摘要
肌肉减少症是一种进行性和全身性骨骼肌疾病,与胰岛素抵抗、炎症反应、肠道菌群、衰老等诸多因素相关,涉及PI3K/Akt、Wnt/β-catenin、Notch、NF-κB等多条信号通路,目前仍缺乏针对性药物。与临床常用激素类药物、降糖药物、ACEI类、抗炎类药物等相比,中医药疗效明显,且安全性更高。肌少症属“痿证”“虚劳”等范畴,主要责之于年老体衰、久病衰弱、饮食失宜、劳逸失常等多种原因,导致机体脏腑功能衰退,气血阴阳亏虚,或内生痰、湿、浊、瘀等病理产物,致使精髓气血等营养物质无以充盛肌肤,骨肉不相亲,日久发为本病。笔者通过综述相关文献发现,临床治疗方面多以调补肝、脾、肾为主,兼顾痰、湿、浊、瘀等病理产物,标本兼治;此外阳明学说、营卫理论等为肌少症的临床诊疗提供了不同的思路。诸多临床及实验研究均证实,中药、针灸、导引等中医药手段能够改善骨代谢,促进骨量、骨微结构以及肌细胞的增殖分化,改善胰岛素抵抗、线粒体功能障碍、炎症反应、氧化应激等过程,延缓骨质丢失和肌肉萎缩,甚至促进骨骼肌质量和力量的增加,从而改善、预防肌肉减少症的发生和发展。其中,熊果酸、Omega-3、鸢尾素等具有潜在应用价值。
Sarcopenia is a progressive and systemic skeletal muscle disease associated with various factors such as insulin resistance,inflammatory response,gut microbiota,and aging.It involves multiple signaling pathways including PI3K/Akt,Wnt/β-catenin,Notch,and NF-κB.Currently,there is still a lack of targeted drugs.In comparison to commonly used clinical drugs such as steroids,hypoglycemic agents,ACE inhibitors,and anti-inflammatory drugs,traditional Chinese medicine(TCM)has shown significant efficacy and higher safety.Sarcopenia belongs to the categories of"Wei syndrome"or"deficiency-consumption",etc.,in TCM theory,mainly attributed to factors such as aging,chronic illness,improper diet,and irregular lifestyle,leading to the decline of organ functions,deficiency of qi,blood,yin,and yang,or the production of pathological products such as phlegm,dampness,turbidity,and stasis,resulting in insufficient nutrition to nourish the muscles and unwell-connection between bones and muscles,eventually leading to the onset of this disease.Through literature review,it was found that clinical treatment mainly focuses on regulating and tonifying the liver,spleen,and kidneys,while also addressing pathological products such as phlegm,dampness,turbidity,and stasis,treating both the root cause and the symptoms.In addition,theories such as Yangming and nutrient and defense provide different perspectives for the clinical diagnosis and treatment of sarcopenia.Many clinical and experimental studies have confirmed that traditional Chinese medicine methods such as Chinese herbal medicine,acupuncture,and guidance can improve bone metabolism,promote bone mass and microstructure,proliferation,and differentiation of muscle cells,improve insulin resistance,mitochondrial dysfunction,inflammatory response,oxidative stress,delay bone loss and muscle atrophy,and even promote the increase of muscle mass and strength,thereby improving and preventing the occurrence and development of sarcopenia.Among them,ursolic acid,Omega-3,and irisin have potential app
作者
华健
崔德芝
HUA Jian;CUI Dezhi(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)
出处
《中医药信息》
2024年第9期80-84,89,共6页
Information on Traditional Chinese Medicine
基金
山东省中医药科技项目(2020M011)。
关键词
肌肉减少症
发病机制
衰弱
中医药疗法
痿证
虚劳
Sarcopenia
Pathogenesis
Weakness
Traditional Chinese medicine therapy
Wei syndrome
Deficiency-consumption
