中药地黄防治骨质疏松症的研究进展

Research progress of Rehmanniae Radix in prevention and treatment of osteoporosis

高致残和致死率的骨质疏松性骨折是严重影响个体生活质量的棘手难题。目前,临床上仍缺少靶点明确和药效显著的防治骨质疏松药品。中药地黄及组方临床抗骨质疏松效果显著,已有越来越多的研究报道了地黄及其活性成分此方面的作用和机制,取得一定的研究成果。该文检索PubMed、Web of science、中国知网和万方数据库等近十年文献,搜集并整理地黄抗骨质疏松方面的最新研究进展,对于中药饮片生、制地黄、地黄中活性成分如梓醇、桃叶珊瑚苷、毛蕊花糖苷和地黄多糖等以及地黄组方等归纳其研究动态、作用指标和机制,挖掘潜在的活性成分、作用靶点和信号通路,包括对于骨髓间充质干细胞的影响、促进成骨细胞增殖和促进成骨分化(增加碱性磷酸酶、Ⅰ型胶原蛋白、骨保护素和骨钙素等以及促进钙沉积)和增大骨密度以及抑制破骨细胞数量和分化、促进破骨细胞凋亡、减少抗酒石酸酸性磷酸酶和减少骨吸收陷窝面积等,为更好地发挥和研究地黄抗骨质疏松作用及机制提供参考和开拓新思路。

Osteoporosis fracture with high disability and mortality is a difficult problem that seriously affects the life quality of individuals. At present, there is still a lack of anti-osteoporosis drugs with clear target and significant efficacy in the clinical practice. Rehmanniae Radix and its prescriptions have significant clinical effects. In this regard, more and more studies have reported the effects and mechanisms of Rehmanniae Radix and its active components, and the certain research outputs have been achieved. In this article, the PubMed, Web of science, China National Knowledge Infrastructure, and Wanfang database were searched to collect and organize the latest research progress of Rehmanniae Radix treatment of osteoporosis in the recent 10 years. We summarized the research dynamics as well as the function indexes and mechanisms of the raw and processed Rehmanniae Radix, active ingredients such as catalpol, aucubin, acteoside and Rehmanniae Radix polysaccharide, and their formulating prescriptions, and then excavated the potential active ingredients, targets and signaling pathways, including the effect on bone marrow mesenchymal stem cells, promoting the osteoblast proliferation and promoting osteogenesis differentiation(increasing alkaline phosphatase, typeⅠ collagen, osteoprotegerin, and osteocalcin and promoting calcium deposits), increasing the bone density, inhibiting the osteoclast quantity and differentiation, promoting the osteoclast apoptosis, and reducing tartrate resistant acid phosphatase and bone resorption pit area to provide the reference and develop new ideas for developing Rehmanniae Radix prescriptions for treatment of osteoporosis and exploring its mechanism.