中医药调节 PI3K/Akt 信号通路干预激素性股骨头坏死研究进展  

Research Progress of the Intervention of Steroid-induced Osteonecrosis of the Femoral Head by Traditional Chinese Medicine Through Regulating the PI3K/Akt Signaling Pathway

作　　者：焦勇皓 安玉芳 JIAO Yonghao;AN Yufang(Heilongjiang Academy of Traditional Chinese Medical Sciences,Harbin,Heilongjiang,China,150040)

机构地区：[1]黑龙江省中医药科学院,黑龙江哈尔滨150040

出　　处：《河南中医》2025年第3期463-470,共8页Henan Traditional Chinese Medicine

摘　　要：PI3K/AKT信号通路在激素性股骨头坏死(steroid-induced necrosis of femoral head,SANFH)的防治中发挥着重要作用,该通路通过激活一系列细胞信号分子,能够有效地促进成骨细胞生成新的骨骼组织,同时抑制破骨细胞的活性和分化过程,从而维持骨质平衡。目前,临床治疗SANFH常用的单味中药有大蒜、葛根、淫羊藿、黄芪、红景天、骨碎补、银杏叶等;中药复方有鹿角胶丸、续断散加当归、骨碎补、骨蚀方、骨坏死康复丸、补正续骨丸等。中医药通过调节PI3K/Akt信号通路治疗SANFH已有相关研究,但其具体机制尚未明确,且存在诸多问题:(1)对于中医药治疗SANFH的机理和疗效评价体系尚不完善,缺乏足够的科学证据支持其作为一线治疗方法;(2)由于中药成分复杂,如何精确量化其在治疗过程中的作用仍然是一大难题;(3)中医个体化用药方案也要因病制宜,才能更好地发挥疗效。今后,需继续挖掘中医药治疗SANFH的优势和潜力,为临床防治SANFH提供新的理论依据。The PI3K/AKT signaling pathway plays a significant role in the prevention and treatment of steroid-induced necrosis of the femoral head(SANFH).By activating a series of cellular signaling molecules,this pathway can effectively promote the generation of new bone tissue by osteoblasts,while simultaneously inhibit the activity and differentiation process of osteoclasts,thereby maintaining bone mass balance.At present,the commonly used single Chinese medicines for the clinical treatment of SANFH include Dasuan(Bulbus Allii),Gegen(Radix Puerariae Lobatae),Yinyanghuo(Herba Epimedii),Huangqi(Radix Scutellariae),Hongjingtian(Herba Rhodiolae),Gusuibu(Rhizoma Drynariae),Yinxingye(Folium Ginkgo),etc.The commonly used Chinese medical compound formulas include Himalayan Teasel Root Powder with Danggui(Radix Angelicae Sinensis),and Gusuibu(Rhizoma Drynariae),Gushi Formula,Necrosis of Femoral Head Rehabilitation Pills,Himalayan Teasel Root Pills for Supplementing Original Qi,etc.There have been relevant studies on the treatment of SANFH through regulating the PI3K/Akt signaling pathway with TCM,but the specific mechanism remains unclear and there are still many problems:Firstly,the mechanism and efficacy evaluation system of TCM in treating SANFH are not yet perfect,and there is a lack of sufficient scientific evidence to support it as the first-choice treatment.Secondly,due to the complex composition of Chinese medicinals,how to precisely quantify its role in the treatment process remains a major challenge.In addition,individualized treatment plans in TCM should also be adapted to the specific disease to better exert their therapeutic effects.In the future,it is necessary to continue to explore the advantages and potential of TCM in treating SANFH to provide new theoretical basis for the clinical prevention and treatment of SANFH.

关 键 词：激素性股骨头坏死 PI3K/AKT信号通路 中药提取物 中药复方 

分 类 号：R274.981.8[医药卫生—中西医结合]