中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (21): 3438-3444.doi: 10.12307/2023.510

• 生物材料综述 biomaterial review • 上一篇    

“补肾壮骨”中药应用于骨组织工程支架修复节段性骨缺损

熊  伟1，袁灵梅2，钱国文3，黄锦阳1，潘  斌1，郭  灵1，曾志奎1，2   

  1. 1江西中医药大学，江西省南昌市  330004；2江西中医药大学附属医院，江西省南昌市  330006；3江西理工大学，江西省南昌市  330013
  • 收稿日期:2022-08-12 接受日期:2022-09-21 出版日期:2023-07-28 发布日期:2022-11-26
  • 通讯作者: 曾志奎，博士，博士生导师，江西中医药大学，江西省南昌市 330004；江西中医药大学附属医院创伤骨科，江西省南昌市 330006
  • 作者简介:熊伟，男，1998年生，江西省瑞昌市人，汉族，江西中医药大学临床医学院在读硕士，主要从事中医药与骨缺损修复研究。
  • 基金资助:
    国家自然科学基金项目(81960880)，项目负责人：曾志奎

Application of Chinese medicines of tonifying kidney and strengthening bones in the repair of segmental bone defects using bone tissue engineering scaffolds

Xiong Wei1, Yuan Lingmei2, Qian Guowen3, Huang Jinyang1, Pan Bin1, Guo Ling1, Zeng Zhikui1, 2   

  1. 1Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China; 2Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang 330006, Jiangxi Province, China; 3Jiangxi University of Science and Technology, Nanchang 330013, Jiangxi Province, China
  • Received:2022-08-12 Accepted:2022-09-21 Online:2023-07-28 Published:2022-11-26
  • Contact: Zeng Zhikui, MD, Doctoral supervisor, Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China; Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang 330006, Jiangxi Province, China
  • About author:Xiong Wei, Master candidate, Jiangxi University of Chinese Medicine, Nanchang 330004, Jiangxi Province, China
  • Supported by:
    the National Natural Science Foundation of China, No. 81960880 (to ZZK)

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摘要：


文题释义：

补肾壮骨：是基于肾主骨的指导思想，中医学认为骨的生成、发育、强弱及盛衰均与肾密切关系，调控肾气的盛衰可以调节骨的局部代谢。
骨组织工程支架：可通过在人工支架上负载生长因子或药物，促进成骨细胞增殖、诱导成骨分化及加快血管形成从而修复骨缺损。应用的人工支架材料包括聚合物材料，如天然高分子材料和人工合成高分子聚合物材料；生物陶瓷和医用金属也是目前广泛应用于骨组织修复的支架材料。
节段性骨缺损：骨缺损范围超过骨周径的50%或缺损长度> 2 cm的骨缺损，又称大段骨缺损。

背景：节段性骨缺损为骨科难题，现有治疗手段效果欠佳。新兴骨组织工程技术在节段性骨缺损修复方面展现出巨大的潜力，但仅使用人工支架进行骨缺损修复，成骨性能往往难以满足需求，负载活性因子又存在价格昂贵、不稳定等问题。中药取材广泛、价格低廉，“补肾壮骨”中药有效成分有充当外源性生物因子的潜力，中药复合支架展现出良好的骨组织修复效果。 
目的：介绍几种常用的骨组织工程支架材料，及骨碎补、淫羊藿、杜仲等“补肾壮骨”代表药物在支架材料上的复合应用，探讨“补肾壮骨”中药应用于骨组织工程支架修复节段性骨缺损的潜力。
方法：由第一作者检索中国知网(CNKI)、万方、PubMed和Web of Science数据库，以“中药，补肾，骨碎补，淫羊藿，杜仲，骨缺损，骨修复，骨组织工程，支架”为中文检索词，以“Chinese medicine，Tonifying kidney，Drynariae，Epimedium，Eucommia，bone defects，Bone repair，Bone Tissue Engineering，Scaffold”为英文检索词，检索2007-2022年期间关于“补肾壮骨”中药应用于骨组织工程支架修复节段性骨缺损的文章。
结果与结论：①现有骨组织工程支架材料包括生物陶瓷材料、医用金属材料及聚合物材料，因各材料的性能差异可复合使用以弥补单一材料的缺陷。②外源性生长因子结合骨组织工程支架修复节段性骨缺损疗效确切，但生长因子存在不稳定性、单价昂贵等问题。③现代药理学发现“补肾壮骨”中药对骨髓间充质干细胞有显著促进成骨分化作用，可替代生长因子在骨组织工程支架中的角色。④将“补肾壮骨”中药及其活性成分与支架材料融合，所制备复合支架在修复节段性骨缺损上展现出独特优势，应用前景广阔。
https://orcid.org/0000-0002-9318-0244(熊伟)
中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程

关键词: 中药, 补肾, 骨碎补, 淫羊藿, 杜仲, 骨缺损, 骨修复, 骨组织工程, 支架

Abstract: BACKGROUND: Segmental bone defects are a challenging orthopedic problem and the existing treatment methods are not effective. Bone tissue engineering techniques have shown great potential in the repair of segmental bone defects; however, the osteogenic properties of artificial scaffolds alone are often insufficient to meet the needs of bone defect repair and the loading of growth factors is expensive and unstable. Chinese medicines are widely available and inexpensive and those with the active ingredients of “tonifying kidney and strengthening bones” have the potential to act as exogenous growth factors. Therefore, the composite scaffolds of Chinese medicines have shown good bone tissue repair effects.
OBJECTIVE: To introduce several commonly used bone tissue engineering scaffold materials as well as some representative drugs of tonifying kidney and strengthening bones, such as Rhizome Drynariae, Epimedium, and Eucommia, that are used combined with scaffold materials, and discuss the potential of Chinese medicines with the active ingredients of “tonifying kidney and strengthening bones” in the repair of segmental bone defects using bone tissue engineering scaffolds. 
METHODS: The first author searched for relevant literature (published from 2007 to 2022) regarding the use of Chinese medicines of “tonifying kidney and strengthening bones” in the repair of segmental bone defects using bone tissue engineering scaffolds in CNKI, WanFang, PubMed, and Web of Science. Search terms included “Chinese medicine, Tonifying kidney, Drynariae, Epimedium, Eucommia, Bone defects, Bone repair, Bone tissue engineering, Scaffold” in Chinese and English.
RESULTS AND CONCLUSION: (1) The existing bone tissue engineering scaffold materials include bioceramic materials, medical metal materials, and polymer materials, which can be used in combination to compensate for the performance deficiencies of a single material as per the difference in their properties. (2)Exogenous growth factors combined with bone tissue engineering scaffolds are highly effective in repairing segmental bone defects, but growth factors are unstable and expensive. (3) Modern pharmacology has found that Chinese medicines of tonifying kidney and strengthening bones can significantly promote the osteogenic differentiation of bone marrow mesenchymal stem cells, which can replace the role of growth factors in bone tissue engineering scaffolds. (4) The combination of Chinese medicines of tonifying kidney and strengthening bones and its active ingredients with scaffold materials to produce composite scaffolds has shown unique advantages in the repair of segmental bone defects and has great potential for application.

Key words: Chinese medicine, tonifying kidney, drynariae, epimedium, eucommia, bone defect, bone repair, bone tissue engineering, scaffold

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