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子宫内膜异位症诊治困局与思考
俞超芹*
0
(海军军医大学(第二军医大学)第一附属医院中医妇科, 上海 200433
*通信作者)
摘要:
子宫内膜异位症(EM)是一种雌激素依赖性的神经炎症性疾病,其导致的慢性盆腔痛、卵巢子宫内膜异位囊肿、不孕症等严重影响女性的生活质量。中医认为血瘀是EM的核心病机,现证型繁杂,治疗方案多样但缺乏规范和标准;现代医学则认为非可控性炎症和粘连是EM的病理过程,但目前缺乏敏感的非侵入性生物诊断标志物和理想的治疗方法。EM是一种慢性疾病,需要长期的管理。在EM诊治过程中要重视临床诊断,避免诊断延迟;同时要重视中医药的规范化治疗,尽早介入、尽早使用;要积极提高中医药在EM治疗中的地位和临床使用率。
关键词:  子宫内膜异位症  血瘀证  中医药  长期管理
DOI:10.16781/j.CN31-2187/R.20220197
投稿时间:2022-03-08修订日期:2022-12-04
基金项目:国家自然科学基金面上项目(82074206,81774352,81573755),上海市科学技术委员会科技创新行动计划(21Y21920500),海军军医大学第一附属医院"234学科攀峰计划"(2020YXK007),上海市中西医临床协作试点建设项目(ZY[2018-2020]-FWTX-1107).
Diagnosis and treatment of endometriosis: difficulties and thinking
YU Chao-qin*
(Department of Traditional Chinese Medicine (Gynecology), The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Endometriosis (EM) is an estrogen-dependent neuroinflammatory disease, which leads to chronic pelvic pain, ovarian cysts and infertility seriously affecting women's quality of life. Traditional Chinese medicine (TCM) believes that blood stasis is the core pathogenesis of EM, with complex syndrome types and diverse treatment plans, but lack of norms and standards. Modern medicine believes that uncontrollable inflammation and adhesion are the pathological processes of EM, but there is a lack of sensitive non-invasive diagnostic markers and ideal treatment methods. EM is a chronic disease, which needs long-term management. Clinical diagnosis should be emphasized in the process of diagnosis and treatment of EM to avoid diagnosis delay. At the same time, attentions should be paid to the standardized treatment of TCM, with early intervention and early use, so as to actively improve the status and clinical utilization rate of TCM in the treatment of EM.
Key words:  endometriosis  syndrome of blood stasis  traditional Chinese medicine  long-term management