淫羊藿苷在治疗股骨头坏死中的应用

Application of Icariin in the Treatment of Osteonecrosis of the Femoral Head

淫羊藿苷是传统中草药淫羊藿的重要活性成分,具有促进成骨细胞增殖并提高其活性、抑制破骨细胞的分化形成与骨吸收、诱导骨髓间充质干细胞(bone marrow mysenchymal stem cells,BMSCs)的成骨分化以及保护股骨头部位血管的作用。同时,淫羊藿苷可与各类复合材料支架相结合,在动物实验中取得了令人满意的效果,这种结合可能是未来淫羊藿苷应用于股骨头坏死与骨缺损手术治疗的重点。临床研究亦发现含有淫羊藿苷成分的方剂也对股骨头坏死具有明显的防治作用。但目前对于淫羊藿苷的研究以基础实验为主,且对其复杂机制层面的研究相对薄弱;缺乏淫羊藿苷结合复合材料应用于人体的相关报道以及单独使用淫羊藿苷治疗股骨头坏死的临床报道,应进一步关注淫羊藿苷的临床应用及其对于人体的影响,为股骨头坏死的治疗提供新思路;此外,淫羊藿苷治疗股骨头坏死的最适药物浓度有待商榷,考虑到动物模型的局限性,应开展更多种类的哺乳类动物实验或通过临床试验数据加以证实,找到淫羊藿苷在人体内的最适浓度。

Icariin is an important active ingredient of Yinyanghuo(Epimedium brevicornu Maxim.),a traditional Chinese herbal.It can promote the proliferation of osteoblasts and increase their activity,inhibit the differentiation and formation of osteoclasts and bone resorption,induce osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs),and protect blood vessels in the femoral head.At the same time,icariin can be combined with various composite material scaffolds,and satisfactory results have been achieved in animal experiments.This combination may be the focus of icariin in the treatment of osteonecrosis of the femoral head and bone defects in the future.Clinical studies have also found that prescriptions containing icariin also have a significant preventive effect on osteonecrosis of the femoral head.However,the current research on icariin is mainly based on basic experiments,and the research on its complex mechanism is relatively weak.And there is a lack of relevant reports on the application of icariin combined with composite materials in humans and clinical reports on the use of icariin alone in the treatment of osteonecrosis of the femoral head.Further attention should be paid to the clinical application of icariin and its impact on the human body.provide new ideas for treatment.In addition,the optimal drug concentration of icariin in the treatment of osteonecrosis of the femoral head remains to be discussed.Considering the limitations of animal models,more types of mammalian experiments should be carried out or confirmed by clinical trial data to find the optimal concentration of icariin in the human body.