Journal of Traditional Chinese Medicine ›› 2026, Vol. 46 ›› Issue (4): 809-820.DOI: 10.19852/j.cnki.jtcm.2026.04.004
• Original Articles • Previous Articles Next Articles
Shaofu Zhuyu decoction (少腹逐瘀汤) can inhibit the progression of endometriosis fibrosis through the transforming growth factor-β1/ smads signaling pathway mediated by 5’ adenosine monophosphate-activated protein kinase
LI Bingbing1, DING Meiqi1, CHEN Xiangying1, LI Wenzhe1, WEI Chao1, YU Bin1, MA Xiaona2(
), SUN Xinhui3()
- 1
College of Integrated Traditional Chinese and Western Medicine ,Jining Medical University Jining 272000, China
2Gynecology department ,Beijing University of Chinese Medicine Third Affiliated Hospital Beijing 100029, China
3Gynecology department ,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine; National Clinical Research Center for Chinese Medicine Tianjin 300000, China
-
Received:2025-09-28Accepted:2026-04-13Online:2026-08-15Published:2026-08-08 -
Contact:MA Xiaona, Gynecology department, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China. fightandfight@yeah.net;
SUN Xinhui, Gynecology department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine; National Clinical Research Center for Chinese Medicine, Tianjin 300000, China. weimo0827@163.com,Telephone: +86-19801226182 -
Supported by:National Natural Science Foundation of China: To Explore the Mechanism of Shaofu Zhuyu Decoction in the Treatment of Endometriosis Based on Adiponectin/AdipoR/5' Adenosine Monophosphate-activated Protein Kinase Pathway-Mediated Fibrosis(82104920);Natural Science Foundation of Shandong Province: Adipose-Derived Stem Cell Exosomes Regulate the Transforming Growth Factor β1/Smads Pathway-mediated Fibrosis in Endometriosis and the Intervention Effect of Shaofu Zhuyu Decoction(ZR2021QH129);Shandong Provincial Key Laboratory of Traditional Chinese Medicine: Laboratory for Integrated Traditional Chinese Medicine-Western Medicine Clinical Research([2022]4)
Cite this article
LI Bingbing, DING Meiqi, CHEN Xiangying, LI Wenzhe, WEI Chao, YU Bin, MA Xiaona, SUN Xinhui. Shaofu Zhuyu decoction (少腹逐瘀汤) can inhibit the progression of endometriosis fibrosis through the transforming growth factor-β1/ smads signaling pathway mediated by 5’ adenosine monophosphate-activated protein kinase[J]. Journal of Traditional Chinese Medicine, 2026, 46(4): 809-820.
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Figure 1 Effect of SFZYD on the formation of ectopic lesions A: images of ectopic lesions or uterine tissues in the five groups of mice; B: volume of the ectopic lesions in each group; C: weight of the ectopic lesions in each group; D: HE staining of the uterus of mice in the Control group and of the ectopic lesions in the other groups (scale bars: 50 μm). A1-A5: in vivo images; A6-A10: ex vivo images; A1, A6, D1: Control group; A2, A7, D2: Model group; A3, A8, D3: SFZYD-L group; A4, A9, D4: SFZYD-H group; A5, A10, D5: Dinorgestrel group. Black arrow: uterin and ectopic lesions; red arrow: giand; blue arrow: epithelium. Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290 g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks. SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; SD: standard deviation; HE: hematoxylin and eosin. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are expressed as the mean ± standard deviation (n = 6/group) and these represent independent biological replicates. aP < 0.05 versus Model group; bP < 0.01 versus Model group.
