. Human Reproduction Update, 27, 108-129. [Google Scholar] [CrossRef] [PubMed]
[4] Guo, Z., Duan, H., Wang, S., Wang, S., Lin, Q. and Li, Y. (2022) RNA-Seq Reveals Co-Dysregulated Circular RNAs in the Adenomyosis Eutopic Endometrium and Endometrial–myometrial Interface. BMC Womens Health, 22, Article No. 293. [Google Scholar] [CrossRef] [PubMed]
[5] Xu, Y., Shao, L., Zhou, Z., Zhao, L., Wan, S., Sun, W., et al. (2024) ARG2 Knockdown Promotes G0/G1 Cell Cycle Arrest and Mitochondrial Dysfunction in Adenomyosis via Regulation NF-κB and Wnt/β-Catenin Signaling Cascades. International Immunopharmacology, 140, Article 112817. [Google Scholar] [CrossRef] [PubMed]
[6] Jin, T., Li, M., Li, T., Yan, S., Ran, Q. and Chen, W. (2023) The Inactivation of Hippo Signaling Pathway Promotes the Development of Adenomyosis by Regulating EMT, Proliferation, and Apoptosis of Cells. Reproductive Sciences, 30, 2715-2727. [Google Scholar] [CrossRef] [PubMed]
[7] Driva, T.S., Schatz, C., Sobočan, M. and Haybaeck, J. (2022) The Role of mTOR and Eif Signaling in Benign Endometrial Diseases. International Journal of Molecular Sciences, 23, Article 3416. [Google Scholar] [CrossRef] [PubMed]
[8] Zipponi, M., Cacciottola, L., Camboni, A., Stratopoulou, C.A., Taylor, H.S. and Dolmans, M. (2025) Endometrial Stromal Cell Signaling and MicroRNA Exosome Content in Women with Adenomyosis. Molecular Human Reproduction, 31, gaae044. [Google Scholar] [CrossRef] [PubMed]
[9] 刘洋, 师伟. 探讨师伟教授治疗子宫腺肌病的用药规律信息学研究[J]. 中药药理与临床, 2024, 40(8): 103-107, 35.
[10] 蒋欣, 邵明义, 王振亮. 经方辨治子宫腺肌病研究进展[J]. 中国中医基础医学杂志, 2023, 29(11): 1948-1951.
[11] Zhang, J., Hu, H., Zhu, Y., Jin, Y., Zhang, H., Fan, R., et al. (2025) Bushen Jianpi Tiaoxue Decoction (BJTD) Ameliorates Oxidative Stress and Apoptosis Induced by Uterus Ageing through Activation of the SIRT1/NRF2 Pathway. Phytomedicine, 136, Article 156288. [Google Scholar] [CrossRef] [PubMed]
[12] Sztachelska, M., Ponikwicka-Tyszko, D., Martínez-Rodrigo, L., Bernaczyk, P., Palak, E., Półchłopek, W., et al. (2022) Functional Implications of Estrogen and Progesterone Receptors Expression in Adenomyosis, Potential Targets for Endocrinological Therapy. Journal of Clinical Medicine, 11, Article 4407. [Google Scholar] [CrossRef] [PubMed]
[13] Vannuccini, S., Clemenza, S., Rossi, M. and Petraglia, F. (2022) Hormonal Treatments for Endometriosis: The Endocrine Background. Reviews in Endocrine and Metabolic Disorders, 23, 333-355. [Google Scholar] [CrossRef] [PubMed]
[14] Jiang, C., Gong, W., Chen, R., Ke, H., Qu, X., Yang, W., et al. (2018) Rhoa/Rock/Arhgap26 Signaling in the Eutopic and Ectopic Endometrium Is Involved in Clinical Characteristics of Adenomyosis. Journal of International Medical Research, 46, 5019-5029. [Google Scholar] [CrossRef] [PubMed]
[15] Sun, F., Duan, H., Wang, S. and Li, J. (2015) 17β-Estradiol Induces Overproliferation in Adenomyotic Human Uterine Smooth Muscle Cells of the Junctional Zone through Hyperactivation of the Estrogen Receptor-Enhanced Rhoa/Rock Signaling Pathway. Reproductive Sciences, 22, 1436-1444. [Google Scholar] [CrossRef] [PubMed]
[16] Zhang, J., Shi, L., Duan, J., Li, M. and Li, C. (2024) Proteomic Detection of COX-2 Pathway-Related Factors in Patients with Adenomyosis. PeerJ, 12, e16784. [Google Scholar] [CrossRef] [PubMed]
