中药保留灌肠治疗女性盆腔炎的临床及 基础研究进展

Clinical and Basic Research Progress of Traditional Chinese Medicine Retention Enema in the Treatment of Female Pelvic Inflammatory Disease

摘要: 慢性盆腔炎是困扰育龄期女性的常见慢性炎症性疾病，以病程迁延、反复发作、易致盆腔粘连和不孕为特点，临床治疗棘手。中药保留灌肠作为中医特色外治法之一，凭借“药达病所、避开头过”的独特优势，在该病治疗中展现出卓越潜力。本文系统梳理了中药保留灌肠治疗慢性盆腔炎的临床应用现状，并从现代药理学角度深入阐释其抗炎、免疫调节、改善微循环、抗纤维化及调节肠道微生态等多靶点作用机制，同时基于“肺与大肠相表里”理论探讨直肠给药与全身气血调节的内在联系，最后分析了该疗法的剂型革新、技术优化与未来研究方向，以期为该疗法的临床推广与深入研究提供理论依据。

Abstract: Chronic pelvic inflammatory disease (CPID) is a common chronic inflammatory condition affecting women of reproductive age, characterized by a protracted course, recurrent episodes, and a high propensity to cause pelvic adhesions and infertility, posing significant clinical challenges. Traditional Chinese medicine (TCM) retention enema, as a distinctive external therapy of TCM, has demonstrated remarkable potential in treating CPID by virtue of its unique advantage of “delivering medicine directly to the affected site while bypassing hepatic first-pass metabolism”. This article systematically reviews the current clinical application status of TCM retention enema in treating CPID, and provides an in-depth elucidation of its multi-target mechanisms from the perspective of modern pharmacology, including anti-inflammatory effects, immunomodulation, improvement of microcirculation, anti-fibrosis, and regulation of the intestinal microecology. Furthermore, based on the TCM theory of “the lung and large intestine being interior-exteriorly related”, this paper explores the intrinsic connection between rectal administration and systemic regulation of Qi and blood. Finally, it analyzes the innovations in dosage forms, technological optimization, and future research directions of this therapy, aiming to provide a theoretical foundation for its clinical promotion and further investigation.