淫羊藿及其复方制剂治疗糖皮质激素性骨质疏松症的研究进展
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摘要
淫羊藿具有补肾壮阳、祛风除湿和强筋健骨的功效,主治腰酸腿痛、四肢拘挛、筋骨痿软等症。古人常用淫羊藿医治骨痿、骨痹、腰痛等疾病。现代医学也常将淫羊藿作为治疗各种类型骨质疏松症的中药之一。糖皮质激素常被用于治疗各种炎症、风湿及免疫相关疾病,随着临床医疗的普遍应用,其副作用也日益凸显,其中最严重的副作用之一就是会导致骨质疏松,即糖皮质激素性骨质疏松症。糖皮质激素性骨质疏松症是最常见的继发性骨质疏松症之一,仅居于老年性骨质疏松症和绝经后骨质疏松症之后,位于第三位。近年来对淫羊藿治疗骨质疏松症方面的研究日渐增多,大量医学研究表明淫羊藿在糖皮质激素性骨质疏松症的医治方面具有广阔的发展空间。本文通过查阅国内外相关文献,对目前淫羊藿治疗糖皮质激素性骨质疏松症作一文献综述,旨在为临床研究及实验研究奠定理论基础。
Epimedium herb has the functions of nourishing kidney and strengthening Yang, removing wind and dampness, strengthening muscle and strengthening bone. Epimedium herb is mainly used for the treatment of pain in the leg, spasm of limbs, physique impotent and so on. In ancient times, epimdium was commonly used to treat diseases such as impotence of bone, stuffiness of bone and backache. Epimedium is often used in modern medicine as one of the traditional Chinese medicines for the treatment of various types of osteoporosis. Glucocorticoid is commonly used to treat various inflammation, rheumatism and immune-related diseases. With the widespread application of glucocorticoid, its side effects are increasingly prominent. One of the most serious side effects is osteoporosis, namely glucocorticoid-induced osteoporosis(GIOP). Glucocorticoid-induced osteoporosis is one of the most common secondary osteoporosis, after senile osteoporosis and postmenopausal osteoporosis, it ranks the third. In recent years, more and more studies have been done on the effects of epimedium in the treatment of osteoporosis, a large number of medical studies have shown that epimedium has great potential in the treatment of glucocorticoid-induced osteoporosis. In this paper, by referring to relevant literature in domestic and abroad, we reviewed the treatment effect of epimedium in GIOP, aiming at laying the theoretical foundation for clinical research and experiment study.
Epimedium herb has the functions of nourishing kidney and strengthening Yang, removing wind and dampness, strengthening muscle and strengthening bone. Epimedium herb is mainly used for the treatment of pain in the leg, spasm of limbs, physique impotent and so on. In ancient times, epimdium was commonly used to treat diseases such as impotence of bone, stuffiness of bone and backache. Epimedium is often used in modern medicine as one of the traditional Chinese medicines for the treatment of various types of osteoporosis. Glucocorticoid is commonly used to treat various inflammation, rheumatism and immune-related diseases. With the widespread application of glucocorticoid, its side effects are increasingly prominent. One of the most serious side effects is osteoporosis, namely glucocorticoid-induced osteoporosis(GIOP). Glucocorticoid-induced osteoporosis is one of the most common secondary osteoporosis, after senile osteoporosis and postmenopausal osteoporosis, it ranks the third. In recent years, more and more studies have been done on the effects of epimedium in the treatment of osteoporosis, a large number of medical studies have shown that epimedium has great potential in the treatment of glucocorticoid-induced osteoporosis. In this paper, by referring to relevant literature in domestic and abroad, we reviewed the treatment effect of epimedium in GIOP, aiming at laying the theoretical foundation for clinical research and experiment study.
引文
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[6] 徐晓东,邓洋洋,郑洪新.糖皮质激素诱导肾虚骨质疏松症大鼠骨组织中BMP6/BMP7mRNA及蛋白表达的影响[J].中华中医药学刊,2014,32(3):472-474.
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[10] 刘仁慧,杨婧,王培,等.淫羊藿女贞子对激素干预撤停阶段大鼠哮喘模型HPA轴及骨代谢的影响[J].中国实验方剂学杂志,2011,17(5):137-139.
