基于“阳化气”理论探讨线粒体-炎症通路在原发性痛经中的作用-现代医学

基于“阳化气”理论探讨线粒体-炎症通路在原发性痛经中的作用

单位：南京中医药大学附属医院/江苏省中医院妇科, 江苏南京 210029

分类号：R271.11;R249

出版年·卷·期（页码）：2025·53·第十期（1574-1579）

摘要：

目的：探讨中西医对原发性痛经(PD)病理机制的认识差异，阐明温经止痛方的治疗机制与价值。方法：结合文献研究梳理PD的西医线粒体功能障碍-炎症机制及中医“阳化气”理论下阳气不足致瘀病机，通过实验验证方药对线粒体及炎症通路的调控作用，并辅以临床观察。结果：温经止痛方可改善线粒体能量代谢、抑制炎症通路，缓解子宫缺血缺氧；临床应用能减轻PD疼痛、改善经期延长，调节内分泌、调整异常指标，部分有生育需求患者治疗后成功妊娠。结论：中西医结合从“线粒体-炎症”双维度揭示PD病机，温经止痛方实现标本兼治，为PD治疗(尤其合并生育需求者)提供新思路。

Objective: To explore the differences in the understanding of the pathological mechanism of primary dysmenorrhea(PD) between traditional Chinese medicine(TCM) and Western medicine, and to clarify the therapeutic mechanism and value of Wenjing Zhitong Decoction. Methods: Based on literature research, this study sorted out the Western medicine's “mitochondrial dysfunction-inflammation mechanism” of PD and the TCM pathogenesis of “blood stasis caused by Yang deficiency” under the theory of “Yang-transforming-Qi”. Experiments were conducted to verify the regulatory effects of the decoction on mitochondria and inflammatory pathways, supplemented by clinical observations. Results: Wenjing Zhitong Decoction could improve mitochondrial energy metabolism, inhibit inflammatory pathways, and alleviate uterine ischemia and hypoxia. Clinically, it could reduce PD-related pain, improve prolonged menstrual periods, regulate endocrine function, and correct abnormal indicators. Some patients with fertility needs successfully conceived after treatment. Conclusion: Integrative Chinese and Western medicine reveals the pathogenesis of PD from the “mitochondria-inflammation” dual dimensions. Wenjing Zhitong Decoction achieves the effect of treating both the root cause and symptoms, providing a new idea for PD treatment(especially for patients with fertility needs).

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