TCM Treatment of Endometriosis: Pathogenesis, Mechanism and Clinical Practice

Juan Du,1 Zimo Li,2 Shujun Chen,2 Xia Zheng,3 Yu Zhang,2 Xingwei Pu,4 Mingya Zhu,2 Xiang Hu51School of Medicine and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 2Clinical Medical College of Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 3Reproductive & Maternal-Child Health Hospital Affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 4Suining Data Group Co. Ltd, Suining, Sichuan, People’s Republic of China; 5TCM Prevention and Treatment of Metabolic and Chronic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Xiang Hu, TCM Prevention and Treatment of Metabolic and Chronic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China, Email [email protected]: Endometriosis (EMs) is a chronic neuroinflammatory disorder prevalent in women of reproductive age characterized by heterogeneous clinical manifestations, while conventional Western therapies are limited by obvious adverse reactions and unsatisfactory long-term efficacy. In traditional Chinese medicine (TCM), endometriosis is categorized as "abdominal mass” and "dysmenorrhea”, and qi stagnation and blood stasis is recognized as the core pathogenic basis. TCM exerts therapeutic effects on endometriosis mainly by suppressing NF-κB-mediated inflammatory cascades, modulating immune homeostasis, balancing sex hormone secretion and abnormal angiogenesis. Clinically, herbal compound prescriptions, acupuncture and combined TCM interventions can alleviate pelvic pain, shrink ectopic lesions and cut postoperative recurrence risks. Nevertheless, the clinical application of TCM is hindered by non-unified syndrome differentiation criteria and insufficient high-level mechanistic verification. This review concludes that TCM serves as a valuable adjunctive regimen for endometriosis management; however, standardized multi-omics mechanistic exploration, large-sample randomized controlled trials and integrated Chinese-Western therapeutic protocol optimization are urgently required to facilitate the standardized formulation and international recognition of TCM for endometriosis treatment.Keywords: EMs, keywords TCM, acupuncture and moxibustion, Chinese herbal compound, blood stasis block