[17] Inoue, S., Hirota, Y., Ueno, T., Fukui, Y., Yoshida, E., Hayashi, T., et al. (2019) Uterine Adenomyosis Is an Oligoclonal Disorder Associated with KRAS Mutations. Nature Communications, 10, Article No. 5785. [Google Scholar] [CrossRef] [PubMed]
[18] Zhang, H., Li, C., Li, W., Xin, W. and Qin, T. (2024) Research Advances in Adenomyosis-Related Signaling Pathways and Promising Targets. Biomolecules, 14, Article 1402. [Google Scholar] [CrossRef] [PubMed]
[19] Huang, E. and Chen, L. (2023) RNA N6-Methyladenosine Modification in Female Reproductive Biology and Pathophysiology. Cell Communication and Signaling, 21, Article No. 53. [Google Scholar] [CrossRef] [PubMed]
[20] Zhang, L., Li, C., Kakar, M.U., Khan, M.S., Wu, P., Amir, R.M., et al. (2021) Resveratrol (RV): A Pharmacological Review and Call for Further Research. Biomedicine & Pharmacotherapy, 143, Article 112164. [Google Scholar] [CrossRef] [PubMed]
[21] Zhu, B., Chen, Y., Zhang, H., Liu, X. and Guo, S. (2015) Resveratrol Reduces Myometrial Infiltration, Uterine Hyperactivity, and Stress Levels and Alleviates Generalized Hyperalgesia in Mice with Induced Adenomyosis. Reproductive Sciences, 22, 1336-1349. [Google Scholar] [CrossRef] [PubMed]
[22] Guan, Y., Liao, J., Li, K., Li, Y., Song, Y., Ling, J., et al. (2014) Potential Mechanisms of an Antiadenomyosis Chinese Herbal Formula Shaoyao‐Gancao Decoction in Primary Cell Culture Model. Evidence-Based Complementary and Alternative Medicine, 2014, Article ID: 982913. [Google Scholar] [CrossRef] [PubMed]
[23] 屈丽媛, 魏绍斌, 冯婷婷, 等. 清湿化瘀法对子宫腺肌病小鼠雌激素效应因子pten、p-p65的时空变化影响[J]. 时珍国医国药, 2017, 28(2): 263-264.
[24] 王烨, 范小雪, 屈丽媛, 等. 清湿化瘀法对子宫腺肌病小鼠Ras基因和COX2-PGE2-P450arom正反馈环调控机制变化的研究[J]. 时珍国医国药, 2017, 28(9): 2094-2096.
[25] 喻梦蝶, 王信, 刘洪云, 等. 桂枝挥发油对子宫腺肌病异位内膜细胞侵袭、迁移的研究[J]. 中药药理与临床, 2023, 39(3): 52-58.
[26] 唐静, 侯俊芳, 郭艳, 等. 异鼠李素对子宫腺肌病小鼠子宫的作用[J]. 西北药学杂志, 2022, 37(5): 59-63.
[27] Zhai, J., Li, S., Sen, S., Vallvé-Juanico, J., Irwin, J.C., Vo, K.C., et al. (2022) Transcriptomic Analysis Supports Collective Endometrial Cell Migration in the Pathogenesis of Adenomyosis. Reproductive BioMedicine Online, 45, 519-530. [Google Scholar] [CrossRef] [PubMed]
[28] Guo, J., Chen, L., Luo, N., Li, C., Chen, R., Qu, X., et al. (2016) LPS/TLR4-Mediated Stromal Cells Acquire an Invasive Phenotype and Are Implicated in the Pathogenesis of Adenomyosis. Scientific Reports, 6, Article No. 21416. [Google Scholar] [CrossRef] [PubMed]
[29] Yao, J., Sterling, K., Wang, Z., Zhang, Y. and Song, W. (2024) The Role of Inflammasomes in Human Diseases and Their Potential as Therapeutic Targets. Signal Transduction and Targeted Therapy, 9, Article No. 10. [Google Scholar] [CrossRef] [PubMed]
[30] Liu, H., Zhao, Y., Yang, Y., Huang, W. and Chao, L. (2022) GRIM19 Downregulation-Induced Pyroptosis of Macrophages through NLRP3 Pathway in Adenomyosis. Reproductive BioMedicine Online, 44, 211-219. [Google Scholar] [CrossRef] [PubMed]
[31] Song, D., Hao, J. and Fan, D. (2020) Biological Properties and Clinical Applications of Berberine. Frontiers of Medicine, 14, 564-582. [Google Scholar] [CrossRef] [PubMed]
[32] Zhu, B., Chen, Y., Guo, M., zhang, C., Huang, L., Pan, Q., et al. (2022) Berberine Attenuates Hyperalgesia in Mice with Adenomyosis. Archives of Gynecology and Obstetrics, 306, 115-125. [Google Scholar] [CrossRef] [PubMed]
[33] 张毅然, 石雅馨, 张科科, 等. 基于IL-6、IL-8、TNF-α和COX-2表达探讨通脉化癥汤抑制AM模型小鼠炎性反应的研究[J]. 世界科学技术-中医药现代化, 2023, 25(5): 1757-1765.
