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| 从“补肾活血”法探讨淫羊藿苷调节软骨细胞自噬治疗膝骨关节炎的研究进展 |
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钟吉崴1,2,3, 王继达1,2, 曹东东1,2, 刘琪1,2, 陈睿思1,2, 杜超1,2, 刘爱峰1,2
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1.天津中医药大学第一附属医院, 天津 300381;2.中医国家临床医学研究中心, 天津 300381;3.天津中医药大学, 天津 301617
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| 摘要: |
| 膝骨关节炎（KOA）是一种慢性退行性疾病，软骨细胞凋亡与自噬功能障碍是其关键病理特征。中医“肾虚血瘀”理论提供了独特的发病机制视角，淫羊藿苷（ICA）作为传统补肾中药淫羊藿核心成分，通过多靶点、多途径干预KOA。ICA不仅通过激活5’-腺苷酸活化蛋白激酶（AMPK）/哺乳动物雷帕霉素靶蛋白（mTOR）和沉默信息调节因子1（SIRT1）/AMPK信号轴调控自噬，还通过促进转录因子EB（TFEB）核转位增强自噬流，改善关节微环境，抑制铁死亡、氧化损伤和炎症反应，延缓软骨退变。其“补肾”与“活血”功效不仅符合中医理论，且已被体内外实验证实对膝关节软骨修复有效。文章综述了ICA在分子层面通过多靶点、多途径调节软骨细胞自噬治疗KOA的机制，分析其应用价值，旨在为ICA治疗KOA的未来临床研究提供理论依据。 |
| 关键词: 补肾活血 淫羊藿苷 软骨细胞 自噬 膝骨关节炎 分子机制 综述 |
| DOI：10.11656/j.issn.1672-1519.2026.07.15 |
| 分类号:R684.3 |
| 基金项目:国家自然科学基金面上项目（82474538）；现代中医药海河实验室科技项目（4022500051）。 |
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| Research progress on icariin in regulating chondrocyte autophagy for the treatment of knee osteoarthritis based on the “tonifying kidney and activating blood”theory |
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ZHONG Jiwei1,2,3, WANG Jida1,2, CAO Dongdong1,2, LIU Qi1,2, CHEN Ruisi1,2, DU Chao1,2, LIU Aifeng1,2
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1.First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China;2.National Clinical Research Center for Chinese Medicine, Tianjin 300381, China;3.Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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| Abstract: |
| Knee osteoarthritis（KOA）is a chronic degenerative disease，with chondrocyte apoptosis and autophagy dysfunction being the key pathological features. The traditional Chinese medicine theory of“kidney deficiency and blood stasis”offers a unique perspective on the pathogenesis. Icariin（ICA），the core component of the traditional kidney-tonifying herb Epimedium，intervenes in KOA through multiple targets and pathways. ICA not only regulates autophagy by activating the AMPK/mTOR signaling axes and SIRT1/AMPK signaling axes but also enhances autophagic flux by promoting TFEB nuclear translocation，improving the joint microenvironment，inhibiting ferroptosis，oxidative damage，and inflammatory responses，and delaying cartilage degeneration. Its “kidney tonification”and“blood activation”effects are in line with traditional Chinese medicine theory，and have been validated by in vitro and in vivo experiments in repairing knee joint cartilage. This review summarizes the mechanisms by which icariin（ICA） regulates chondrocyte autophagy through multiple targets and pathways at the molecular level for the treatment of knee osteoarthritis （KOA），analyzes its therapeutic potential，and aims to provide a theoretical basis for future clinical research on ICA in KOA. |
| Key words: tonifying kidney and promoting blood circulation icariin chondrocyte autophagy knee osteoarthritis molecular mechanism review |
