Research Advances on Chinese Herbal Enema for Thin Endometrial Receptivity Based on the Theory of “Chong Meridian as the Sea of Blood”

Abstract

Thin endometrium (TE) is one of the key factors leading to impaired endometrial receptivity (ER) and failure of assisted reproductive technology (ART). The theory of “Chong Meridian as the Sea of Blood” is a core concept in traditional Chinese medicine (TCM) reproductive health, which posits that deficiency of the Chong Meridian and insufficiency of the Sea of Blood are the central pathological mechanisms underlying TE. As an external treatment method in TCM, Chinese herbal retention enema allows herbal components to be absorbed via the rectum and directly delivered to the pelvic cavity and uterus. This approach offers unique advantages in promoting blood circulation, removing stasis, tonifying the kidney and essence, and regulating the Chong and Ren Meridians. Modern research suggests that this therapy may comprehensively improve ER through multiple pathways and targets, including enhancing endometrial blood perfusion, promoting angiogenesis, regulating sex hormone receptor expression, and exerting anti-inflammatory and immunomodulatory effects. This article systematically reviews the theoretical basis and modern mechanistic research progress on Chinese herbal enema for TE under the guidance of the “Chong Meridian as the Sea of Blood” theory, aiming to provide new insights and a theoretical foundation for clinical practice.