黄芪及其活性成分治疗骨关节炎的研究现状  

Research Status of Huangqi(Astragali Radix)and Its Active Ingredients in Treatment of Osteoarthritis

作　　者：范元赫 杨永菊[2] 张宇[1] 郑曲 何璠玙 关雪峰 FAN Yuanhe;YANG Yongju;ZHANG Yu;ZHENG Qu;HE Fanyu;GUAN Xuefeng(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;Shenyang Pharmaceutical University,Shenyang 110016,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032 [3]沈阳药科大学,辽宁沈阳110016

出　　处：《中华中医药学刊》2025年第2期168-172,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(2021YFC1712800);辽宁省科技厅创新能力提升联合基金项目(2022-NLTS-13-02);辽宁省中医药科学院平台建设项目-地方科研基础条件和能力建设项目(2019JH6/10100002)。

摘　　要：黄芪性甘,微温,归脾肺经,是一种常见补气补血的中药材,近些年许多专家发现黄芪不单可以用于内科疾病的治疗,在治疗膝骨关节炎(Knee osteoarthritis,KOA)方面也有着良好的疗效。黄芪中多种主要有效成分如黄芪总皂苷、黄芪总黄酮、黄芪多糖等。经现代实验验证黄芪和这些有效成分在KOA的治疗中扮演着重要的角色,这些有效活性成分能降低体内或关节液中的炎性因子含量,也可减少氧化应激反应带来的消极作用,最终减轻软骨的降解,降低骨重塑和减轻滑膜的炎性病变或滑膜组织的纤维化,最终减轻了关节的形态学改变,起到了防治KOA的作用。这些有效成分经验证可以在Wnt/β-catenin、PI3K/AKT/mTOR、河马(Hippo)等信号通路的作用下,调节软骨细胞自身代谢,降低凋亡关键基因Bcl-2、Bax的表达,从而抑制软骨细胞凋亡;也可降低MMPs蛋白的表达,保护了软骨中的Ⅱ型胶原和聚集蛋白聚糖,进而预防了软骨的退变延缓了KOA的进展;通过搜集近10年关于黄芪及有效成分治疗KOA的文献进行总结,详细叙述黄芪及有效成分在治疗KOA中的作用及机制,为KOA治疗提供方向和依据。Huangqi(Astragali Radix)is sweet,slightly warm and its meridian tropism is spleen and lung meridians.It is a common herbal medicine to replenish Qi and blood.In recent years,many experts have found that Huangqi(Astragali Radix)can not only be used for the treatment of medical diseases,but also has a good effect in the treatment of knee osteoarthritis(KOA).There are many effective main components in Huangqi(Astragali Radix),such as Astragalus saponins,Astragalus flavones and Astragalus polysaccharides.Modern experiments have confirmed that Huangqi(Astragali Radix)and these active ingredients play an important role in the treatment of KOA.These active ingredients reduce the contents of inflammatory factors in the body or joint fluid,and also can reduce the negative effects of oxidative stress reaction,and ultimately reduce the degradation of cartilage,bone remodeling and inflammatory lesions of synovial tissue or fibrosis of synovial tissue.Finally,it alleviates the morphological changes of the joint and plays a role in preventing and treating KOA.These active ingredients have been proven to regulate chondrocyte metabolism and reduce the expressions of Bcl-2 and Bax,the key genes for apoptosis,under the action of Wnt/β-catenin,PI3K/AKT/mTOR,Hippo and other signaling pathways,thereby inhibiting the apoptosis of chondrocytes.It also can reduce the expressions of MMPs protein,protect typeⅡcollagen and agglutinoglycan in cartilage,and then prevent cartilage degeneration and delay the progression of KOA.This paper summarized the articles on Huangqi(Astragali Radix)and its active ingredients in the treatment of KOA in the past ten years,and described the role and mechanism of Huangqi(Astragali Radix)and its active ingredients in the treatment of KOA in detail,so as to provide direction and basis for the treatment of KOA.

关 键 词：黄芪 活性成分 膝骨关节炎 作用机制 

分 类 号：R285[医药卫生—中药学] R274.9[医药卫生—中医学]