淫羊藿的临床应用及作用机制
Clinical Application and Mechanism of Epimedium
DOI: 10.12677/TCM.2022.112028, PDF,    科研立项经费支持
作者: 邹亚楠：河北大学中医学院，河北 保定；天津中医药大学第一附属医院，天津；余丞浩：辽宁中医药大学，辽宁 沈阳；赵汉青*：河北大学中医学院，河北 保定
关键词: 淫羊藿；临床应用；作用机制；综述；Epimedium； Clinical Application； Mechanism of Action； Review
摘要: 淫羊藿是传统补阳类中药，味辛、甘，性温，具有补肾壮阳，祛风除湿等功效，中医常用以治阳痿遗精，小便淋沥，筋骨痿软，风湿痹痛，麻木拘挛等。淫羊藿的主要化学成分包括黄酮类、木脂素类、多糖类等。现代药理学研究表明淫羊藿对骨代谢、免疫系统、神经–内分泌系统有调节作用，并具有抗炎、抗氧化、抗肿瘤等药理活性，临床常以成方制剂或中药处方形式治疗骨骼、内分泌、生殖、循环等系统疾病及肿瘤疾病。本研究通过分析和总结近十年国内外淫羊藿相关研究文献，对淫羊藿临床应用及作用机制进行综述，以期为淫羊藿进一步研究和开发应用提供参考。
Abstract: Epimedium is a kind of Chinese medicine with pungent taste, sweet taste and warm nature, which has the effects of tonifying the kidney and strengthening yang, dispelling wind and removing dampness. It is commonly used in treatment of impotence, spermatorrhea, urination, muscle weakness, rheumatism arthralgia, numbness and contracture and so on. The main chemical constituents of Epimedium include flavonoids, lignans and polysaccharides. Modern pharmacological studies show that Epimedium can regulate bone metabolism, immune system, neuroendocrine system, and has anti-inflammatory, antioxidant, anti-tumor and other pharmacological activities. Clinical treatment of bone, endocrine, reproductive, circulatory and other systemic diseases and tumor diseases is often carried out in the form of prescription preparation or traditional Chinese medicine prescription. This paper reviews the clinical application and mechanism of Epimedium by analyzing and summarizing the relevant research literature of Epimedium at home and abroad, in order to provide reference for further research and development of Epimedium.
文章引用：邹亚楠, 余丞浩, 赵汉青. 淫羊藿的临床应用及作用机制[J]. 中医学, 2022, 11(2): 167-175. https://doi.org/10.12677/TCM.2022.112028

参考文献

[1] 国家药典委员会. 中华人民共和国药典一部[S]. 北京: 中国医药科技出版社, 2020: 340.
[2] 刘海燕. 中药淫羊藿治疗骨质疏松症的临床观察[J]. 内蒙古中医药, 2019, 38(1): 16-17.
[3] 代轶楠, 向楠, 周广文. 淫羊藿胶囊对绝经后骨质疏松患者骨密度及骨代谢标志物的影响[J]. 湖北中医杂志, 2016, 38(12): 3-5.
[4] 朱贵忱, 刘明雨, 才智, 孙利锋, 宋雪花. 淫羊藿联合钙尔奇D治疗老年骨质疏松症临床观察[J]. 河北医药, 2014, 36(2): 183-184.
[5] 卢敏, 王林华, 罗毅文, 葛继荣, 高书图, 陈久毅, 等. 淫羊藿总黄酮胶囊治疗原发性骨质疏松症360例的多中心临床观察[J]. 中国骨质疏松杂志, 2013, 19(3): 279-282.
[6] 周金良, 毛晓明, 李慧英. 淫羊藿方治疗早中期激素性股骨头坏死的临床观察[J]. 生物技术世界, 2015(7): 144.
[7] 高利峰, 廖文胜, 高冠民, 侯秀伟. 仙灵骨葆胶囊对激素性股骨头坏死患者血液高凝状态的早期干预[J]. 中国医药指南, 2013, 11(36): 523-525.
[8] 蓝培桂. 淫羊藿用于治疗精液异常男性不育症的疗效[J]. 中国实用医药, 2018, 13(13): 127-128.
[9] 冼峰. 淫羊囊治疗精液异常男性不育症临床疗效观察[J]. 环球中医药, 2013, 6(S1): 60-61.
