| 摘要: |
| 骨质疏松症是以骨量减少和骨微结构退化为特征的全身性骨病，早期防治具有重要的临床价值。近年来，“肠-骨轴”理论揭示了肠道微生物群通过短链脂肪酸（SCFAs）、免疫调节与内分泌信号等途径调控骨代谢的重要作用，为骨质疏松的防治提供了新思路。中医认为“肾主骨，生髓”，骨质疏松病机以肾虚为本，血瘀为标，临床常用补肾活血中药治疗，疗效明确。文章系统综述了补肾活血中药通过调控“肠-骨轴”治疗骨质疏松的机制，包括修复肠道屏障、调节菌群结构、促进有益代谢物生成、抑制炎症反应与氧化应激，并直接或间接调控Wnt/β-连环蛋白（β-catenin）、骨保护素（OPG）/核因子-κB受体活化因子配体（RANKL）/核因子-κB受体活化因子（RANK）、骨形态发生蛋白（BMP）/Smad等骨代谢关键信号通路，从而协同促进成骨、抑制破骨，恢复骨稳态。研究表明，杜仲、淫羊藿、骨碎补、黄芪等代表性药物具有多成分、多靶点、整体调节的特点。未来应深入开展临床验证、剂型优化及多组学机制研究，进一步推动补肾活血中药在骨质疏松治疗中的现代化与精准化应用。 |
| 关键词: 骨质疏松症 肠-骨轴 补肾活血 中医药 肠道微生物群 |
| DOI：10.11656/j.issn.1672-1519.2026.07.16 |
| 分类号:R681.1 |
| 基金项目:云南省社科联-云南中医药大学联合专项（LHZX202423）：云南省科技人才与平台计划（院士专家工作站）（202305AF150151）。 |
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| Systematic mechanisms and pathways of Bushen Huoxue Chinese herbal medicine in regulating the“gut-bone axis”for prevention and treatment of osteoporosis |
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DONG Jiahao1, CHEN Tao2, YU Weijie2, PENG Zhongyu2, LONG Yuan1, XIA Yifeng1
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1.The First Clinical Medical College, Yunnan University of Chinese Medicine, Kunming 650500, China;2.Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming 650021, China
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| Abstract: |
| Osteoporosis（OP）is a systemic bone disease characterized by reduced bone mass and degradation of bone microstructure， for which early prevention and treatment hold significant clinical value. In recent years，the“gut-bone axis”theory has revealed the crucial role of gut microbiota in regulating bone metabolism through pathways such as short-chain fatty acids（SCFAs），immune modulation，and endocrine signaling，offering novel insights for the prevention and treatment of osteoporosis. Traditional Chinese medicine（TCM）posits that“the kidney governs the bones and generates marrow”with the pathogenesis of osteoporosis rooted in kidney deficiency and manifested by blood stasis. Clinically，Bushen Huoxue Chinese herbal medicines are commonly employed with established therapeutic efficacy. This article systematically reviews the mechanisms by which Bushen Huoxue herbal medicines treat osteoporosis through the regulation of the“gut-bone axis，”including repairing the intestinal barrier，modulating microbial community structure，promoting the generation of beneficial metabolites，and suppressing inflammatory responses and oxidative stress. Furthermore，they directly or indirectly regulate key bone metabolic signaling pathways such as Wnt/β-catenin，OPG/RANKL/RANK， and BMP/Smad，thereby synergistically promoting osteogenesis，inhibiting osteoclastogenesis，and restoring bone homeostasis. Studies indicate that representative herbs such as Eucommia ulmoides Oliv.，Epimedium brevicornu Maxim.，Drynaria fortunei（Kunze）J. Sm.， and Astragalus membranaceus（Fisch.）Bunge. exhibit characteristics of multi-component，multi-target，and holistic regulation. Future research should deepen clinical validation，formulation optimization，and multi-omics mechanistic studies to further advance the modernization and precision application of Bushen Huoxue herbal medicines in the treatment of osteoporosis. |
| Key words: osteoporosis gut-bone axis Bushen Huoxue traditional Chinese medicine gut microbiota |