Figure 1 Effect of SFZYD on the formation of ectopic lesions A: images of ectopic lesions or uterine tissues in the five groups of mice; B: volume of the ectopic lesions in each group; C: weight of the ectopic lesions in each group; D: HE staining of the uterus of mice in the Control group and of the ectopic lesions in the other groups (scale bars: 50 μm). A1-A5: in vivo images; A6-A10: ex vivo images; A1, A6, D1: Control group; A2, A7, D2: Model group; A3, A8, D3: SFZYD-L group; A4, A9, D4: SFZYD-H group; A5, A10, D5: Dinorgestrel group. Black arrow: uterin and ectopic lesions; red arrow: giand; blue arrow: epithelium. Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290 g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks. SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; SD: standard deviation; HE: hematoxylin and eosin. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are expressed as the mean ± standard deviation (n = 6/group) and these represent independent biological replicates. aP < 0.05 versus Model group; bP < 0.01 versus Model group.
Figure 2 Effect of SFZYD on fibrotic staining of ectopic lesions A: images of Masson’s trichrome of the uterine tissue of the mice in the control group and of the ectopic lesions of the mice in the other groups (scale bars: 50 μm); B: images of Sirius red staining of the uterine tissue of the mice in the control group and of the ectopic lesions of the mice in the other groups (scale bars: 50 μm); C: intergroup comparisons of Masson’s trichrome results in each group; D: intergroup comparisons of Sirius red staining results in each group; A1, B1: Control group; A2, B2: Model group; A3, B3: SFZYD-L group; A4, B4: SFZYD-H group; A5, B5: Dinorgestrel group. Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks. SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; SD: standard deviation. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are expressed as the mean ± standard deviation (n = 3/group) and these represent independent biological replicates. aP < 0.01 versus Control group; bP < 0.05 versus Model group; cP < 0.01 versus Model group.
Figure 2 Effect of SFZYD on fibrotic staining of ectopic lesions A: images of Masson’s trichrome of the uterine tissue of the mice in the control group and of the ectopic lesions of the mice in the other groups (scale bars: 50 μm); B: images of Sirius red staining of the uterine tissue of the mice in the control group and of the ectopic lesions of the mice in the other groups (scale bars: 50 μm); C: intergroup comparisons of Masson’s trichrome results in each group; D: intergroup comparisons of Sirius red staining results in each group; A1, B1: Control group; A2, B2: Model group; A3, B3: SFZYD-L group; A4, B4: SFZYD-H group; A5, B5: Dinorgestrel group. Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks. SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; SD: standard deviation. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are expressed as the mean ± standard deviation (n = 3/group) and these represent independent biological replicates. aP < 0.01 versus Control group; bP < 0.05 versus Model group; cP < 0.01 versus Model group.
Figure 3 Analysis of the mRNA levels of fibrosis-related factors A: mRNA levels of AMPK; B: mRNA levels of TGF-β1; C: mRNA levels of COL1A1; D: mRNA levels of α-SMA; E: mRNA levels of CTGF; Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290 g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks; SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; AMPK: 5′ adenosine monophosphate-activated protein kinase; TGF-β1: transforming growth factor beta 1; COL1A1: collagen type I alpha 1 chain; α-SMA: alpha smooth muscle actin; SD: standard deviation. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are presented as the mean ± standard deviation (n = 3/group). aP < 0.01, dP < 0.05 versus Control group; bP < 0.01, cP < 0.05 versus Model group.
Figure 3 Analysis of the mRNA levels of fibrosis-related factors A: mRNA levels of AMPK; B: mRNA levels of TGF-β1; C: mRNA levels of COL1A1; D: mRNA levels of α-SMA; E: mRNA levels of CTGF; Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290 g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks; SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; AMPK: 5′ adenosine monophosphate-activated protein kinase; TGF-β1: transforming growth factor beta 1; COL1A1: collagen type I alpha 1 chain; α-SMA: alpha smooth muscle actin; SD: standard deviation. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are presented as the mean ± standard deviation (n = 3/group). aP < 0.01, dP < 0.05 versus Control group; bP < 0.01, cP < 0.05 versus Model group.
