从“肾”论治激素性骨质疏松症的研究进展

Research Progress in Treatment of Glucocorticoid-induced Osteoporosis from Kidney

近年来,激素(Glucocorticoid, GC)在临床上的不规范及大剂量使用导致糖皮质激素性骨质疏松(Glucocorticoid-induced osteoporosis, GIOP)的发病逐渐增多。中医药防治GIOP疗效确切,备受关注,但由于缺乏客观的药效学机制及分子学依据,难以达到标准化防治水平。Wnt/β-catenin、OPG/RANK/RANKL、BMPs等信号通路的发现,为临床防治GIOP等骨代谢疾病提供了新思路。文章结合GIOP的中医病因病机,从"肾"论治的药效学及分子学机制,探讨GIOP的中医辨治,为临床及后续研究提供依据。

The clinical irregularities and high doses of hormones have led to an increase in the incidence of glucocorticoid-induced osteoporosis in recent years.The efficacy of traditional Chinese medicine in the prevention and treatment of GIOP is very clear and has received much attention.However, due to the lack of objective pharmacodynamic mechanisms and molecular basis, it is difficult to achieve standardized levels of prevention and treatment.The discovery of signaling pathways such as Wnt/β-catenin, OPG/RANK/RANKL,and BMPs provides new ideas for clinical prevention and treatment of bone metabolic diseases such as GIOP.Combining the etiology and pathogenesis of GIOP in traditional Chinese medicine, this paper discusses the differentiation and treatment of GIOP from the pharmacodynamics and molecular mechanism of kidney, and provides the basis for clinical and follow-up researches.