中药苷类化合物防治骨质疏松症作用机制的研究进展

Research Progress on Mechanism of Traditional Chinese Medicine Glycosides in Preventing and Treating Osteoporosis

骨质疏松症的特征是骨量低和髓腔扩张,即使是轻微的撞击也会导致手腕、脊椎和髋部骨折,随着全球人口老龄化,骨质疏松症正成为主要的经济和社会负担,对有效预防和治疗策略的需求日益增加。目前主要治疗手段有钙剂、维生素D、抑制破骨细胞的药物或抑制骨吸收的药物,以及选择性雌激素受体调节剂等药物治疗手段,这些替代疗法在预防及治疗骨质疏松症的同时,增加了乳腺癌、子宫内膜癌以及其他心血管疾病的发生率,并且随着治疗周期的延长表现出治疗效果不明显和安全性等问题。中医药用于防治骨质疏松症临床疗效显著,与化学合成的药物相比,中医药具有不良反应少、适合长期服用和治疗效果稳定的特点,逐渐成为一种主流治疗手段。苷类药物在临床使用中作用广泛,可用于多种疾病的治疗,其中包括骨质疏松症的治疗。基于此,就苷类药物在与骨质疏松的关系,以及苷类中药通过促进成骨分化、抑制破骨生成、调节骨质疏松相关信号通路、调节机体免疫、抑制骨的转化、增强骨组织自噬水平抗骨质疏松机制作一综述,旨在为临床苷类中药诊疗骨质疏松提供新思路。

Osteoporosis is characterized by low bone mass and dilated medullary cavity.Even a slight impact can lead to wrist,spine and hip fractures.With the aging of the global population,osteoporosis is becoming a major economic and social burden,and the demand for effective prevention and treatment strategies is increasing.At present,the main treatment methods are calcium,vitamin D,the drugs that inhibit osteoclast or bone resorption and selective estrogen receptor modulators.These alternative therapies not only prevent and treat osteoporosis,but also increase the incidence of breast cancer,endometrial cancer and other cardiovascular diseases,and with the extension of treatment cycle,the treatment effect is not obvious and safe.Traditional Chinese medicine(TCM)has a significant clinical effect in the prevention and treatment of osteoporosis.Compared with chemically synthesized drugs,TCM has the characteristics of less adverse reactions,long-term use and stable treatment effect,and has gradually become a mainstream treatment method.Glycosides are widely used in clinical practice and can be used for the treatment of many diseases,including osteoporosis.Based on this,the author reviewed the relationship between glycosides and osteoporosis,and the anti-osteoporosis mechanism of glycosides by promoting osteogenic differentiation,inhibiting osteoclast generation,regulating osteoporosis-related signal pathways,regulating organism immunity,inhibiting bone transformation,and enhancing autophagy level of bone tissue,in order to provide new ideas for clinical diagnosis and treatment of osteoporosis with glycosides.