杜仲化学成分、药理作用和临床应用研究进展

杜仲Eucommia ulmoides是我国特有的珍稀濒危二类保护植物,其皮、叶、雄花和种子均具有药用价值和食用价值。化学成分研究发现杜仲不同部位（皮、叶、雄花、种子）主要有木脂素类、环烯醚萜类、黄酮类、苯丙素类、萜类和甾体类等成分,具有抗骨质疏松、抗炎、神经保护、降血压、降血糖、调血脂、免疫调节、抗菌、抗病毒等药理作用,广泛应用在医药、保健食品、饲料添加剂及日化用品等多个领域。通过对2000年1月—2022年12月在中国知网（CNKI）和PubMed数据库中发表的杜仲文献进行检索,共检索到相关文献1772篇,其中有效文献188篇。综述了杜仲在化学成分、药理作用、临床研究和开发应用方面的研究进展,为后续杜仲的临床应用及相关产品开发提供参考。     

An update on therapies for the treatment of diabetes-induced osteoporosis

Introduction: Currently, 424 million people aged between 20 and 79 years worldwide are diabetic. More than 25% of adults aged over 65 years in North America have Type 2 diabetes mellitus (DM). Diabetes-induced osteoporosis (DM-OS) is caused by chronic hyperglycemia, advanced glycated end products and oxidative stress. The increase in the prevalence of DM-OS has prompted researchers to develop new biological therapies for the management of DM-OS.

Areas covered: This review covered the current and novel biological agents used in the management of DM-OS. Data were retrieved from PubMed, Scopus, American Diabetes Association and International Osteoporosis Foundation websites, and ClinicalTrials.gov. The keywords for the search included: DM, osteoporosis, and management.

Expert opinion: Several biological molecules have been examined in order to find efficient drugs for the treatment of DM-OS. These biological agents include anti-osteoporosis drugs: net anabolics (parathyroid hormone/analogs, androgens, calcilytics, anti-sclerostin antibody), net anti-resorptive osteoporosis drugs (calcitonin, estrogen, selective estrogen receptor modulators, bisphosphonates, RANKL antibody) and anti-diabetic drugs (alpha glucosidase inhibitors, sulfonylureas, biguanides, meglitinides, thiazolidinediones, GLP-1 receptor agonists, dipeptidylpeptidase-4 inhibitors, sodium glucose co-transporter-2 inhibitors, insulin). Biological medications that effectively decrease hyperglycemia and, at the same time, maintain bone health would be an ideal drug/drug combination for the treatment of DM-OS.     

锁阳药理作用的研究进展

锁阳为我国传统补肾类中药,是锁阳科植物锁阳Cynomorium songaricum Rupr.的肉质茎。锁阳中含有多种化学成分,具有增强组织耐低氧能力、抗疲劳、保肝护肝、抗骨质疏松及对神经系统的保护等多种药理作用。综述了锁阳药理作用的研究进展,为今后锁阳的进一步研究提供参考。     

In Vitro Anti-Osteoporosis Properties of Diverse Korean Drynariae rhizoma Phenolic Extracts

Drynariae rhizoma has been used to prevent bone loss that occurs with increasing age. However, the chemical compounds in extracts that act on bone metabolism in herbal medicine are poorly understood. This study aimed to investigate and compare the extraction efficacy of polyphenolic compounds, antioxidant activity, and in vitro anti-osteoporosis properties of water extract (DR-DW) and ethanol extract (DR-EtOH) from D. rhizoma. Total phenolics and flavonoids were better extracted with 70% EtOH, and this extraction method also resulted in higher antioxidant activity and in vitro anti-osteoporosis properties in these extracts. In particular, the contents of phloroglucinol, protocatechuic acid ethyl ester, 2-amino-3,4-dimethyl-benzoic acid, 3-(3,5-dimethyl-pyrazol-1-yl)-benzoic acid, chlorogenic acid, syringic acid, trans-ferulic acid, (−)-epigallocatechin, epigallocatechin gallate, quercetin dehydrate, luteolin and emodin in DR-EtOH were higher than those in DR-DW. These results indicated that DR-EtOH could be a good source of natural herbs with anti-osteoporosis properties.     

抗骨质疏松药物对骨质疏松症患者糖代谢、脂代谢的影响

骨质疏松症与心血管疾病已成为影响中老年人健康与生活质量的重要原因。研究发现糖代谢、脂代谢可以与骨代谢相互影响,而糖脂代谢异常可致心血管风险增高。目前现有研究发现抗骨质疏松药物可以影响心血管事件的发生,但关于其风险因素的研究却较少。因此,本文拟通过综述抗骨质疏松药物对患者糖代谢、脂代谢的影响,探讨抗骨质疏松药物非骨骼方面的益处和危害,使患者在控制骨折风险的同时,对心血管疾病进行管理,从而改善患者的整体状况。     

