中医药调控PI3K/Akt通路治疗激素性股骨头坏死的研究进展  

Mechanism of Traditional Chinese Medicine in Treating Steroid-Induced Osteonecrosis of Femoral Head via Regulating PI3K/Akt Pathway:A Review

作　　者：张亚奇 李博 汤建成 丁冉[1] 黄诚 徐雅萍[1] 张启栋[1] 王卫国[1] ZHANG Yaqi;LI Bo;TANG Jiancheng;DING Ran;HUANG Cheng;XU Yaping;ZHANG Qidong;WANG Weiguo(China-Japan Friendship Hospital,Beijing 100029,China;Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中日友好医院,北京100029 [2]北京中医药大学研究生院,北京100029

出　　处：《中国实验方剂学杂志》2025年第5期141-149,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81972107,82072494)。

摘　　要：激素性股骨头坏死(SONFH)是一种由于长期或大量使用糖皮质激素而引发的严重骨关节疾病。其特征包括骨细胞的缺血、坏死和骨小梁断裂,伴随疼痛、股骨头塌陷和关节功能障碍,严重时可致残疾。SONFH的发病机制涉及激素诱导的成骨细胞凋亡、骨微血管内皮细胞(BMECs)凋亡、氧化应激和炎症反应等。其中,磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路在疾病发展中起着核心作用。通过调节PI3K/Akt信号通路,可以促进Akt磷酸化,进而激发骨髓间充质干细胞和成骨细胞的成骨分化、BMECs的血管生成,并抑制破骨细胞的生成。中医药在治疗SONFH方面的研究逐渐受到关注。近年来的研究显示中药单体和中药复方通过干预PI3K/Akt信号通路对SONFH具有潜在的治疗作用。这些研究不仅为中医药在SONFH治疗中的应用提供了科学依据,也为开发新的治疗策略提供了新思路。该文综述了近5年来国内外关于PI3K/Akt信号通路在SONFH研究中的进展,包括信号通路的组成和传导机制,以及对成骨细胞、间充质干细胞、破骨细胞、BMECs等细胞的调控作用。同时,综述还探讨了中医对SONFH的认识和中药单体、复方在PI3K/Akt通路干预方面的应用。通过系统分析和整理这些研究成果,该文旨在为临床防治SONFH提供参考和方向,推动中医药在该领域的进一步发展。随着对PI3K/Akt通路的深入研究和中医药的现代化应用,预期将为SONFH患者带来更安全有效的治疗选择。Steroid-induced osteonecrosis of the femoral head(SONFH)is a severe musculoskeletal disorder often induced by the prolonged or excessive use of glucocorticoids.Characterized by ischemia of bone cells,necrosis,and trabecular fractures,SONFH is accompanied by pain,femoral head collapse,and joint dysfunction,which can lead to disability in severe cases.The pathogenesis of SONFH involves hormone-induced osteoblast apoptosis,bone microvascular endothelial cell(BMEC)apoptosis,oxidative stress,and inflammatory responses.The phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway plays a pivotal role in the development of the disease.Modulating the PI3K/Akt signaling pathway can promote Akt phosphorylation,thereby stimulating the osteogenic differentiation of bone marrow mesenchymal stem cells and osteoblasts,promoting angiogenesis in BMECs,and inhibiting osteoclastogenesis.The research on the treatment of SONFH with traditional Chinese medicine(TCM)has gained increasing attention.Recent studies have shown that TCM monomers and compounds have potential therapeutic effect on SONFH by intervening in the PI3K/Akt signaling pathway.These studies not only provide a scientific basis for the application of TCM in the treatment of SONFH but also offer new ideas for the development of new therapeutic strategies.This review summarized the progress in Chinese and international research on the PI3K/Akt signaling pathway in SONFH over the past five years.It involved the composition and transmission mechanisms of the signaling pathway,as well as its regulatory effects on osteoblasts,mesenchymal stem cells,osteoclasts,BMECs,and other cells.Additionally,the review explored the TCM understanding of SONFH and the application of TCM monomers and compounds in the intervention of the PI3K/Akt pathway.By systematically analyzing and organizing these research findings,this article aimed to provide references and point out directions for the clinical prevention and treatment of SONFH and promote further development of TCM in t

关 键 词：激素性股骨头坏死 磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt) 中药 机制 研究进展 

分 类 号：R2-0[医药卫生—中医学] R22R2-031R681R285.5