中药调节自噬相关信号通路改善激素性股骨头坏死的研究进展

Modulation of Autophagy-Related Signaling Pathway by Traditional Chinese Medicine toAmeliorate Steroid-Induced Avascular Necrosis of the Femoral Head: A Research Progress

激素性股骨头坏死(steroid-induced avascular necrosis of the femoral head,SANFH)是一类临床骨科系统常见病与多发病,究其原因是激素的不合理使用造成股骨头缺血缺氧,而最终发展为股骨头坏死。目前来说,对SANFH的治疗尚无临床特效药物,但随着研究手段的进步,已发现自噬在该病的致病过程中扮演重要角色,且已明确部分信号通路能够对自噬产生影响。现阶段,中药防治SANFH的研究备受关注,但其作用机制尚不清楚。本文通过查阅相关国内外文献,就自噬(成骨细胞、破骨细胞、线粒体等)与SANFH的发病关系及中药(如黄芪多糖、葛根素、柚皮苷、川芎嗪、淫羊藿苷等中药单体及化合物,以及桂枝芍药知母汤、右归饮、健骨散、骨痹通消方、活血通络汤等中药复方)调节自噬相关信号通路从而改善SANFH进行概述,以期为拓展SANFH的治疗措施及明确中药应用价值提供参考。

Steroid-induced avascular necrosis of the femoral head(SANFH)is a common and frequently-occurring disease in the clinical orthopedic system,its cause is the ischemia and hypoxia of the femoral head caused by the irrational use of hormones,which eventually develops into femoral head necrosis.At present,there is no specific drug for the treatment of SANFH,but with the progress of research,autophagy has been found to play an important role in the pathogenic process of the disease,and it has been clarified that part of the signaling pathway can have an effect on autophagy.At this stage,the research of Chinese medicine against SANFH has attracted much attention,but its mechanism of action is still unclear.In this ar-ticle,we reviewed the relevant domestic and international literature to provide an overview of the relationship between autophagy(osteoblasts,osteo-clasts,mitochondria,etc)and SANFH,and the modulation of autophagy-related signaling pathways by traditional Chinese medicines(Such as as-tragalus polysaccharide,puerarin,naringin,Chuanxiongzine,epimedium glycosides and other Chinese medicine monomers and compounds,as well as Guizhi Shaoyao Zhimu soup,Yougui drink,Bone Strengthening powder,Gubi Tongxiao decoction,Huoxue Tongluo Soup,and other Chinese medicine compound formulae),with the aim of expanding the therapeutic measures and clarifying the value of traditional Chinese medicines in the treatment of SANFH.