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中药和肠道菌群双向串扰在抗骨质疏松症中的作用OA

Role of bidirectional interaction between TCM and gut microbiota in treatment of osteoporosis

中文摘要英文摘要

随着我国人口老龄化程度逐渐加重,骨质疏松症(OP)的患病率逐年增长,不仅严重影响患者生活质量,也给家庭和社会带来沉重的经济负担.尽管现代西医在抑制 OP 进展和缓解相关临床症状方面取得了一定成效,但由于药物不良反应及患者耐受性等问题,其整体治疗效果仍难以达到理想水平.所以寻求高效、安全且经济的防治策略成为当前 OP 临床与科研工作的迫切任务.近年来,随着微生物组学的深入研究,肠道菌群可以通过调节免疫系统、影响钙磷吸收和产生短链脂肪酸等多种机制调控骨骼的数量与质量,从而改善骨微环境.而中药作为传统医学的重要组成部分,具有多成分、多靶点的作用特点和整体调节的治疗优势.研究表明,中药可以有效改善骨密度、抑制骨吸收并促进骨形成,且其不良反应发生率较低,药性平和,在 OP 防治领域展现出独特的临床价值.与此同时,中药和肠道菌群之间还存在复杂的相互作用.一方面,中药活性成分可以调节肠道菌群的组成和结构,降低系统性炎症水平,最终改善骨代谢;另一方面,肠道菌群也可以代谢转化中药活性成分,提高其生物利用度,促进药效发挥.因此,本文通过系统综述肠道菌群和中药分别对 OP 产生的作用以及中药和肠道菌群双向串扰防治 OP 等途径,为临床治疗 OP 提供新的思路和依据.

With the progressive aging of the population in China,the incidence of osteoporosis(OP)is rising annually.This condition not only severely impacts patients' quality of life but also imposes a substantial economic burden on both families and the society.Although modern western medicine has achieved progress in inhibiting OP progression and alleviating associated clinical symptoms,its overall therapeutic efficacy remains suboptimal due to issues such as adverse drug reactions and patient tolerance.Consequently,developing efficient,safe,and cost-effective prevention and treatment strategies has become an urgent priority in current OP-related clinical and scientific research.In recent years,growing insights into the microbiome have revealed that the gut microbiota can regulate bone quantity and quality through multiple mechanisms,including immune modulation,calcium and phosphorus absorption,and the production of short-chain fatty acids,thereby improving the bone microenvironment.As an important component of traditional medicine,TCM is characterized by multi-component and multi-target effects,with therapeutic advantages in holistic regulation.Studies have shown that TCM can effectively improve bone mineral density,inhibit bone resorption,and promote bone formation,with a low incidence of adverse reactions and mild pharmacological effects,demonstrating its unique clinical value in the prevention and treatment of OP.Simultaneously,complex interactions exist between TCM and the gut microbiota.On the one hand,the active components of TCM can modulate the composition and structure of the gut microbiota,reduce systemic inflammation,and ultimately improve bone metabolism.On the other hand,the gut microbiota can metabolize and transform the active components of TCM,enhancing their bioavailability and promoting therapeutic efficacy.This article systematically reviews the roles of gut microbiota and TCM in OP,as well as the bidirectional interaction between TCM and gut microbiota in the prevention and treatment of OP,aiming to provide new insights and evidence for the clinical management of OP.

南懿琼;魏立伟;陈汝娜;郑旭霞;柴爽;有曼;张虹;秦娜

河南中医药大学 药学院,河南 郑州 450046河南省洛阳正骨医院(河南省骨科医院)运动医学关节镜科,河南 郑州 450016河南中医药大学 药学院,河南 郑州 450046河南省洛阳正骨医院(河南省骨科医院)药剂科,河南 郑州 450016河南省洛阳正骨医院(河南省骨科医院)骨髓炎科,河南 郑州 450016河南省洛阳正骨医院(河南省骨科医院)药剂科,河南 郑州 450016河南省洛阳正骨医院(河南省骨科医院)科研学科办,河南 郑州 450016河南省洛阳正骨医院(河南省骨科医院)药剂科,河南 郑州 450016

骨质疏松症肠道菌群中药双向串扰作用机制

osteoporosisgut microbiotaTCMbidirectional interactionmechanism of action

《中国中药杂志》 2026 (16)

4581-4593,13

国家自然科学基金面上项目(82174413)河南省中医药科学研究专项课题(20-21ZY1063)河南省卫健委中青年学科带头人项目(HNSWJW-2021016)河南省中医药科研专项联合共建项目(2025LHZX5002,2025LHZX5012,2025LHZX5045)洛阳市科技计划项目(2401112B,2401114B)

10.19540/j.cnki.cjcmm.20260504.801

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