国际妇产科学杂志

国际妇产科学杂志 ›› 2026, Vol. 53 ›› Issue (3): 352-356.doi: 10.12280/gjfckx.20260056

• 普通妇科疾病及相关研究:论著 • 上一篇    下一篇

经颅直流电刺激通过抑制NLRP3炎症小体激活缓解子宫内膜异位症相关性疼痛的研究

郑萍, 赵立明, 张雪芳, 顾彬, 尤爱虹, 郎景和, 冷金花(), 刘崇东()   

  1. 100020 首都医科大学附属北京朝阳医院妇产科（郑萍， 张雪芳， 刘崇东）；中国康复研究中心北京博爱医院作业疗法科（赵立明，顾彬）；广州医科大学附属第三医院妇产科（尤爱虹）；中国医学科学院北京协和医院妇产科（郎景和，冷金花）
  • 收稿日期:2026-01-21 出版日期:2026-06-15 发布日期:2026-07-06
  • 通讯作者: 冷金花,刘崇东 E-mail:length_pumch@163.com;liuchongdong@coga.org.cn
  • 基金资助:
    国家自然科学基金(81471440);广东省基础与应用基础研究基金项目(2021A1515111120);首都医科大学科研培育基金(PYZ22091)

Transcranial Direct Current Stimulation Alleviates Endometriosis-Related Pain by Inhibiting NLRP3 Inflammasome Activation

ZHENG Ping, ZHAO Li-ming, ZHANG Xue-fang, GU Bin, YOU Ai-hong, LANG Jing-he, LENG Jin-hua(), LIU Chong-dong()   

  1. Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China (ZHENG Ping, ZHANG Xue-fang, LIU Chong-dong); Department of Occupational Therapy, China Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing 100071, China (ZHAO Li-ming, GU Bin); Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China (YOU Ai-hong); Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China (LANG Jing-he, LENG Jin-hua)
  • Received:2026-01-21 Published:2026-06-15 Online:2026-07-06
  • Contact: LENG Jin-hua,LIU Chong-dong E-mail:length_pumch@163.com;liuchongdong@coga.org.cn

RichHTML

12

PDF (PC)

8

摘要：

目的：评估经颅直流电刺激（transcranial direct current stimulation，tDCS）对子宫内膜异位症（endometriosis，EMs）相关性疼痛的治疗效果，并探讨其涉及核苷酸结合结构域富含亮氨酸重复序列和含热蛋白结构域受体3（nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3，NLRP3）炎症小体通路的潜在作用机制。方法：选择2024年1月—2025年6月在首都医科大学附属北京朝阳医院就诊的40例EMs相关慢性盆腔痛患者，按随机数字表法分为20例tDCS组和20例假刺激对照组。tDCS组采用阳极置于F3区域、阴极置于对侧眶上部Fp2区域的刺激方案，电流强度为2 mA，每日1次，每次20 min，连续治疗10 d。假刺激对照组电极放置位置与tDCS组一致，电流强度为0 mA。分别在治疗前、治疗结束后10 d采用视觉模拟评分法（visual analogue scale，VAS）评估疼痛程度，治疗前及治疗结束后10 d通过酶联免疫吸附分析（enzyme-linked immunosorbent assay，ELISA）检测血清中NLRP3炎症小体活化后的下游因子白细胞介素-1β（interleukin-1β，IL-1β）、IL-18及乳酸脱氢酶（lactate dehydrogenase，LDH）水平。采用GraphPad Prism 5.0软件进行数据分析。结果：2组患者的年龄、孕次、产次、基线VAS评分比较，差异无统计学意义（均P>0.05）。治疗后，tDCS组的VAS评分低于假刺激对照组，差异有统计学意义（t=8.953，P<0.001）。ELISA检测结果显示，治疗后，tDCS组血清IL-1β、IL-18、LDH水平低于假刺激对照组，差异有统计学意义（均P<0.05）。相关性分析显示，tDCS组治疗后VAS评分与血清IL-1β（r=0.512，P=0.021）、LDH水平（r=0.580， P=0.007）呈显著正相关，与IL-18水平不相关（P=0.073）；而治疗前上述相关性均不显著（均P>0.05）。结论：tDCS可有效缓解EMs相关性疼痛，其机制可能与抑制NLRP3炎症小体激活、减少下游促炎细胞因子释放及减轻细胞焦亡相关，且治疗后疼痛缓解程度与炎症因子及细胞损伤指标的降低直接关联。

关键词: 经颅直流电刺激, 子宫内膜异位症, 痛经, NLR家族，热蛋白结构域包含蛋白3, 白细胞介素类

Abstract:

Objective: To evaluate the therapeutic efficacy of transcranial direct current stimulation (tDCS) on endometriosis (EMs)-related pain and explore its potential mechanism involving the nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3(NLRP3) inflammasome pathway. Methods: From January 2024 to June 2025, 40 patients with EMs-related chronic pelvic pain admitted to Beijing Chao-Yang Hospital, Capital Medical University were selected and randomly divided into a tDCS group (n=20) and a sham stimulation control group (n=20) using a random number table. The tDCS group received stimulation with the anode placed over the F3 area and the cathode over the contralateral supraorbital Fp2 area, with a current intensity of 2 mA, once daily for 20 minutes per session, for 10 consecutive days. The sham stimulation control group had electrode placed in identical position as the tDCS group, but with a current intensity of 0 mA. Pain levels were assessed using the visual analogue scale (VAS) before treatment and 10 days after treatment completion. Serum levels of the downstream factors of NLRP3 inflammasome activation, interleukin-1β (IL-1β), IL-18 and lactate dehydrogenase (LDH), were measured by enzyme-linked immunosorbent assay (ELISA) before and 10 days after treatment. Data analysis was performed using GraphPad Prism 5.0 software. Results: There were no statistically significant differences between the two groups in age, gravidity, parity, or baseline VAS scores (all P>0.05). After treatment, the VAS score in the tDCS group was significantly lower than that in the sham stimulation control group (t=8.953, P<0.001). ELISA results showed that serum levels of IL-1β, IL-18, and LDH in the tDCS group were significantly lower than those in the sham stimulation control group after treatment (all P<0.05). Correlation analysis revealed that in the tDCS group, the post-treatment VAS score was significantly positively correlated with serum IL-1β (r=0.512, P=0.021) and LDH levels (r=0.580, P=0.007), but not with IL-18 levels (P=0.073). No significant correlations were observed before treatment (all P>0.05). Conclusions: tDCS effectively alleviate EMs-related pain. Its mechanism may be related to the inhibition of NLRP3 inflammasome activation, reduction in the release of downstream pro-inflammatory cytokines, and attenuation of pyroptosis. Furthermore, the degree of pain relief after treatment is directly associated with the reduction in inflammatory factors and cellular damage indicatiors.

Key words: Transcranial direct current stimulation, Endometriosis, Dysmenorrhea, NLR family, pyrin domain-containing 3 protein, Interleukins