[34] 王润涵, 刘洋, 师伟, 等. 中医药治疗子宫腺肌病的作用机制研究进展[J]. 中国实验方剂学杂志, 2024, 30(16): 295-302.
[35] 刘发英, 邹阳, 杨必成, 等. 丹莪妇康煎膏对子宫腺肌病异位子宫内膜间质细胞y14增殖、迁移及侵袭的影响[J]. 现代妇产科进展, 2019, 28(11): 822-825.
[36] Feng, Q., Yang, Y., Qiao, Y., Zheng, Y., Yu, X., Liu, F., et al. (2023) Quercetin Ameliorates Diabetic Kidney Injury by Inhibiting Ferroptosis via Activating NRF2/Ho-1 Signaling Pathway. The American Journal of Chinese Medicine, 51, 997-1018. [Google Scholar] [CrossRef] [PubMed]
[37] Nie, J. and Liu, X. (2017) Quercetin Alleviates Generalized Hyperalgesia in Mice with Induced Adenomyosis. Molecular Medicine Reports, 16, 5370-5376. [Google Scholar] [CrossRef] [PubMed]
[38] Pu, X., Xu, Z., Gao, R. and Song, J. (2021) Research Progress on Biosynthesis and Synthetic Biology of Crocin. Chinese Science Bulletin, 66, 219-232. [Google Scholar] [CrossRef
[39] 周江妍, 宋晓园, 徐黎贤. 西红花苷对子宫腺肌病异位子宫内膜间质细胞生长周期的影响及机制研究[J]. 中国现代医生, 2020, 58(23): 45-49, 193.
[40] Liu, X., Shen, M., Qi, Q., Zhang, H. and Guo, S. (2016) Corroborating Evidence for Platelet-Induced Epithelial-Mesenchymal Transition and Fibroblast-To-Myofibroblast Transdifferentiation in the Development of Adenomyosis. Human Reproduction, 31, 734-749. [Google Scholar] [CrossRef] [PubMed]
[41] Bernacchioni, C., Rossi, M., Vannuzzi, V., Prisinzano, M., Seidita, I., Raeispour, M., et al. (2024) Sphingosine-1-Phosphate Receptor 3 Is a Non-Hormonal Target to Counteract Endometriosis-Associated Fibrosis. Fertility and Sterility, 121, 631-641. [Google Scholar] [CrossRef] [PubMed]
[42] 王子璐. 中医综合方案治疗子宫腺肌病疗效观察及抗病灶纤维化机制的研究[D]: [硕士学位论文]. 济南: 山东中医药大学, 2024.
[43] 费洋, 曹秋雨, 李茵, 等. 加味芍药甘草汤对人来源性子宫腺肌病裸鼠铁死亡相关基因表达的影响[J]. 中华中医药学刊, 2022, 40(9): 67-72, 266.
[44] 黄秋月. 大黄-桃仁药对调控子宫腺肌病糖基化应激作用研究[D]: [硕士学位论文]. 宜昌: 三峡大学, 2023.
[45] Huang, T., Chen, Y., Chou, T., Chen, C., Li, H., Huang, B., et al. (2014) Oestrogen‐Induced Angiogenesis Promotes Adenomyosis by Activating the Slug‐VEGF Axis in Endometrial Epithelial Cells. Journal of Cellular and Molecular Medicine, 18, 1358-1371. [Google Scholar] [CrossRef] [PubMed]
[46] Liang, S., Shi, L.Y., Duan, J.Y., et al. (2021) Celecoxib Reduces Inflammation and Angiogenesis in Mice with Adenomyosis. American Journal of Translational Research, 13, 2858-2866.
