摘要
肌少症是一种与增龄相关的肌肉质量减少、肌肉力量下降和/或躯体功能减退的老年综合征。鉴于肌少症的发病机制仍未阐明,目前尚无明确的治疗手段。肌少症归属于中医学“痿证”疾病范畴,其病机为脾肾亏虚,气血虚弱,治则上应以健脾补肾,补益气血为主。现代研究证实,中药复方如补中益气汤通过下调萎缩相关基因并激活PI3K/Akt/mTOR通路改善肌肉合成代谢。单药成分亦可通过调控蛋白质降解与合成平衡延缓肌萎缩。非药物疗法中,针刺足三里、肾俞等穴可抑制MuRF1表达并激活IGF-1通路;推拿通过调节“肠道菌群-肌肉轴”增强代谢;传统功法则经神经内分泌调控改善肌肉功能。现归纳中医药在肌少症治疗中的特色与优势,以期为肌少症的临床治疗提供新的思路。
Sarcopenia,an age-related geriatric syndrome characterized by loss of muscle mass,reduced strength,and/or impaired physical function,remains a therapeutic challenge due to its incompletely elucidated pathogenesis.In Traditional Chinese Medicine(TCM),sarcopenia is classified under“flaccidity syndrome”,attributed to deficiency of the spleen and kidney and weakness of qi and blood.Therapeutic strategies emphasize tonifying the spleen-kidney system and replenishing qi-blood balance.Modern studies validate that TCM formulations,such as Buzhong Yiqi decoction,ameliorate muscle atrophy by downregulating atrophy-related genes and activating the PI3K/Akt/mTOR pathway to enhance protein synthesis.Active compounds modulate proteostasis by balancing protein degradation and synthesis.Non-pharmacological interventions demonstrate mechanistic efficacy:Acupuncture at Zusanli(ST36)and Shenshu(BL23)suppresses MuRF1 expression and activates IGF-1 signaling;Tuina(Chinese therapeutic massage)enhances muscle metabolism via gut microbiota-muscle axis regulation;Mind-body exercises improve neuromuscular coordination through neuroendocrine modulation.This review summarizes the characteristics and advantages of TCM in the treatment of sarcopenia,in order to provide new ideas for the clinical treatment of sarcopenia.
作者
顾逸浩
何志伟
陈煜
韦晓
刘超
胡欣
GU Yihao;HE Zhiwei;CHEN Yu;WEI Xiao;LIU Chao;HU Xin(Department of Endocrinology,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Key Laboratory of Gall Disease Treatment,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China;Center of Integrated Chinese and Western Medicine,The First Affiliated Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen 361003,China)
出处
《陕西中医》
2025年第10期1429-1432,共4页
Shaanxi Journal of Traditional Chinese Medicine
基金
国家自然科学基金资助项目(82205050)。
关键词
肌少症
痿证
病因病机
中医适宜技术
针刺
Sarcopenia
Flaccidity syndrome
Etiology pathogenesis
Traditional Chinese medicine treatment
Acupuncture
