子宫内膜异位症多系统协同综合治疗方案研究进展

Research Progress in Multisystem Collaborative Comprehensive Treatment Regimens for Endometriosis

摘要: 子宫内膜异位症(EMT)是育龄期女性高发的慢性激素依赖性疾病，以具有活性的子宫内膜组织异位生长、周期性出血引发慢性炎症、疼痛、不孕等症状为核心特征，其主要特点有病程长、易复发、累及全身多系统。传统单一治疗模式主要聚焦在病灶切除或对其进行激素抑制，难以实现兼顾症状缓解、生育保护、长期管理及全身多系统的全面调节，临床疗效有限且复发率居高不下。近年来，随着对EMT病理生理机制的不断深入研究，多系统协作治疗理念成为该病诊疗的主攻方向，通过整合不同治疗方式的优势，实现局部病灶控制与全身调节的协同统一，契合慢病长期管理的临床趋势。本文基于EMT临床诊疗现状及新进展，系统阐述对EMT患者的神经内分泌调控、手术干预、免疫调节、生育支持、疼痛的长期管理、心理干预、肠道的微生态调节等多方面协作的诊疗模式，旨在为EMT规范化、个体化、全周期综合治疗提供理论参考，推动临床诊疗模式从单一对症治疗向多系统全面管理的转变。

Abstract: Endometriosis (EMT) is a chronic hormone-dependent disease with high incidence in women of reproductive age. It is characterized by ectopic growth of active endometrial tissue and cyclic bleeding, leading to chronic inflammation, pain, infertility and other symptoms. The disease features a long course, high recurrence rate, and systemic multisystem involvement. Traditional single-treatment modalities mainly focus on lesion resection or hormonal suppression, which can hardly achieve comprehensive regulation covering symptom relief, fertility preservation, long-term management and systemic multisystem adjustment, resulting in limited clinical efficacy and a persistently high recurrence rate. In recent years, with in-depth research on the pathophysiological mechanism of EMT, the concept of multisystem collaborative therapy has become the main direction of diagnosis and treatment of this disease. By integrating the advantages of different treatment methods, it achieves the synergy and unification of local lesion control and systemic regulation, which conforms to the clinical trend of long-term management of chronic diseases. Based on the current status and new progress of clinical diagnosis and treatment of EMT, this paper systematically elaborates on the collaborative diagnosis and treatment model of neuroendocrine regulation, surgical intervention, immune regulation, fertility support, long-term pain management, psychological intervention, intestinal microecological regulation and other aspects for patients with EMT. It aims to provide theoretical reference for the standardized, individualized and full-cycle comprehensive treatment of EMT, and promote the transformation of clinical diagnosis and treatment mode from single symptomatic treatment to comprehensive multisystem management.