The Effect of Tonifying the Kidney and Activating Blood on Endometrial Tolerance in Infertile Patients with Endometriosis Based on the “Kidney-Tiankai-Congren-Uterus” Axis

基于“肾–天癸–冲任–胞宫”轴探讨补肾活血法对子宫内膜异位症不孕患者内膜容受性的影响 The Effect of Tonifying the Kidney and Activating Blood on Endometrial Tolerance in Infertile Patients with Endometriosis Based on the “Kidney-Tiankai-Congren-Uterus” Axis The Effect of Tonifying the Kidney and Activating Blood on Endometrial Tolerance in Infertile Patients with Endometriosis Based on the “Kidney-Tiankai-Congren-Uterus” Axis DOI: 10.12677/acm.2025.154895, PDF, 被引量 作者: 袁 滢：黑龙江中医药大学研究生院，黑龙江 哈尔滨；张天婵*：黑龙江中医药大学附属第二医院妇科，黑龙江 哈尔滨 关键词: 肾–天癸–冲任–胞宫生殖轴；子宫内膜异位症；子宫内膜容受性；不孕；补肾活血法；Kidney-Tiankui-Chongren-Uterus Reproductive Axis； Endometriosis； Endometrial Tolerance； Infertility； Tonifying the Kidney and Invigorating the Blood 作者: 袁 滢：黑龙江中医药大学研究生院，黑龙江 哈尔滨；张天婵*：黑龙江中医药大学附属第二医院妇科，黑龙江 哈尔滨 关键词: 肾–天癸–冲任–胞宫生殖轴；子宫内膜异位症；子宫内膜容受性；不孕；补肾活血法；Kidney-Tiankui-Chongren-Uterus Reproductive Axis； Endometriosis； Endometrial Tolerance； Infertility； Tonifying the Kidney and Invigorating the Blood 摘要: 子宫内膜异位症(Endometriosis，简称EMs)是一种良性的病理状况，主要对处于生育年龄的女性产生影响。此病症常常与不孕症并存，给患者带来了显著的生理和心理负担。研究表明，子宫内膜对胚胎的容受性降低是导致EMs患者出现不孕的重要原因之一。因此，提升子宫内膜容受性并增强生育能力被视为治疗该疾病的核心目标。在这一领域，中医药展现出独特的治疗优势，其理论体系不仅为临床实践提供了科学依据，还在指导治疗方案制定方面发挥了不可替代的作用。本研究基于中医学的理论框架，深入探究了“肾–天癸–冲任–胞宫”这一生殖轴与子宫内膜容受性之间的内在联系，旨在为临床上针对EMs引发的不孕症提供新的治疗思路和理论依据。 Abstract: Endometriosis (EMs) is a benign disease that occurs in women of reproductive age and is often associated with infertility. It often coexists with infertility, causing significant physical and psychological burdens for the patient. Reduced endometrial tolerance is one of the main factors leading to infertility in EMs, and improving endometrial tolerance and fertility is the key to treating this disease. Traditional Chinese medicine (TCM) has unique advantages in improving endometrial tolerance, especially the theory of TCM plays an important role in guiding the treatment. In this paper, we discuss the relationship between the reproductive axis of “kidney-tianji-chongren-cystic uterus” and endometrial tolerance from the perspective of Chinese medicine theory, with a view to providing ideas for the clinical treatment of infertility in EMs. 文章引用：袁滢, 张天婵. 基于“肾–天癸–冲任–胞宫”轴探讨补肾活血法对子宫内膜异位症不孕患者内膜容受性的影响[J]. 