[47] Middelkoop, M., Don, E.E., Hehenkamp, W.J.K., Polman, N.J., Griffioen, A.W. and Huirne, J.A.F. (2023) Angiogenesis in Abnormal Uterine Bleeding: A Narrative Review. Human Reproduction Update, 29, 457-485. [Google Scholar] [CrossRef] [PubMed]
[48] Yalaza, C., Canacankatan, N., Gürses, İ., Aytan, H. and Taşdelen, B. (2020) Altered VEGF, BCL-2 and IDH1 Expression in Patients with Adenomyosis. Archives of Gynecology and Obstetrics, 302, 1221-1227. [Google Scholar] [CrossRef] [PubMed]
[49] 刘雨昕, 王国华. 桂枝茯苓丸对子宫腺肌病小鼠RhoA/ROCK信号通路相关分子的影响[J]. 中医药导报, 2021, 27(6): 25-30.
[50] 付先芸, 魏绍斌, 冯婷婷. 丹莪妇康煎膏对子宫腺肌瘤小鼠在位及异位内膜mmp-2及vegf表达的不同影响[J]. 中成药, 2013, 35(11): 2523-2525.
[51] 侯睿捷. 赵瑞华教授治疗子宫腺肌病痛经核心处方筛选及其作用机制初探[D]: [硕士学位论文]. 北京: 中国中医科学院, 2023.
[52] 李天真, 付先芸, 魏绍斌. 蒲灵化瘀止痛方对子宫腺肌病模型小鼠异位和在位内膜血管生成相关因子的影响[J]. 西部中医药, 2014, 27(11): 17-21.
[53] 付先芸, 魏绍斌. 蒲灵化瘀止痛方治疗小鼠子宫腺肌病的药效学观察[J]. 中国实验方剂学杂志, 2014, 20(23): 156-159.
[54] 付先芸, 魏绍斌. 蒲灵化瘀止痛方治疗子宫腺肌病小鼠的多靶点作用研究[J]. 中华中医药杂志, 2015, 30(6): 2164-2167.
[55] Juárez-Barber, E., Segura-Benítez, M., Carbajo-García, M.C., Bas-Rivas, A., Faus, A., Vidal, C., et al. (2023) Extracellular Vesicles Secreted by Adenomyosis Endometrial Organoids Contain MiRNAs Involved in Embryo Implantation and Pregnancy. Reproductive BioMedicine Online, 46, 470-481. [Google Scholar] [CrossRef] [PubMed]
[56] Mengie Ayele, T., Tilahun Muche, Z., Behaile Teklemariam, A., Bogale, A. and Chekol Abebe, E. (2022) Role of JAK2/STAT3 Signaling Pathway in the Tumorigenesis, Chemotherapy Resistance, and Treatment of Solid Tumors: A Systemic Review. Journal of Inflammation Research, 15, 1349-1364. [Google Scholar] [CrossRef] [PubMed]
[57] Lin, S., Li, W., Lin, S., Hou, H., Tsai, Y., Lin, T., et al. (2023) Targeting YAP1 Ameliorates Progesterone Resistance in Endometriosis. Human Reproduction, 38, 1124-1134. [Google Scholar] [CrossRef] [PubMed]
[58] Lei, Y., Fu, X., Chen, M., Yi, Y., Mao, P., Peng, L., et al. (2023) Dahuang—Taoren, a Botanical Drug Combination, Ameliorates Adenomyosis via Inhibiting Rho GTPases. Frontiers in Pharmacology, 14, Article ID: 1089004. [Google Scholar] [CrossRef] [PubMed]
[59] 谭蕾, 张婷婷, 朱南孙, 等. 紫蛇方对子宫腺肌病细胞系增殖及血管生成相关因子作用的研究[J]. 上海中医药杂志, 2014, 48(12): 75-79.
[60] Shi, Y., Zhang, C., Wang, X., Wang, Z., Zhang, Y., Liu, Z., et al. (2022) Analysis of the Mechanism of Guizhifuling Wan in Treating Adenomyosis Based on Network Pharmacology Combined with Molecular Docking and Experimental Verification. Evidence-Based Complementary and Alternative Medicine, 2022, Article ID: 6350257. [Google Scholar] [CrossRef] [PubMed]