[10] 张士更, 吕伯东, 陈世涛, 黄晓军. 淫羊藿苷复合物与利多卡因凝胶治疗原发性早泄的临床对比研究[J]. 中华中医药学刊, 2012, 30(4): 727-730.
[11] 庄璘, 万焕真. 脱水淫羊藿素同系物治疗男性勃起功能障碍的临床观察[J]. 中国性科学, 2013, 22(4): 58-60.
[12] 林家冉, 唐爽, 柳红芳. 淫羊藿、人参、附子治疗阳光不足型抑郁状态经验——仝小林三味小方撷萃[J]. 吉林中医药, 2020, 40(3): 296-298.
[13] 林昱, 李永慧, 邱财荣, 杨来启, 杨喜民. 补肾解郁方配合西药治疗抑郁症126例[J]. 陕西中医, 2014, 35(10): 1345-1346.
[14] 龙小平. 二仙汤加减对围绝经期抑郁症患者症状及内分泌指标改善的疗效分析[J]. 四川中医, 2018, 36(8): 169-172.
[15] 郭亚平, 吕本强. 生脉饮合淫羊藿治疗缓慢性心律失常的临床研究[J]. 时珍国医国药, 2007, 18(3): 686-687.
[16] 吴同和, 刘亚洋, 徐素娥, 李宝同, 李鹤, 乙伶. 降脂胶囊联合小剂量辛伐他汀对冠心病心绞痛合并高脂血症的影响[J]. 中国中西医结合杂志, 2012, 32(10): 1428-1429.
[17] 武继涛, 王维峰, 王丹. 补肾活血方联合西药治疗脑卒中高危人群颈动脉粥样硬化斑块30例[J]. 中医研究, 2017, 30(9): 20-21.
[18] 毕青, 张俊富, 温玉焕, 孙克诚. 复方仙灵脾冲剂对慢性乙型肝炎患者sIL-2R T淋巴细胞亚群的影响[J]. 中西医结合肝病杂志, 2000, 10(1): 14-16.
[19] 李在林. 去甲斑鳌素与淫羊藿联合对原发性肝癌的临床效果分析[J]. 中外医学研究, 2015, 13(26): 8-9.
[20] 陈琛. 淫羊藿结合补骨脂治疗乳腺癌多发性骨转移瘤的临床效果观察[J]. 中国中医基础医学杂志, 2015, 21(3): 360-361.
[21] 林铭堉. 《神农本草经》对研发抗肿瘤中药的贡献[D]: [博士学位论文]. 广州: 广州中医药大学, 2011.
[22] 黄俊廷, 刘宇, 黄楚栓, 胡绚, 黄凯锋, 庾慧. 刘伟胜教授治疗肺癌用药规律的挖掘分析[J]. 中国实验方剂学杂志, 2017, 23(17): 222-227.
[23] 刘海涛, 冯解语, 罗斌, 衣秀秀, 钱芳芳, 田建辉. 基于数据挖掘田建辉主任医师中医药综合治疗肺癌用药规律研究[J]. 中医研究, 2018, 31(10): 45-49.
[24] 周尧. 喘可治注射液对哮喘患者发作期的免疫影响和临床疗效[J]. 当代医学, 2020, 26(2): 30-32.
[25] 熊妲妮, 宋红. 喘可治注射液治疗支气管哮喘24例的疗效观察[J]. 国际中医中药杂志, 2011, 33(9): 838-840.
[26] 敬郭, 陈弘东, 强周, 赵锡艳. 仝小林运用淫羊藿经验[J]. 山东中医杂志, 2016, 35(4): 336-338.
[27] 梁传军, 郭秋萍, 李建香. 中药加味二仙汤配合抗菌药物治疗女性患者慢性尿路感染的临床疗效评价[J]. 抗感染药学, 2016, 13(6): 1433-1435.
[28] 窦文. 二仙汤治疗尿路感染临床观察40例[J]. 医学信息, 2009, 22(6): 1017-1018.