[11] 康学,周琦,李崭,等.淫羊藿-女贞子对GIOP大鼠骨密度和激素水平的相关性分析[J].中国实验方剂学杂志,2013,19(23):250-253.
[12] 贾晓斌,兰雪莲,陈彦,等.淫羊藿黄酮类成分抗骨质疏松作用及其机制研究进展[J].中国药房,2010,21(3):269.
[13] 杨燕,年宏蕾,刘仁慧,等.淫羊藿-女贞子配伍对糖皮质激素性骨质疏松大鼠TGF-β1/Smads通路的影响[J].中国实验方剂学杂志,2017,23(9):99-104.
[14] 翟远坤,牛银波,潘亚磊,等.柚皮苷对体外培养乳鼠颅骨成骨细胞增殖和分化成熟的影响[J].中国中药杂志,2013,38(1):105-111.
[15] 贾英民,李瑞玉,武密山,等.补肾中药成分配伍对成骨细胞成骨活性及Smad4 mRNA表达的影响[J].中国组织工程研究,2015,19(33):5289-5294.
[16] 张国哲,郑洪新,朱辉,等.补肾中药对糖皮质激素性骨质疏松大鼠脂类代谢异常的调节作用[J].辽宁中医药大学学报,2011,13(6):53-56.
[17] 程英雄,罗毅文,王斌,等.补肾活血汤水提物调控Cbfal/RUNX2基因沉默骨髓间充质干细胞SP7/Osterix及碱性磷酸酶的表达[J].中国组织工程研究,2018(13):1987-1992.
[18] 王剑,郑洪新,张锦萍,等.补肾、健脾、活血中药复方对糖皮质激素性骨质疏松症大鼠肾组织Runx2 mRNA及蛋白表达影响的比较研究[J].成都中医药大学学报,2011,34(4):54-58.
[19] 王剑,郑洪新,宗志宏,等.补肾、健脾、活血中药对糖皮质激素性骨质疏松症大鼠骨组织Osterix mRNA及蛋白表达的影响[J].中华中医药杂志,2011,26(4):801-805.
[20] 孙平,王金枝,刘丰,等.中药复方护骨胶囊治疗糖皮质激素性骨质疏松症[J].实用医学杂志,2016,32(24):4122-4124.
[21] 吴剑静,温利平,吴云刚,等.仙灵骨葆胶囊治疗糖皮质激素性骨质疏松症的临床疗效观察[J].中国骨伤,2009,22(3):193-195.
[22] 史建强,陈丽娟,许宗严,等.补骨胶囊对SLE患者激素治疗后骨质疏松的作用及细胞因子表达的影响[J].中国皮肤性病学杂志,2010,24(2):169-171.
[23] 杨亚珊,罗云霞,竺红.骨疏康胶囊治疗糖皮质激素性骨质疏松症的临床研究[J].中国骨质疏松杂志,2017,23(6):795-799.
[24] 张学武,姚海红,梅轶芳,等.全国多中心使用糖皮质激素风湿病患者骨质疏松调查[J].中华临床免疫和变态反应杂志,2017,11(3):277-284.
[2] 崔健超,杨志东,江晓兵,等.糖皮质激素性骨质疏松症的中医证型分布特点[J].中国骨质疏松杂志,2016,22(2):217-220,250.
[3] Hsieh TP,Sheu SY,Sun JS,et al.Icariin isolated from Epimedium pubescens regulates osteoblasts anabolism through BMP-2,SMAD4,and Cbfa1 expression[J].Phytomedicine,2010,17(6):414-423.
[4] Feng R,Feng L,Yuan Z,et al.Icariin protects against glucocorticoid-induced osteoporosis in vitro and prevents glucocorticoid -induced osteocyte apoptosis in vivo[J].Cell Biochem Biophys,2013,67 (1):189-197.
[5] 沈奕,李晓淼,王伟力.骨形态发生蛋白7在骨科的应用[J].中国组织工程研究与临床康复,2011,15(26):4864-4867.
