基于“肾主骨”理论的中药调控线粒体自噬防治骨质疏松症的研究进展

Research Progress on the Use of Traditional Chinese Medicine to Regulate Mitochondrial Autophagy and Prevent Osteoporosis Based on the Theory of “The Kidney Governs the Bones”

摘要: 目的：系统综述中医“肾主骨”理论指导下，中药调控线粒体自噬防治骨质疏松症的作用机制与研究进展，为中医药干预骨代谢疾病提供科学依据。方法：检索PubMed、CNKI、Bioscience、知网、万方、维普等国内外数据库，筛选相关文献，分析中药干预与线粒体自噬的关联性研究。结果：淫羊藿、骨碎补、补骨脂等单味中药提取物，以及左归丸、右归丸、八子补肾胶囊、补肾健脾方等中药复方，可通过PINK1/Parkin通路、ULK1/FUNDC1通路、HIF-1α/BNIP3通路等多靶点调节线粒体自噬，改善骨微环境，延缓骨量流失，促进成骨。其作用机制与“肾主骨”理论中补肾填精、健脾益气的治法高度契合。结论：中药调控线粒体自噬为骨质疏松症防治提供了新思路，但仍需进一步明确其作用靶点及临床转化路径。

Abstract: Objective: To systematically review the mechanisms and research progress of traditional Chinese medicine (TCM) in regulating mitochondrial autophagy to prevent and treat osteoporosis under the guidance of the TCM theory that “the kidney governs bones”, thereby providing a scientific basis for TCM intervention in bone metabolism disorders. Methods: Relevant literature was retrieved from domestic and international databases, including PubMed, CNKI, Bioscience, CNKI Knowledge Base, Wanfang, and VIP, with a focus on studies investigating the relationship between TCM interventions and mitochondrial autophagy. Results: Extracts of individual herbs, such as Lygodium japonicum, Achyranthes bidentata, and Psoralea corylifolia, as well as TCM compound formulations, such as Zuogui Wan, Yougui Wan, Bazibushen Capsule, and Bushen Jianshi Formula, can modulate mitochondrial autophagy through multiple pathways—including PINK1/Parkin, ULK1/FUNDC1, and HIF-1α/BNIP3—to improve the bone microenvironment, delay bone loss, and promote osteogenesis. These mechanisms align closely with the TCM therapeutic principles of “tonifying the kidney and replenishing essence” and “strengthening the spleen and enhancing qi”. Conclusion: TCM regulation of mitochondrial autophagy offers novel approaches for osteoporosis prevention and treatment; however, further clarification of its target mechanisms and clinical translation pathways is required.