代谢微环境探讨健脾补肾方治疗男性骨质疏松的机制  

Exploring the mechanism of Jianpi Bushen Recipe in treating male osteoporosis based on metabolic microenvironment

作　　者：孙杰[2] 郭杨[2] 李晓锋[1,4] 薛纯纯 马勇[2] 李沐哲 唐德志[3] 笪巍伟 施杞[1,4] SUN Jie;GUO Yang;LI Xiaofeng;XUE Chunchun;MA Yong;LI Muzhe;TANG Dezhi;DA Weiwei;SHI Qi(The Affiliated Traditional Chinese Medical Hospital of Shanghai Traditional Chinese Medical University,Shanghai 200071,China;Nanjing Traditional Chinese Medical University,Nanjing 210023,China;The Affiliated Longhua Hospital of Shanghai Traditional Chinese Medical University,Shanghai 200032,China;Shiqiming Traditional Chinese Medicine Studio,Shanghai 200007,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]南京中医药大学,江苏南京210023 [3]上海中医药大学附属龙华医院,上海200032 [4]施杞名中医传承工作室,上海200071

出　　处：《中国骨质疏松杂志》2025年第3期374-381,423,共9页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金项目(82374471,81904229);上海医学创新发展基金会中医药科技发展项目(WL-HBMS-2022001K);上海中医药大学附属医院“临床研究型骨干人才培养计划”(2023LCRC16);上海医学创新发展基金会中医药传承发展项目(WLJH2021ZY-GZS001,ZLZX001)。

摘　　要：目的基于骨-糖脂代谢微环境探讨健脾补肾方治疗男性骨质疏松的作用机制。方法通过网络药理学分析健脾补肾方治疗男性骨质疏松的潜在作用机制;建立60只雄性小鼠骨质疏松模型,随机分配为假手术组、模型组、中药组、十一酸睾酮组,并利用生理盐水、健脾补肾方、十一酸睾酮进行干预,8周后分析骨微结构、生物力学、骨代谢及糖脂代谢等指标。结果KEGG富集分析提示健脾补肾方有效成分主要涉及AGE-RAGE信号通路、脂质和动脉粥样硬化通路。与模型组相比,中药组HE染色可见骨小梁数量增加,骨髓腔内脂肪空泡数量减少;BMD增加(P<0.05),BV/TV、Tb.Th、Tb.N显著升高(P<0.01),Tb.Sp显著降低(P<0.01);三点弯曲实验显示断裂能量显著提高(P<0.01),刚度、最大挠度增加(P<0.05),但最大载荷差异无统计学意义(P>0.05);同时,血清TC、TG、LDL、FFA、胰岛素以及ALP、TRAP、β-CTX水平均显著降低(P<0.01),HDL、IGF-1及OCN水平显著升高(P<0.01)。结论健脾补肾方能够有效改善雄性去势小鼠的高骨转换状态,恢复骨形成和骨吸收的平衡,并可能通过调节糖脂代谢的异常水平,协同改善骨微结构、提高骨密度,从而达到治疗男性骨质疏松的作用。Objective To explore the molecular mechanism of Jianpi Bushen recipe in the treatment of male osteoporosis,focusing on the bone-glucolipid metabolic microenvironment.Methods The potential mechanism of Jianpi Bushen recipe in treating male osteoporosis was analyzed through network pharmacology.An osteoporosis model was established in 60 male mice.Mice were randomly assigned into four groups:sham operation group,model group,traditional Chinese medicine(TCM)group,and testosterone undecanoate(TU)group.The interventions included Jianpi Bushen recipe,testosterone undecanoate,and normal saline.After 8 weeks,bone microstructure,biomechanics,bone metabolism,glucose and lipid metabolism,and other indicators were analyzed.Results KEGG enrichment analysis indicated that the active ingredients of Jianpi Bushen recipe were mainly involved in the AGE-RAGE signaling pathway and lipid and atherosclerosis pathways.Compared to that in the model group,HE staining in the TCM group showed an increase in the number of bone trabeculae and a decrease in the number of fat vacuoles in the bone marrow cavity.BMD increased(P<0.05),and BV/TV,Tb.Th,and Tb.N significantly increased(P<0.01),while Tb.Sp significantly decreased(P<0.01).The three-point bending experiment showed a significant increase in fracture energy(P<0.01),stiffness,and maximum deflection(P<0.05),but there was no statistical difference in maximum load(P>0.05).Serum levels of TC,TG,LDL,FFA,insulin,ALP,TRAP,andβ-CTX reduced significantly(P<0.01),while HDL,IGF-1,and OCN levels increased significantly(P<0.01).Conclusion Jianpi Bushen recipe effectively improves the high bone turnover state in male ovariectomized mice,promoting a balance between bone formation and bone resorption.It may also synergistically improve bone microstructure and increase bone mineral density by regulating abnormal glucose and lipid metabolism levels,thereby achieving the effect of treating male osteoporosis.

关 键 词：男性骨质疏松 雄性激素 健脾补肾方 骨代谢 糖脂代谢 

分 类 号：R336[医药卫生—人体生理学]