[6] 徐晓东,邓洋洋,郑洪新.糖皮质激素诱导肾虚骨质疏松症大鼠骨组织中BMP6/BMP7mRNA及蛋白表达的影响[J].中华中医药学刊,2014,32(3):472-474.
[7] 周乐,吴铁,崔燎.淫羊藿调节BMP-7预防糖皮质激素致大鼠骨损害的研究[J].中国骨质疏松杂志,2014,20(3):234-237,241.
[8] 伊伟恩,刘德果,李姿蓉,等.骨质疏松症中医用药规律的古代文献研究[J].湖南中医杂志,2017,33(2):116-118.
[9] 杨燕,年宏蕾,刘仁慧,等.淫羊藿女贞子对糖皮质激素性骨质疏松大鼠糖皮质激素受体作用的影响[J].中国医药导报,2016,13(14):4-7.
[10] 刘仁慧,杨婧,王培,等.淫羊藿女贞子对激素干预撤停阶段大鼠哮喘模型HPA轴及骨代谢的影响[J].中国实验方剂学杂志,2011,17(5):137-139.
[11] 康学,周琦,李崭,等.淫羊藿-女贞子对GIOP大鼠骨密度和激素水平的相关性分析[J].中国实验方剂学杂志,2013,19(23):250-253.
[12] 贾晓斌,兰雪莲,陈彦,等.淫羊藿黄酮类成分抗骨质疏松作用及其机制研究进展[J].中国药房,2010,21(3):269.
[13] 杨燕,年宏蕾,刘仁慧,等.淫羊藿-女贞子配伍对糖皮质激素性骨质疏松大鼠TGF-β1/Smads通路的影响[J].中国实验方剂学杂志,2017,23(9):99-104.
[14] 翟远坤,牛银波,潘亚磊,等.柚皮苷对体外培养乳鼠颅骨成骨细胞增殖和分化成熟的影响[J].中国中药杂志,2013,38(1):105-111.
[15] 贾英民,李瑞玉,武密山,等.补肾中药成分配伍对成骨细胞成骨活性及Smad4 mRNA表达的影响[J].中国组织工程研究,2015,19(33):5289-5294.
[16] 张国哲,郑洪新,朱辉,等.补肾中药对糖皮质激素性骨质疏松大鼠脂类代谢异常的调节作用[J].辽宁中医药大学学报,2011,13(6):53-56.
[17] 程英雄,罗毅文,王斌,等.补肾活血汤水提物调控Cbfal/RUNX2基因沉默骨髓间充质干细胞SP7/Osterix及碱性磷酸酶的表达[J].中国组织工程研究,2018(13):1987-1992.
[18] 王剑,郑洪新,张锦萍,等.补肾、健脾、活血中药复方对糖皮质激素性骨质疏松症大鼠肾组织Runx2 mRNA及蛋白表达影响的比较研究[J].成都中医药大学学报,2011,34(4):54-58.
[19] 王剑,郑洪新,宗志宏,等.补肾、健脾、活血中药对糖皮质激素性骨质疏松症大鼠骨组织Osterix mRNA及蛋白表达的影响[J].中华中医药杂志,2011,26(4):801-805.
[20] 孙平,王金枝,刘丰,等.中药复方护骨胶囊治疗糖皮质激素性骨质疏松症[J].实用医学杂志,2016,32(24):4122-4124.
[21] 吴剑静,温利平,吴云刚,等.仙灵骨葆胶囊治疗糖皮质激素性骨质疏松症的临床疗效观察[J].中国骨伤,2009,22(3):193-195.
[22] 史建强,陈丽娟,许宗严,等.补骨胶囊对SLE患者激素治疗后骨质疏松的作用及细胞因子表达的影响[J].中国皮肤性病学杂志,2010,24(2):169-171.
[23] 杨亚珊,罗云霞,竺红.骨疏康胶囊治疗糖皮质激素性骨质疏松症的临床研究[J].中国骨质疏松杂志,2017,23(6):795-799.
[24] 张学武,姚海红,梅轶芳,等.全国多中心使用糖皮质激素风湿病患者骨质疏松调查[J].中华临床免疫和变态反应杂志,2017,11(3):277-284.