二至丸调节Sirt1/Runx2信号通路抑制绝经后骨质疏松症肾阴虚证骨代谢失衡的机制探讨

Discussion on the mechanism of Erzhi Pills inhibit the bone metabolism disorder of postmenopausal osteoporosis with syndrome of kidney yin deficiency by Sirt1/Runx2 signal pathway

绝经后骨质疏松症属中医"骨痿"范畴,病位在肾,病在骨,以肾虚为基本病机,以肾阴虚为临床常见证型之一,采用二至丸治疗的临床疗效可靠。绝经后骨质疏松症以骨量丢失为主要病理变化,Sirt1/Runx2信号通路通过调节成骨细胞与破骨细胞增殖、活化及功能的相关因子表达,参与骨代谢的调控过程。基于肾藏精主骨生髓的理论,针对绝经后骨质疏松症的中医病理特点,提示补肾法是中医治疗的关键治则。因此,文章以Sirt1/Runx2信号通路为切入点,基于国内外的相关文献,采用分析-综合-分析的方法,探讨二至丸抑制绝经后骨质疏松症肾阴虚证骨代谢失衡的作用途径,为从肾论治绝经后骨质疏松症提供一个新的思路和角度。

Postmenopausal osteoporosis（PMOP）, as ‘Gu Wei＇ in traditional Chinese medicine（TCM）, is a disease located in kidney and bone, and its basic pathogenesis is deficiency of the kidney. The syndrome of kidney yin deficiency is one of common clinical syndromes, and Erzhi Pills has been widely used to treatment PMOP with stabilized clinical efficacy. Bone loss as the main pathological change of PMOP is regulated by the Sirt1/Runx2 signal pathway that involved in the regulation of bone metabolism by regulating the expression of the proliferation, activation and function of osteoblasts and osteoclasts. Based on the theory of kidney essence and bone marrow, we put forward kidney-nourishing method as the fundamental treatment of TCM because of the pathological features of PMOP. Therefore, based on the relevant literature at home and abroad, this paper starts with the Sirt1/Runx2 signal pathway as the cutting point and takes the analysis-synthesis-analysis method to explore the underlying mechanism of Erzhi Pills on the bone metabolism disorder of PMOP deficiency of kidney yin. Finally, it provides the new ideas and perspectives from kidney for treatment of PMOP.