[29] Zhao, B.J., Wang, J., Song, J., Wang, C.F., Gu, J.F., Yuan, J.R., et al. (2016) Beneficial Effects of a Flavonoid Fraction of Herba Epimedii on Bone Metabolism in Ovariectomized Rats. Planta Medica, 82, 322-329. [Google Scholar] [CrossRef] [PubMed]
[30] Shi, W.G., Gao, Y.H., Wang, Y.Y., Zhou, J., Wei, Z., Ma, X., et al. (2017) The Flavonol Glycoside Icariin Promotes Bone Formation in Growing Rats by Activating the Camp Signaling Pathway in Primary Cilia of Osteoblasts. Journal of Biological Chemistry, 292, Article ID: 20883. [Google Scholar] [CrossRef] 
[31] Wei, Q.S., Wang, B., Hu, H.L., Xie, C., Ling, L., Gao, J., et al. (2020) Icaritin Promotes the Osteogenesis of Bone Marrow Mesenchymal Stem Cells via the Regulation of Sclerostin Expression. International Journal of Molecular Medicine, 45, 816-824. [Google Scholar] [CrossRef] [PubMed]
[32] 云帆, 王瑞, 赵建宁. 破骨细胞的骨吸收机制[J]. 中国骨伤, 2014, 27(6): 529-532.
[33] Zhang, D.W., Zhang, J.C., Fong, C., Yao, X. and Yang, M. (2012) Herba epimedii Flavonoids Suppress Osteoclastic Differentiation and Bone Resorption by Inducing G2/M Arrest and Apoptosis. Biochimie, 94, 2514-2522. [Google Scholar] [CrossRef] [PubMed]
[34] Xue, L.M., Jiang, Y.P., Han, T., Zhang, N., Qin, L., Xin, H., et al. (2016) Comparative Proteomic and Metabolomic Analysis Reveal the Antiosteoporotic Molecular Mechanism of Icariin from Epimedium brevicornu Maxim. Journal of Ethnopharmacology, 192, 370-381. [Google Scholar] [CrossRef] [PubMed]
[35] 何丹丹, 夏海建, 蒋俊, 等. 淫羊藿素与RANKL蛋白靶点结合抑制破骨细胞分化抗骨质疏松作用研究[J]. 中草药, 2017, 48(22): 4707.
[36] An, R., Li, B., You, L.S. and Wang, X.H. (2015) Improvement of Kidney Yang Syndrome by Icariin Through Regulating Hypothalamus-Pituitary-Adrenal Axis. Chinese Journal of Integrative Medicine, 21, 756-771. [Google Scholar] [CrossRef] [PubMed]
[37] Wei, Z.S., Mang, M.X., Hong, M.F., et al. (2016) Icariin Exerts Estrogen-Like Activity in Ameliorating EAE via Mediating Estrogen Receptor β, Modulating HPA Function and Glucocorticoid Receptor Expression. American Journal of Translational Research, 8, 1910-1918.
[38] 吴瑕, 杨薇, 张磊, 王岚, 李东晓, 邓文龙. 下丘脑-垂体-性腺轴阻断对淫羊藿促性激素作用的影响[J]. 中国实验方剂学杂志, 2011, 17(5): 161-164.
[39] 许兰芝, 蒋淑君. 肾阳虚大鼠下丘脑-垂体-甲状腺轴内分泌及钙调蛋白基因表达与淫羊藿总黄酮的干预[J]. 中国临床康复, 2006, 10(11): 138-139.
[40] Deng, Y., Long, L., Wang, K., Zhou, J., Zeng, L., He, L., et al. (2017) Icariside II, a Broad-Spectrum Anti-Cancer Agent, Reverses Beta-Amyloid-Induced Cognitive Impairment through Reducing Inflammation and Apoptosis in Rats. Frontiers in Pharmacology, 8, Article No. 39. [Google Scholar] [CrossRef] [PubMed]
[41] Cao, L.H., Qiao, J.Y., Huang, H.Y., Fang, X.-Y., Zhang, R., Miao, M.-S., et al. (2019) PI3K-AKT Signaling Activation and Icariin: The Potential Effects on the Perimenopausal Depression-Like Rat Model. Molecules, 24, Article No. 3700. [Google Scholar] [CrossRef] [PubMed]
[42] Liu, M.B., Wang, W., Gao, J.M., Li, F., Shi, J.-S. and Gong, Q.-H. (2020) Icariside II Attenuates Cerebral Ischemia/Reperfusion-Induced Blood-Brain Barrier Dysfunction in Rats via Regulating the Balance of MMP9/TIMP1. Acta Pharmacologica Sinica, 41, 1457-1556. [Google Scholar] [CrossRef] [PubMed]
[43] Xiong, W., Ma, H.Y., Zhang, Z., Jin, M., Wang, J., Xu, Y., et al. (2020) The Protective Effect of Icariin and Phosphorylated Icariin against LPS-Induced Intestinal Goblet Cell Dysfunction. Innate Immunity, 26, 97-106. [Google Scholar] [CrossRef] [PubMed]
[44] 邓炜, 郑民强, 张静, 黄聪, 张雅莉. 2种黔产淫羊藿总黄酮对免疫功能影响的比较研究[J]. 中国中药杂志, 36(4): 511-513.