Figure 4 Regulation of the AMPK/TGF-β1/Smads pathway by SFZYD in mice with ectopic lesions A: immunohistochemical labeling of TGF-β1 in the different groups (scale bars: 50 μm); B: changes of TGF-β1; C: immune ohistochemical labeling of COL1A1 in the different groups (scale bars: 50 μm); D: changes of COL1A1; E: immunohistochemical labeling of α-SMA in the different groups (scale bars: 50 μm); F: changes of α-SMA; G: Western blot analysis of the protein expression levels of AMPK, p-AMPK, TGF-β1, Smad2/3, p-Smad2/3, COL1A1, α-SMA, CTGF, and β-actin protein levels in uterine tissue and ectopic lesions; H1: changes of p-AMPK/AMPK; H2: changes of TGF-β1; H3: changes of p-Smad2/3/Smad2/3; H4: changes of COL1A1;H5: changes of α-SMA; H6: changes of CTGF; A1, C1, E1: Control group; A2, C2, E2: Model group; A3, C3, E3: SFZYD-L group; A4, C4, E4: SFZYD-H group; A5, C5, E5: Dinorgestrel group. Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290 g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks. SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; AMPK: 5′ adenosine monophosphate-activated protein kinase; TGF-β1: transforming growth factor beta 1; COL1A1: collagen type I alpha 1 chain; α-SMA: alpha smooth muscle actin; SD: standard deviation. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are expressed as the mean ± standard deviation (n = 3/group) and these represent independent biological replicates. aP < 0.01, dP < 0.05 versus Control group; bP < 0.05, cP < 0.01 versus Model group.
Figure 4 Regulation of the AMPK/TGF-β1/Smads pathway by SFZYD in mice with ectopic lesions A: immunohistochemical labeling of TGF-β1 in the different groups (scale bars: 50 μm); B: changes of TGF-β1; C: immune ohistochemical labeling of COL1A1 in the different groups (scale bars: 50 μm); D: changes of COL1A1; E: immunohistochemical labeling of α-SMA in the different groups (scale bars: 50 μm); F: changes of α-SMA; G: Western blot analysis of the protein expression levels of AMPK, p-AMPK, TGF-β1, Smad2/3, p-Smad2/3, COL1A1, α-SMA, CTGF, and β-actin protein levels in uterine tissue and ectopic lesions; H1: changes of p-AMPK/AMPK; H2: changes of TGF-β1; H3: changes of p-Smad2/3/Smad2/3; H4: changes of COL1A1;H5: changes of α-SMA; H6: changes of CTGF; A1, C1, E1: Control group; A2, C2, E2: Model group; A3, C3, E3: SFZYD-L group; A4, C4, E4: SFZYD-H group; A5, C5, E5: Dinorgestrel group. Control group: the mice received 0.9% NaCl once every day for 3 weeks; Model group: the mice received 0.9% NaCl once every day for 3 weeks; SFZYD-L group: the mice received SFZYD at a dose of 8.645 g/kg once every day for 3 weeks; SFZYD-H group: the mice received SFZYD at a dose of 17.290 g/kg once every day for 3 weeks; Dinorgestrel group: the mice received Dinorgestrel at a dose of 0.3 mg/kg once every day for 3 weeks. SFZYD: Shaofu Zhuyu decoction; SFZYD-L: low-dose Shaofu Zhuyu decoction; SFZYD-H: high-dose Shaofu Zhuyu decoction; AMPK: 5′ adenosine monophosphate-activated protein kinase; TGF-β1: transforming growth factor beta 1; COL1A1: collagen type I alpha 1 chain; α-SMA: alpha smooth muscle actin; SD: standard deviation. The data passed tests for normality and homogeneity of variance. Statistical significance was assessed using one-way analysis of variance. Data are expressed as the mean ± standard deviation (n = 3/group) and these represent independent biological replicates. aP < 0.01, dP < 0.05 versus Control group; bP < 0.05, cP < 0.01 versus Model group.
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