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营养在子宫内膜异位症防治中的作用:综述

Nutrition in the prevention and treatment of endometriosis: A review.

作者信息

Barnard Neal D, Holtz Danielle N, Schmidt Natalie, Kolipaka Sinjana, Hata Ellen, Sutton Macy, Znayenko-Miller Tatiana, Hazen Nicholas D, Cobb Christie, Kahleova Hana

机构信息

Department of Clinical Research, Physicians Committee for Responsible Medicine, Washington, DC, United States.

Adjunct Faculty, George Washington University School of Medicine and Health Sciences, Washington, DC, United States.

出版信息

Front Nutr. 2023 Feb 17;10:1089891. doi: 10.3389/fnut.2023.1089891. eCollection 2023.

Abstract

Endometriosis is characterized by the presence of endometrial tissues outside the uterine lining, typically on the external surface of the uterus, the ovaries, fallopian tubes, abdominal wall, or intestines. The prevalence of endometriosis in North America, Australia, and Europe is ~1-5% in women of reproductive age. Treatment options for endometriosis are limited. While over-the-counter medications may be used to reduce acute pain, hormonal treatments are common and may interfere with fertility. In more severe cases, laparoscopic excision procedures and even hysterectomies are used to treat the pain associated with endometriosis. Nutritional interventions may be helpful in the prevention and treatment of endometriosis and associated pain. Reducing dietary fat and increasing dietary fiber have been shown to reduce circulating estrogen concentrations, suggesting a potential benefit for individuals with endometriosis, as it is an estrogen-dependent disease. Meat consumption is associated with greater risk of developing endometriosis. Anti-inflammatory properties of plant-based diets may benefit women with endometriosis. Additionally, seaweed holds estrogen-modulating properties that have benefitted postmenopausal women and offers potential to reduce estradiol concentrations in pre-menopausal women. Furthermore, consumption of vitamin D has been shown to reduce endometrial pain increased antioxidant capacity and supplementation with vitamins C and E significantly reduced endometriosis symptoms, compared with placebo. More randomized clinical trials are needed to elucidate the role of diet in endometriosis.

摘要

子宫内膜异位症的特征是子宫内衬以外存在子宫内膜组织,通常出现在子宫外表面、卵巢、输卵管、腹壁或肠道。在北美、澳大利亚和欧洲,育龄女性子宫内膜异位症的患病率约为1%-5%。子宫内膜异位症的治疗选择有限。虽然非处方药物可用于减轻急性疼痛,但激素治疗较为常见,且可能会影响生育能力。在更严重的情况下,会采用腹腔镜切除手术甚至子宫切除术来治疗与子宫内膜异位症相关的疼痛。营养干预可能有助于预防和治疗子宫内膜异位症及相关疼痛。减少饮食中的脂肪并增加膳食纤维已被证明可降低循环雌激素浓度,这表明对子宫内膜异位症患者可能有益,因为该病是一种雌激素依赖性疾病。食用肉类会增加患子宫内膜异位症的风险。植物性饮食的抗炎特性可能对患有子宫内膜异位症的女性有益。此外,海藻具有调节雌激素的特性,已使绝经后女性受益,并有可能降低绝经前女性的雌二醇浓度。此外,与安慰剂相比,摄入维生素D已被证明可减轻子宫内膜疼痛,提高抗氧化能力,补充维生素C和E可显著减轻子宫内膜异位症症状。需要更多的随机临床试验来阐明饮食在子宫内膜异位症中的作用。

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