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Journal of Traditional Chinese Medicine >

2026 , Vol. 46 >Issue 4: 809 - 820

DOI: https://doi.org/10.19852/j.cnki.jtcm.2026.04.004

Original 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 Bingbing ,
  • DING Meiqi ,
  • CHEN Xiangying ,
  • LI Wenzhe ,
  • WEI Chao ,
  • YU Bin ,
  • MA Xiaona ,
  • SUN Xinhui
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  • 1 College of Integrated Traditional Chinese and Western Medicine, Jining Medical University, Jining 272000, China
    2 Gynecology department, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, China
    3 Gynecology department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine; National Clinical Research Center for Chinese Medicine, Tianjin 300000, China

Received date: 2025-09-28

  Accepted date: 2026-04-13

  Online published: 2026-08-08

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)

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Abstract

OBJECTIVE: To investigate the mechanisms by which Shaofu Zhuyu decoction (SFZYD, 少腹逐瘀汤) modulates fibrosis in a mouse model of endometriosis.

METHODS: Mice were divided into control, endometriosis model, low-dose SFZYD, high-dose SFZYD, and dinorgestrel groups. Ectopic lesion weights and volumes were evaluated post-intervention. Uterine or lesion morphology and fibrosis were assessed using hematoxylin/eosin and Masson’s trichrome and Sirius red staining, respectively. Gene expression levels of 5′ adenosine monophosphate-activated protein kinase (AMPK), transforming growth factor β1 (TGF-β1), collagen type 1 alpha 1 chain (COL1A1), alpha smooth muscle actin (α-SMA), and connective tissue growth factor (CTGF) were detected using quantitative real-time polymerase chain reaction. Protein expression levels of AMPK, p-AMPK, TGF-β1, Smad2/3, p-Smad2/3, COL1A1, α-SMA and CTGF were detected using immunohistochemistry or Western blotting.

RESULTS: Staining revealed excessive ectopic lesion fibrosis, and p-AMPK/AMPK expression was downregulated in the model group, whereas TGF-β1, Smad2/3, COL1A1, α-SMA, and CTGF expression was upregulated. SFZYD-L group showed the greatest effect in reducing ectopic lesion size and inhibiting fibrosis. These changes were correlated with the activation/ phosphorylation of AMPK, suppression of TGF-β1 and Smad2/3 expression, and downregulation of COL1A1, α-SMA, and CTGF expression, suggesting a potential association with AMPK modulation.

CONCLUSION: SFZYD significantly inhibits both the progression of ectopic lesions and the development of fibrosis in a mouse model of endometriosis. These effects are potentially mediated through the regulation of the AMPK/TGF-β1/Smads signaling pathway.

Key words： endometriosis; fibrosis; mice; AMP-activated protein kinases; transforming growth factor beta1; Smad proteins; Shaofu Zhuyu decoction

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 . DOI: 10.19852/j.cnki.jtcm.2026.04.004

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