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| 基于“脏腑理论”探讨PMOP骨-脂代谢关联机制研究 |
| Research progress in the bone-fat metabolism mechanism in postmenopausal osteoporosis based on the Zang-Fu theory in traditional Chinese medicine |
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| DOI：10.3969/j.issn.1006-7108.2026.07.013 |
| 中文关键词: 绝经后骨质疏松 脏腑理论 骨—脂代谢 骨髓间充质干细胞 |
| 英文关键词:postmenopausal osteoporosis Zang-Fu theory bone–fat metabolism bone marrow mesenchymal stem cells |
| 基金项目:国家自然科学基金项目（82074416，82305350）；湖北省中医药创新发展联合基金项目（2022CFD153，2024AFD296）；湖北省卫生健康委中医药科研项目中医药联合基金项目（ZY2025L222）；第七批全国老中医药专家学术经验继承项目工作（国中医药人教函2022-76号）；湖北省卫生和计划生育委员会湖北中医大师名师评选暨工作室建设工作项目（鄂卫生计生办通[2018]32号） |
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| 中文摘要: |
| 绝经后骨质疏松症（postmenopausal osteoporosis，PMOP）是由雌激素水平下降引起的慢性代谢性骨病，伴随脂质代谢紊乱，严重影响中老年女性的健康。近年来，研究发现骨与脂肪代谢密切相关，二者在骨髓微环境中的相互作用成为PMOP的关键机制之一。骨髓间充质干细胞（BMSCs）向成骨与成脂方向的分化失衡被认为是该疾病的核心病理过程。传统中医学认为，PMOP与肾精不足、肝脾失调密切相关，强调“肾主骨”“脾主运化”“肝藏血主筋”等脏腑功能失衡所致骨质疏松和脂代谢紊乱。中医药在调节骨脂代谢、恢复骨脂平衡方面展现出独特优势。越来越多的研究表明，中药能通过多靶点、多通路的调控作用改善PMOP及脂代谢异常。本综述系统总结了骨-脂代谢相互作用机制，并从中医“肾—脾—肝”三脏理论角度解析其在PMOP中的病理特征，探讨中药干预骨—脂代谢轴的研究进展，旨在为中西医结合治疗提供理论依据与研究框架。 |
| 英文摘要: |
| Postmenopausal osteoporosis (PMOP) is a chronic metabolic bone disease caused by the decline in estrogen levels and is often accompanied with lipid metabolism disorders, posing a significant threat to the health of middle-aged and elderly women. Recent studies have revealed a close relationship between bone and lipid metabolism, with their interactions within the bone marrow microenvi-ronment emerging as a key mechanism underlying PMOP. The imbalance in the differentiation of bone marrow mesenchymal stem cells (BMSCs) toward osteogenic and adipogenic lineages is considered a core pathological process of this disease. Traditional Chinese medicine (TCM) at-tributes PMOP to deficiencies in the kidney essence and dysfunctions of the liver and spleen, emphasizing that imbalances in the visceral functions—such as the kidney governs bone, the spleen governs transformation and transportation, and the liver stores blood and governs the ten-dons—contribute to osteoporosis and lipid metabolic disorders. TCM demonstrates unique ad-vantages in regulating bone-lipid metabolism and restoring homeostasis. In recent years, an in-creasing number of studies have shown that Chinese herbal medicine ameliorates PMOP and lipid metabolism abnormalities through multi-target and multi-pathway regulation. This review sys-tematically summarizes the mechanisms underlying bone-lipid metabolic interactions and analyzes the pathological features of PMOP from the TCM theory of the kidney-spleen-liver tri-viscera system. Furthermore, it discusses recent advances in Chinese medicine interventions targeting the bone-lipid metabolic axis, aiming to provide a theoretical basis and research framework for the integration of traditional Chinese medicine and Western medicine in PMOP treatment. |
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