基于氧化应激的中医药干预椎间盘退变的研究进展

Research Progress of Traditional Chinese Medicine Intervention on Intervertebral Disc Degeneration Based on Oxidative Stress

关键词:  氧化应激  椎间盘退变  活性氧  中医药

Key words:  oxidative stress  intervertebral disc degeneration  reactive oxygen species  traditional Chinese medicine

摘要:

椎间盘退变(intervertebral disc degeneration，IDD)是脊柱疾病发生的病变基础，随着人们工作生活方式的发展变化，IDD近年来逐渐呈现出年轻化的趋势。对IDD的有效防治日益成为临床研究中的热点。近年来相关研究表明氧化应激在IDD中具有重要作用。由于细胞或机体中的活性氧平衡被打破而导致细胞外基质以及椎间盘细胞表型变化，诱发椎间盘氧化应激从而导致IDD的发生。同时氧化应激能够通过对椎间盘细胞凋亡、自噬、衰老及细胞外基质等方式来影响IDD的发展。目前关于IDD的治疗，临床多使用阿片类以及活血止痛类的药物，其在一定程度上能够缓解部分症状，但易诱发胃肠道不良反应，同时由于治疗周期漫长在一定程度上导致患者依从性较差，给治疗带来较大困难。中医药以其物优价廉、不良反应少等优势在治疗IDD中占据重要的地位。随着分子生物学以及网络药理学等现代科技的研究深入，发现中医药能够通过干预氧化应激相关功能表达，即减缓细胞凋亡、自噬及减缓细胞外基质降解等方式，发挥治疗IDD的作用。本文阐述氧化应激在IDD中的作用，以及中医药干预氧化应激的研究成果，以期为中医药防治IDD提供参考和依据。

Abstract:

Intervertebral disc degeneration(IDD) is the pathological basis of spinal diseases. With the development and change of working and living style, IDD gradually presents the trend of younger in recent years. The effective prevention and treatment of IDD has become a hotspot in clinical research. Recent studies have shown that oxidative stress plays an important role in IDD. The disruption of reactive oxygen species balance in cells or the body leads to changes in extracellular matrix and intervertebral disc cell phenotype, which induces oxidative stress of intervertebral disc and leads to IDD. Oxidative stress can affect the development of IDD through apoptosis, autophagy, senescence and extracellular matrix of intervertebral disc. Currently, opioids and drugs for promoting blood circulation and pain relief are commonly used in clinical treatment of IDD, which can alleviate some symptoms to a certain extent, but is easy to induce gastrointestinal and other adverse reactions. Meanwhile, due to the long treatment cycle and poor patient compliance to a certain extent, which brings great difficulties to the treatment. At the same time, traditional Chinese medicine plays an important role in the treatment of IDD due to its advantages of low cost and fewer adverse reactions. With the in-depth research of modern technologies such as molecular biology and network pharmacology, it has been found that traditional Chinese medicine can intervene in the expression of oxidative stress-related functions, namely, slowing down apoptosis, autophagy and degradation of extracellular matrix, etc, to play a role in the treatment of IDD. In this paper, the role of oxidative stress in IDD and the research results on the intervention of traditional Chinese medicine in oxidative stress will be expounded, in order to provide reference for the prevention and treatment of IDD by traditional Chinese medicine.