补肾活血汤在治疗骨伤科疾病中的应用及机制研究进展

Research Advances in the Application and Mechanisms of Bushen Huoxue Decoction for Treating Orthopedic Diseases

摘要: 补肾活血汤出自《伤科大成》，全方功效以补肾益精壮骨为主，兼有活血祛瘀止痛之力，主要用于治疗肝肾亏虚型、气滞血瘀型骨伤科相关基础疾病。近年来，补肾活血汤在临床上主要应用于膝骨关节炎、骨质疏松症、腰椎间盘突出症、股骨头坏死、骨折患者的治疗，并取得显著的临床疗效，同时认为其作用是通过对炎性因子、成骨细胞和破骨细胞、骨代谢标志物、椎间盘的影响而达成，涉及Toll样受体4/髓样分化因子88/核因子κB (TLR4/MyD88/NF-κB)、Wnt信号通路/β-连环蛋白(Wnt/β-catenin)、下调核因子κB受体活化因子配体/核因子κB受体活化因子/骨保护素(RANKL/RANK/OPG)等多条信号通路的调节。本研究通过查阅近5年内补肾活血汤治疗骨伤科疾病的相关文献，对补肾活血汤治疗骨伤科疾病的临床疗效、基础研究作一篇综述，并针对现有实验研究的不足进行探讨，以期完善补肾活血汤的作用机制网络，并推动其临床应用。

Abstract: Bushen Huoxue Decoction (Kidney-Tonifying and Blood-Activating Decoction) originates from the classical text “Shangke Dacheng” (Complete Works of Traumatology). The primary therapeutic effects of this formula focus on tonifying the kidneys, benefiting essence, and strengthening bones, while simultaneously promoting blood circulation, removing blood stasis, and alleviating pain. It is primarily indicated for treating orthopedic and traumatological conditions characterized by liver-kidney deficiency syndrome and qi stagnation-blood stasis syndrome. In recent years, Bushen Huoxue Decoction has been clinically applied in the treatment of knee osteoarthritis, osteoporosis, lumbar disc herniation, femoral head necrosis, and fracture, demonstrating significant clinical efficacy. Its therapeutic mechanisms are believed to be mediated through effects on inflammatory factors, osteoblasts and osteoclasts, bone metabolism markers, and intervertebral discs, involving the regulation of multiple signaling pathways including TLR4/MyD88/NF-κB, Wnt/β-catenin, and RANKL/RANK/OPG. This study reviews the relevant literature from the past five years on Bushen Huoxue Decoction in the treatment of orthopedic diseases, summarizes its clinical efficacy and basic research findings, and analyzes the limitations of existing experimental studies. The aim is to refine the mechanistic network of Bushen Huoxue Decoction and promote its clinical application.