中医药治疗多发性骨髓瘤骨病研究进展  

Research Progress of Traditional Chinese Medicine in the Treatment of Multiple Myeloma Bone Disease

作　　者：曾荣香[1] 李怀国[1] 李宏良[1] ZENG Rongxiang;LI Huaiguo;LI Hongliang(Foshan Hospital of Traditional Chinese Medicine,Foshan,Guangdong,China 528000)

机构地区：[1]广东省佛山市中医院,广东佛山528000

出　　处：《中国药业》2023年第17期I0001-I0006,共6页China Pharmaceuticals

基　　金：广东省佛山市科技计划(医学类科技攻关)项目[2020001005313]。

摘　　要：目的总结中医药治疗多发性骨髓瘤骨病(MMBD)及其作用机制的研究进展。方法采用计算机检索数据库中有关中医药治疗MMBD的文献,分别从现代药理学研究和临床研究进行综述。结果现代药理学研究表明,中药单体可通过某些靶点及通路抑制破骨细胞功能,促进成骨细胞分化或抑制多发性骨髓瘤细胞增殖并诱导凋亡获得治疗MMBD的作用,包括调控护骨因子/核因子-κB受体激活蛋白配体/核因子-κB受体激活蛋白(OPG/RANKL/RANK)信号通路,调控沉默信息调节因子1/Runt相关转录因子2(SIRT1/RUNX2)信号通路,调控Wnt/β-联蛋白(Wnt/β-catenin)信号通路,调控白细胞介素6/Janus激酶2/信号转导与转录激活因子3(IL-6/JAK2/STAT3)信号通路,调控AKT激酶/哺乳动物雷帕霉素靶蛋白(AKT/mTOR)信号通路,调控磷脂酰肌醇-3-激酶/AKT(PI3K/AKT)信号通路,靶向泛素样含植物同源结构域和环指域1(UHRF1),抑制髓样细胞白血病-1(Mcl-1)蛋白转录,抑制髓细胞组织增生蛋白/端粒酶逆转录酶(MYC/TERT)信号通路。临床实践表明,中药复方可能通过改善骨代谢等作用机制治疗MMBD,包括身痛逐瘀汤合涤痰汤、毒结清口服液、补肾活血汤、益肾活血饮联合亚砷酸。结论中医药治疗MMBD前景较好。但多数研究局限于细胞实验阶段,临床转化证据不够充分,信号通路及靶点的研究有待深入;中药复方的临床研究均为单中心研究,样本量小,作用机制研究不足。Objective To summarize the research progress of traditional Chinese medicine(TCM)in the treatment of multiple myeloma bone disease(MMBD)and its mechanism of action.Methods The articles related to the treatment of MMBD with TCM in the database were searched.The modern pharmacological research and clinical research were reviewed.Results Modern pharmacological studies showed that monomer of TCM could inhibit osteoclast function,promote osteoblast differentiation,inhibit multiple myeloma cell proliferation and induce apoptosis through certain targets and pathways to achieve the therapeutic effect of MMBD,including regulating osteoprotegerin/receptor activator of nuclear factor-κB ligand/receptor activator of nuclear factor-κB(OPG/RANKL/RANK)pathway,silence information regulator-1/Runt-related transcription factor-2(SIRT1/RUNX2)signaling pathway,Wnt/β-catenin signaling pathway,interleukin-6/Janus kinase-2/signal transducer and activator of transcription-3(IL-6/JAK2/STAT3)signaling pathway,protein kinase B/mammalian target of rapamycin(AKT/mTOR)signaling pathway,and phosphatidylinositol-3-kinase/AKT(PI3K/AKT)signaling pathway,targeting ubiquitin-like with plant homeodomain(PHD)and ringfinger domains-1(UHRF1),and inhibiting the transcription of myeloid leukemia-1(Mcl-1)protein and the myelocytomatosis proteins/telomere reverse transcriptase(MYC/TERT)signaling pathway.Clinical practice showed that TCM compounds may treat MBD by improving bone metabolism and other mechanisms,and the TCM compounds include Shentongzhuyu Decoction combined with Ditan Decoction,Dujieqing Oral Liquid,Bushenhuoxue Decoction,Yishenhuoxue Decoction combined with arsenite acid.Conclusion TCM has a good prospect in the treatment of MMBD.However,most of the research is limited to the cell experiment stage,the clinical transformation evidence is insufficient,and the research of signaling pathways and targets needs to be in-depth.The clinical studies of TCM compounds are single-center,with a small sample size and insufficient studies on the mechani

关 键 词：多发性骨髓瘤骨病 中医药 现代药理学研究 临床研究 

分 类 号：R932[医药卫生—生药学] R273[医药卫生—药学]