临床医学进展, 2025, 15(4): 1-7. https://doi.org/10.12677/acm.2025.154895 | [1] | Tanbo, T. and Fedorcsak, P. (2017) Endometriosis‐Associated Infertility: Aspects of Pathophysiological Mechanisms and Treatment Options. Acta Obstetricia et Gynecologica Scandinavica, 96, 659-667. [Google Scholar] [CrossRef] [PubMed] | | [2] | Broi, M.G.D., Ferriani, R.A. and Navarro, P.A. (2019) Ethiopathogenic Mechanisms of Endometriosis-Related Infertility. JBRA Assisted Reproduction, 23, 273-280. [Google Scholar] [CrossRef] [PubMed] | | [3] | 赵伶俐, 李文祥, 曹颖. 子宫内膜异位症对内膜容受性的影响及中医药干预作用研究进展[J]. 中国民间疗法, 2021, 29(6): 116-120. | | [4] | Xie, J., Gu, A., He, H., Zhao, Q., Yu, Y., Chen, J., et al. (2023) Autoimmune Thyroid Disease Disrupts Immune Homeostasis in the Endometrium of Unexplained Infertility Women—A Single-Cell RNA Transcriptome Study during the Implantation Window. Frontiers in Endocrinology, 14, Article 1185147. [Google Scholar] [CrossRef] [PubMed] | | [5] | Lessey, B.A. and Young, S.L. (2019) What Exactly Is Endometrial Receptivity? Fertility and Sterility, 111, 611-617. [Google Scholar] [CrossRef] [PubMed] | | [6] | 武之望. 济阴纲目[M]. 北京: 中国中医药出版社, 2009. | | [7] | 黄帝内经·素问[M]. 田代华, 整理. 北京: 人民卫生出版社, 2017. | | [8] | 刘敏如. 罗元恺的女性生殖轴学说[N]. 中国中医药报, 2014-10-15(004). | | [9] | 王冰. 黄帝内经素问∙六节藏象论[M]. 钦定《四库全书》子部本影印本. | | [10] | 傅山. 傅青主女科[M]. 北京: 人民卫生出版社, 2006. | | [11] | 姜晶, 杜菲菲, 王佳楣, 石玥, 何波琳. 五子四物加减方治疗肾虚血瘀型子宫内膜异位症致不孕症的效果及对子宫内膜容受性影响[J]. 四川中医, 2021, 39(10): 161-164. | | [12] | Keller, D.W., Wiest, W.G., Askin, F.B., Johnson, L.W. and Strickler, R.C. (1979) Pseudocorpus Luteum Insufficiency: A Local Defect of Progesterone Action on Endometrial Stroma. The Journal of Clinical Endocrinology & Metabolism, 48, 127-132. [Google Scholar] [CrossRef] [PubMed] | | [13] | Spirtos, N.J., Yurewicz, E.C., Moghissi, K.S., et al. (1985) Pseudocorpus Luteum Insufficiency: A Study of Cytosol Progesterone Receptors in Human Endometrium. Obstetrics & Gynecology, 65, 535-540. | | [14] | 江媚, 刘雁峰, 吕艳莹, 等. 中医药改善子宫内膜容受性的效应机制[J]. 中医杂志, 2013, 54(12): 1064-1066, 1075. | | [15] | 张景岳. 类经[M]. 北京: 人民卫生出版社, 1980. | | [16] | 朱震亨. 格致余论[M]. 北京: 人民卫生出版社, 2005. | | [17] | 黄羚, 顾元烨, 江媚. 胞宫胞脉胞络理论与子宫内膜容受性关系探析[J]. 吉林中医药, 2021, 41(7): 854-857. | | [18] | (隋)巢元方. 诸病源候论[M]. 北京: 中国医药科技出版社, 2011. | | [19] | 练菲艳, 廖燕凤, 张红青, 游慧芳. 补肾化瘀中药治疗肾虚血瘀型子宫内膜异位症伴不孕患者的疗效[J]. 医疗装备, 2020, 33(16): 3-4. | | [20] | 黄羚, 江媚. 从肾-天癸-冲任-胞宫生殖轴论补肾活血法改善子宫内膜容受性低下[J]. 辽宁中医杂志, 2021, 48(10): 45-48. | | [21] | 李世杰. 子宫内膜容受性与子宫内膜异位症[J]. 国外医学妇产科学分册, 2005, 32(6): 358-360. | | [22] | 王芳, 付金荣. 蔡小荪治疗子宫内膜异位症不孕经验[J]. 中医杂志, 2014(4): 283-285. |