老年人骨质疏松性桡骨远端骨折的临床体会

目的：探讨手法整复小夹板外固定结合抗骨质疏松疗法治疗骨质疏松性桡骨远端骨折的临床效果。方法：采用手法整复小夹板外固定结合抗骨质疏松疗法治疗骨质疏松性桡骨远端骨折67例。结果：术后随访6～12个月,关节功能疗效按Gadand与Werley评分标准,优45例,良12例,可6例,差4例,全部病例均无皮肤破损、神经血管损伤等并发症。结论：手法整复小夹板外固定结合抗骨质疏松疗法是治疗骨质疏松性桡骨远端骨折合理有效的一种方法。     

红芪活性组分抗骨质疏松作用的谱效关系研究

目的研究红芪抗骨质疏松药效与HPLC指纹图谱的相关性。方法建立去卵巢大鼠所致骨质疏松模型,红芪(S1)的不同提取部位ig给药,选择红芪抗骨质疏松活性最强的提取部位。采用HPLC法建立10批不同产地红芪乙醇提取部位指纹图谱,获取相应的药效数据,运用偏最小二乘法,进行相关性分析。将筛选出的活性物质单体作用于成骨细胞,验证其抗骨质疏松活性。结果红芪乙醇提取部位抗骨质疏松药效最强。经过相关性分析,该组分指纹图谱共确定9个共有峰,鉴定出的3种化合物中,腺苷、毛蕊异黄酮与药效呈正相关,芒柄花苷与药效呈负相关。体外验证实验结果表明毛蕊异黄酮可以提高成骨细胞碱性磷酸酶(ALP)活性。结论红芪抗骨质疏松作用是其所含各种成分共同作用的结果,腺苷、毛蕊异黄酮对药效有一定的贡献,且毛蕊异黄酮有促进成骨细胞分化的作用。     

覆盆子化学成分的分离鉴定及其新型大麻素2型受体激动剂的筛选和抗骨质疏松作用评价

目的 以大麻素2型受体（cannabinoid receptor type 2,CB2R）为靶点,从补肾中药覆盆子中分离、鉴定、筛选得到具有激动CB2R的激动剂,并探讨其抗骨质疏松作用的机制。方法 以激动CB2R活性为导向进行分离并筛选,采用正相硅胶柱色谱、凝胶柱色谱、大孔树脂、重结晶和半制备型高效液相色谱对二氯甲烷层和醋酸乙酯层浸膏进行分离,结合化合物理化性质和核磁共振波谱对分离得到的化合物进行结构鉴定。通过双荧光素酶方法筛选出具有可特异性激动CB2R的化合物,并通过测定转染CB2R的人胚胎肾细胞HEK293-CB2内环磷酸腺苷（cyclic adenosine monophosphate,c AMP）积聚水平和CB2R蛋白表达情况来验证筛选的化合物对CB2R的特异性激动活性,最后评价筛选得到的化合物对破骨细胞骨代谢方面的调节作用。结果 以激动CB2R为活性导向进行分离和筛选,共得到24个化合物,分别鉴定为山柰酚（1）、木犀草苷（2）、银椴苷（3）、金丝桃苷（4）、橙皮素（5）、刺芒柄花素（6）、槲皮素（7）、对羟基苯甲酸（8）、迷迭香酸（9）、对羟基苯甲酸乙酯（10）、水杨酸（11...     

淫羊藿、女贞子抗骨质疏松症的应用与机制研究进展

对中药淫羊藿、女贞子抗骨质疏松症(OP)的作用机制及临床应用的相关研究进行文献整理和分析。通过中国知网和Pubmed检索工具,以淫羊藿、女贞子、抗骨质疏松为主题词检索近5年的相关文献,筛选整理后对淫羊藿、女贞子的抗OP作用进行介绍。分别概述了淫羊藿、女贞子防治OP的临床应用报道,并对二药抗OP作用机制的相关研究进展进行了分析。淫羊藿、女贞子在防治OP方面具有显著疗效,但开发研究尚处于初级阶段,复方制剂远期疗效尚不明确且未闻淫羊藿、女贞子配伍抗OP作用的相关报道。研究初步证实,二药配伍用于临床防治OP具有广阔的前景。     

Oleanolic acid derivatives for pharmaceutical use: a patent review

Introduction: Oleanolic acid belongs to the pentacyclic triterpene family. In China, oleanolic acid has been used as an over the counter (OTC) hepatoprotective drug for decades. Oleanolic acid and its derivatives present a wide variety of biological activities, supporting their pharmaceutical uses for multiple diseases.

Areas covered: Representative patent publications (1971-2015) covering the preparation, pharmaceutical compositions, and medical uses of oleanolic acid and its derivatives are analyzed, with focus on their anticancer, anti-osteoporosis, anti-obesity, anti-diabetic, lipid-lowering, anti-inflammatory, antioxidant, immune-regulatory, and hepatoprotective effects. A large number of Chinese patents have been given particular attention in this review.

Expert opinion: Detailed efficacy studies are highly worth doing to undoubtedly confirm the clinical potential of oleanolic acid and its derivatives. Based on that, it would be critical to identify the key protein targets of the drugs so as to promote drug development and search for new lead compounds. Together, there is a huge potential for drug-repositioning of oleanolic acid, particularly in the areas of metabolic disease and immunological disorders.