[45] Liu, J.Q., Liu, L.M., Sun, J., Luo, Q., Yan, C., Zhang, H., et al. (2020) Icariin Protects Hippocampal Neurons From Endoplasmic Reticulum Stress and NF-κB Mediated Apoptosis in Fetal Rat Hippocampal Neurons and Asthma Rats. Frontiers in Pharmacology, 10, Article No. 1660. [Google Scholar] [CrossRef] [PubMed]
[46] He, J., Zang, S.L., Liu, N., Ji, M., Ma, D. and Ji, Ch. (2020) Epimedium Polysaccharides Attenuates Hematotoxicity by Reducing Oxidative Stress and Enhancing Immune Function in Mice Model of Benzene-Induced Bone Marrow Failure. Biomedicine & Pharmacotherapy, 125, Article ID: 109908. [Google Scholar] [CrossRef] [PubMed]
[47] 张卫萍, 邓杨阳, 任建勋, 李晶瑾, 陈涛, 郜姗姗. 淫羊藿总黄酮对大鼠心肌急性缺血再灌注损伤氧化应激干预机制的研究[J]. 中国中药杂志, 2016, 41(18): 3400-3405.
[48] Xiang, Y.X., Zhang, J., Li, H.F., Wang, Q., Xiao, L., Weng, H., et al. (2016) Epimedium Polysaccharide Alleviates Polyglutamine-Induced Neurotoxicity in Caenorhabditis elegans by Reducing Oxidative Stress. Rejuvenation Research, 20, 32-41. [Google Scholar] [CrossRef] [PubMed]
[49] Wang, S., Wang, Q., Wang, H., Qin, C., Cui, X., Li, L., et al. (2019) Induction of ROS and DNA Damage-Dependent Senescence by Icaritin Contributes to Its Antitumor Activity in Hepatocellular Carcinoma Cells. Pharmaceutical Biology, 57, 424-431. [Google Scholar] [CrossRef] [PubMed]
[50] 代云龙, 吴礼国, 章志军, 欧扬, 黄俊伟, 彭兵. 淫羊藿苷抑制β-catenin和NF-κB p65的活性对小鼠胰腺癌皮下移植瘤生长和运动的调节[J]. 中国免疫学杂志, 2020, 16(3): 343-348.
[51] Lu, X.D., Xue, B.Y., Zhang, T.R., Zhou, X. and Zhang, Y. (2019) Down-Regulation of MicroRNA-10a Mediates the Anti-Tumor Effect of Icaritin in A549 Cells via the PTEN/AKT and ERK Pathway. General Physiology and Biophysics, 38, 525-533. [Google Scholar] [CrossRef] [PubMed]
[52] Tian, M.L., Yang, S. and Yan, X.P. (2018) Icariin Reduces Human Colon Carcinoma Cell Growth and Metastasis by Enhancing p53 Activities. Brazilian Journal of Medical and Biological Research, 51, Article No. e7151. [Google Scholar] [CrossRef] [PubMed]
[53] 邓淑蓉, 潘宇政, 彭玲玲, 陈铭坚, 董菲菲. 淫羊藿苷对气管切开插管大鼠肺部肥大细胞活性及炎性反应的影响[J]. 中华中医药杂志, 2018, 33(4): 1594-1597.
[54] Wang, G.Q., Li, D.D., Huang, C., Lu, D.-S., Zhang, C., Zhou, S.-Y., et al. (2018) Icariin Reduces Dopaminergic Neuronal Loss and Microglia-Mediated Inflammation in Vivo and in Vitro. Frontiers in Molecular Neuroscience, 10, Article No. 441. [Google Scholar] [CrossRef] [PubMed]