[1]石龙,李扬,颜鸿宇,等.二精丸治疗脾肾亏虚型肌少症的临床疗效观察[J].中国中医骨伤科杂志,2026,34(03):84-89.[doi:10.20085/j.cnki.issn1005-0205.260313]
　SHI Long,LI Yang,YAN Hongyu,et al.Clinical Observation on the Therapeutic Effect of Erjing Pills in Treating Sarcopenia of Spleen and Kidney Deficiency Type[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(03):84-89.[doi:10.20085/j.cnki.issn1005-0205.260313]
点击复制

二精丸治疗脾肾亏虚型肌少症的临床疗效观察()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年03期
页码:
84-89
栏目:
临床研究
出版日期:
2026-03-15

文章信息/Info

Title:
Clinical Observation on the Therapeutic Effect of Erjing Pills in Treating Sarcopenia of Spleen and Kidney Deficiency Type
文章编号:
1005-0205(2026)03-0084-06
作者:
石龙1; 李扬 2; 3; 4; 颜鸿宇1; 冉泽海1; 刘育恺1; 张志文2; 3; 4△
1湖北中医药大学针灸骨伤学院(武汉,430061); 2湖北省中医院(湖北中医药大学附属医院); 3中医肝肾研究及应用湖北省重点实验室(湖北省中医院); 4湖北时珍实验室
Author(s):
SHI Long1; LI Yang2; 3; 4; YAN Hongyu1; RAN Zehai1; LIU Yukai1; ZHANG Zhiwen2; 3; 4△
1School of Acupuncture and Orthopedics,Hubei University of Chinese Medicine,Wuhan 430061,China; 2Hubei Provincial Hospital of Traditional Chinese Medicine(Affiliated Hospital of Hubei University of Chinese Medicine),Wuhan 430061,China; 3Hubei Key Laboratory of Theory and Application Research of Liver and Kidney in Traditional Chinese Medicine(Hubei Provincial Hospital of Traditional Chinese Medicine),Wuhan 430061,China; 4Hubei Shizhen Laboratory,Wuhan 430061,China.
关键词:
二精丸;  脾肾亏虚型肌少症;  骨骼肌质量;  炎症指标;  回顾性研究
Keywords:
Erjing pills;  sarcopenia of spleen and kidney deficiency type;  skeletal muscle mass;  inflammatory markers;  retrospective study
分类号:
R259
DOI:
10.20085/j.cnki.issn1005-0205.260313
文献标志码:
A
摘要:
目的:观察二精丸治疗脾肾亏虚型肌少症的临床疗效。方法:回顾性分析2024年1月至2025年1月收治的64例诊断为脾肾亏虚型肌少症患者的临床资料,根据治疗方式不同分为对照组和观察组,其中对照组36例,观察组28例; 对照组采用骨化三醇口服治疗,观察组采用二精丸汤剂(含黄精和枸杞子各24 g,具有补益肝肾、益精填髓之功效)联合骨化三醇治疗,疗程为6个月,比较两组治疗前后中医证候评分、肌肉功能(握力、6 m步速、L3竖脊肌密度(ESMD))、血清炎症指标(肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6))及血清25羟维生素D(25(OH)D)水平。结果:治疗前,两组间握力、6 m步速、L3竖脊肌密度、IL-6、TNF-α、25(OH)D、脾肾亏虚证候评分(肌肉萎缩、肢体痿软无力、神疲乏力、食少便溏)差异均无统计学意义(P>0.05)。治疗6个月后,对照组与观察组IL-6、TNF-α水平及肌肉萎缩、肢体痿软无力症状均低于(轻于)治疗前同组基线水平,差异有统计学意义(P<0.05); 观察组食少便溏症状明显减轻,差异有统计学意义(P<0.05); 两组握力、6 m步速、25(OH)D水平均高于治疗前同组基线水平,差异有统计学意义(P<0.05); L3竖脊肌密度均呈现上升趋势,但差异无统计学意义(P>0.05)。治疗6个月后,观察组握力、6 m步速水平明显高于对照组,差异有统计学意义(P<0.05); IL-6水平及肌肉萎缩、肢体痿软无力症状明显低于(轻于)对照组,差异有统计学意义(P<0.05); TNF-α、25(OH)D水平及神疲乏力、食少便溏症状差异无统计学意义(P>0.05); L3竖脊肌密度差异无统计学意义(P>0.05),但观察组上升幅度(6.67%)大于对照组(3.48%)。结论:二精丸可显著缓解慢性炎症状态,从而改善并维持脾肾亏虚型肌少症患者的肌肉功能(握力、6 m步速)及脾肾亏虚型症状(肌肉萎缩、肢体痿软无力),但在短期内对肌肉质量/密度的改善不明显,其机制可能与调控炎症通路相关。
Abstract:
Objective:To observe the clinical efficacy of Erjing pills combined with basic therapy in treating sarcopenia of spleen and kidney deficiency type.Methods:A retrospective analysis was conducted on the clinical data of 64 patients with sarcopenia of spleen and kidney deficiency type treated from January 2024 to January 2025.These patients were divided into control group(n=36)and observation group(n=28)according to treatment modality.The control group received oral calcitriol,while the observation group received Erjing pills(comprising Polygonati Rhizoma 24 g,and Lycii Fructus 24 g,with the therapeutic effects of tonifying the liver and kidneys,nourishing the liver and kidney,nourishing essence),combined with calcitriol.The treatment course was 6 months.Comparison of TCM syndrome scores,muscle function(grip strength,6 m walking speed,and L3 erector spinae muscle density(ESMD)),serum inflammatory markers(tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)),and serum 25-hydroxyvitamin D(25(OH)D)levels were compared before and after treatment in the two groups.Results:Before treatment,there were no statistically significant differences between the two groups in grip strength,6 m walking speed,L3 ESMD,IL-6,TNF-α,25(OH)D,or the syndrome score of spleen-kidney deficiency(muscle atrophy,limb weakness,fatigue,poor appetite,and loose stools)(P>0.05).After 6 months of treatment,the control group and the observation group both showed lower levels of IL-6 and TNF-α,as well as symptoms of muscle atrophy and limb weakness,compared to their respective baseline levels before treatment(P<0.05).The observation group also showed a significant improvement in symptoms of poor appetite and loose stools(P<0.05).Grip strength,6 m walking speed,and 25(OH)D levels in both groups were higher than their respective baseline levels before treatment(P<0.05),and L3 ESMD showed an upward trend,although without significant statistical difference(P>0.05).After 6 months of treatment,the observation group exhibited significantly greater grip strength and 6 m walking speed levels than the control group(P<0.05),as well as significantly lower levels of IL-6 and symptoms of muscle atrophy and limb weakness(P<0.05).There were no significant statistical differences in TNF-α,25(OH)D levels,symptoms of fatigue and poor appetite and loose stools between the two groups(P>0.05),and L3 ESMD also showed no significant statistical difference(P>0.05),although its increase(6.67%)was greater than that of the control group(3.48%).Conclusion:The combination of Erjing pills and calcitriol can significantly alleviate chronic inflammation,thereby improving and helping to maintain muscle function(including grip strength,6 m walking speed),as well as alleviating symptoms of spleen and kidney deficiency myopathy(muscle atrophy,limb weakness)in patients with sarcopenia of spleen and kidney deficiency type.However,it does not show significant improvement in muscle mass/density in the short term,and its mechanism may be related to the regulation of inflammatory pathways.

