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中药在骨质疏松症治疗中的作用。

The Role of Traditional Chinese Medicines in the Treatment of Osteoporosis.

机构信息

School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China.

School of Public Health, Nanjing Medical University, Nanjing 210029, P. R. China.

出版信息

Am J Chin Med. 2024;52(4):949-986. doi: 10.1142/S0192415X24500393. Epub 2024 Jun 14.

Abstract

Osteoporosis (OP) represents a substantial public health issue and is associated with increasing rates of morbidity and mortality. It is characterized by reduced bone mineral density, deterioration of bone tissue quality, disruption of the microarchitecture of bones, and compromised bone strength. These changes may be attributed to the following factors: intercellular communication between osteoblasts and osteoclasts; imbalanced bone remodeling; imbalances between osteogenesis and adipogenesis; imbalances in hormonal regulation; angiogenesis; chronic inflammation; oxidative stress; and intestinal microbiota imbalances. Treating a single aspect of the disease is insufficient to address its multifaceted nature. In recent decades, traditional Chinese medicine (TCM) has shown great potential in the treatment of OP, and the therapeutic effects of Chinese patent drugs and Chinese medicinal herbs have been scientifically proven. TCMs, which contain multiple components, can target the diverse pathogeneses of OP through a multitargeted approach. Herbs such as XLGB, JTG, GSB, Yinyanghuo, Gusuibu, Buguzhi, and Nvzhenzi are among the TCMs that can be used to treat OP and have demonstrated promising effects in this context. They exert their therapeutic effects by targeting various pathways involved in bone metabolism. These TCMs balance the activity of osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells), and they exhibit anti-inflammatory, immunomodulatory, anti-oxidative, and estrogen-like functions. These multifaceted mechanisms underlie the efficacy of these herbs in the management and treatment of OP. Herein, we examine the efficacy of various Chinese herbs and Chinese patent drugs in treating OP by reviewing previous clinical trials and basic experiments, and we examine the potential mechanism of these therapies to provide evidence regarding the use of TCM for treating OP.

摘要

骨质疏松症(OP)是一个重大的公共卫生问题,与发病率和死亡率的上升有关。它的特征是骨密度降低、骨组织质量恶化、骨微结构破坏以及骨强度受损。这些变化可能归因于以下因素:成骨细胞和破骨细胞之间的细胞间通讯;骨重建失衡;成骨与成脂之间的失衡;激素调节失衡;血管生成;慢性炎症;氧化应激;和肠道微生物群失衡。治疗疾病的单一方面不足以解决其多方面的性质。近几十年来,传统中药(TCM)在治疗 OP 方面显示出巨大的潜力,中药专利药和中草药的治疗效果已得到科学证明。TCM 含有多种成分,可以通过多靶点的方法针对 OP 的多种发病机制。XLGB、JTG、GSB、Yinyanghuo、Gusuibu、Buguzhi 和 Nvzhenzi 等中草药可用于治疗 OP,并在这方面显示出良好的效果。它们通过靶向涉及骨代谢的各种途径发挥治疗作用。这些 TCM 平衡了成骨细胞(骨形成细胞)和破骨细胞(骨吸收细胞)的活性,具有抗炎、免疫调节、抗氧化和雌激素样功能。这些多方面的机制是这些草药在 OP 管理和治疗中的疗效基础。在此,我们通过回顾以前的临床试验和基础实验,检查各种中草药和中药专利药治疗 OP 的疗效,并研究这些疗法的潜在机制,为 TCM 治疗 OP 提供依据。

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