参考文献/References:

[1] 宓雅琪,张英砾,罗良涛.肌少症的研究进展[J].中华中医药杂志,2025,40(2):807-810.
[2] PETERMANN-ROCHA F,BALNTZI V,GRAY S R,et al.Global prevalence of sarcopenia and severe sarcopenia:a systematic review and meta-analysis[J].Journal of Cachexia,Sarcopenia and Muscle,2022,13(1):86-99.
[3] NARICI M V,MAFFULLI N.Sarcopenia:characteristics,mechanisms and functional significance[J].British Medical Bulletin,2010,95:139-159.
[4] CHEN L K,HSIAO F Y,AKISHITA M,et al.A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update[J].Nature Aging,2025,5(11):2164-2175.
[5] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994.
[6] SAYER A A,COOPER R,ARAI H,et al.Sarcopenia[J].Nature Reviews Disease Primers,2024,10:68.
[7] CRUZ-JENTOFT A J,SAYER A A.Sarcopenia[J].The Lancet,2019,393(10191):2636-2646.
[8] KUZUYA M.Drug-related sarcopenia as a secondary sarcopenia[J].Geriatrics & Gerontology International,2024,24(2):195-203.
[9] 向青,陈聪.中医药治疗肌少症的临床研究进展[J].中国医药导报,2025,22(29):138-141.
[10] 侯佳佳,董旭,冯涛.基于“脾主肌肉”理论治疗肌少症的中西医研究进展[J].中医研究,2024,37(7):87-91.
[11] 刘希贤,张丝怡,杨耀松,等.二精丸的研究进展[J].中药与临床,2023,14(6):104-108.
[12] 颜鸿宇,李扬,郑力铭,等.二精丸对肌少症小鼠运动功能的影响及作用机制[J].世界中医药,2025,20(18):3230-3236.
[13] LI Y,LIU Z Y,YAN H Y,et al.Polygonatum sibiricum polysaccharide ameliorates skeletal muscle aging and mitochondrial dysfunction via PI3K/Akt/mTOR signaling pathway[J].Phytomedicine,2025,136:156316.
[14] 石龙,李扬,颜鸿宇,等.基于SIRT1/Nrf2/HO-1信号通路探讨二精丸改善肌少症骨骼肌细胞炎症反应和细胞凋亡的机制[J].中国实验方剂学杂志,2026,32(3):57-66.
[15] ZHOU X L,XU S Y,ZHANG Z X,et al.Gouqi-derived nanovesicles(GqDNVs)inhibited dexamethasone-induced muscle atrophy associating with AMPK/SIRT1/PGC1α signaling pathway[J].Journal of Nanobiotechnology,2024,22(1):276.
[16] MENG J,LV Z Y,SUN C X,et al.An extract of Lycium barbarum mimics exercise to improve muscle endurance through increasing type IIa oxidative muscle fibers by activating ERRγ[J].The FASEB Journal,2020,34(9):11460-11473.
[17] 黄丽萍,卢龙辉,杨喜洋,等.基于TLR4/NF-κB/NLRP3通路探讨二精丸减轻AD大鼠神经炎症的作用及机制[J].中国中药杂志,2023,48(3):770-777.
[18] REMELLI F,VITALI A,ZURLO A,et al.Vitamin D deficiency and sarcopenia in older persons[J].Nutrients,2019,11(12):2861.
(收稿日期:2026-01-28)

备注/Memo

备注/Memo:
基金项目:湖北省重点研发计划项目(2024BCB035)
△通信作者 E-mail:zzwjjdd@163.com
更新日期/Last Update: 2026-03-15