

浏览全部资源
扫码关注微信
上海中医药大学附属龙华医院针灸科(上海 200032)
Received:30 March 2025,
Published:10 November 2025
移动端阅览
王玮婷,詹逸珺,裴建,等.青藤碱多靶点治疗慢性腰痛:抗炎‑镇痛‑组织修复机制[J].上海中医药杂志,2025,59(11):93-100.
WANG Weiting,ZHAN Yijun,PEI Jian,et al.Multitarget treatment of chronic low back pain with sinomenine: anti‑inflammatory, analgesic, and tissue‑repair mechanisms[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(11):93-100.
王玮婷,詹逸珺,裴建,等.青藤碱多靶点治疗慢性腰痛:抗炎‑镇痛‑组织修复机制[J].上海中医药杂志,2025,59(11):93-100. DOI: 10.16305/j.1007-1334.2025.z20250330002.
WANG Weiting,ZHAN Yijun,PEI Jian,et al.Multitarget treatment of chronic low back pain with sinomenine: anti‑inflammatory, analgesic, and tissue‑repair mechanisms[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(11):93-100. DOI: 10.16305/j.1007-1334.2025.z20250330002.
慢性腰痛已成为一大全球健康问题。青藤碱是从中药青风藤中提取的主要活性成分,具有多靶点调控疼痛的作用。临床实践表明,青藤碱口服或透皮制剂可显著缓解慢性腰痛患者的疼痛症状与功能障碍,同时具有良好的安全性。总结近年来青藤碱治疗慢性腰痛的机制研究进展,并构建“药物-靶点”网络筛选青藤碱干预慢性腰痛的核心治疗靶点,为其临床应用与靶向治疗策略提供依据。
Chronic low back pain (CLBP) has become a major global health challenge. Sinomenine, a primary active compound extracted from the traditional Chinese medicine Sinomenii Caulis, has the effect of regulating pain through multiple targets. Clinical practice has shown that the oral or transdermal formulation of sinomenine can significantly alleviate the pain symptoms and functional impairments of patients with CLBP, alongside favorable safety profiles. This review summarizes recent advances in the pharmacological mechanisms of sinomenine for CLBP treatment and screens core therapeutic targets for sinomenine in treatment of CLBP by constructing the "drug-target" network, thereby providing basis for clinical application and targeted therapeutic strategies.
GBD 2021 Low Back Pain Collaborators . Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021 [J]. Lancet Rheumatol , 2023 , 5 ( 6 ): e316 - e329 .
GBD 2021 Forecasting Collaborators . Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the Global Burden of Disease Study 2021 [J]. Lancet , 2024 , 403 ( 10440 ): 2204 - 2256 .
ZHOU T , SALMAN D , MCGREGOR A H . Recent clinical practice guidelines for the management of low back pain: a global comparison [J]. BMC Musculoskelet Disord , 2024 , 25 ( 1 ): 344 .
CASHIN A G , WAND B M , O'CONNELL N E , et al . Pharmacological treatments for low back pain in adults: an overview of Cochrane Reviews [J]. Cochrane Database Syst Rev , 2023 , 4 ( 4 ): CD013815 .
DOMPER ARNAL M J , HIJOS-MALLADA G , LANAS A . Gastrointestinal and cardiovascular adverse events associated with NSAIDs [J]. Expert Opin Drug Saf , 2022 , 21 ( 3 ): 373 - 384 .
牛升波 , 杨桓 , 吴江红 , 等 . 慢性腰痛诊断与治疗的研究进展 [J]. 海军军医大学学报 , 2023 , 44 ( 6 ): 726 - 732 .
国家药典委员会 . 中华人民共和国药典(2020年版):一部 [M]. 北京 : 中国医药科技出版社 , 2020 : 204 .
国家医保局 , 人力资源社会保障部 . 国家医保局 人力资源社会保障部关于印发《国家基本医疗保险、工伤保险和生育保险药品目录》的通知: 医保发 〔2024〕 33 号[EB/OL]. ( 2024-11-27 )[ 2025-06-06 ]. https://www.gov.cn/zhengce/zhengceku/202411/content_6989859.htm https://www.gov.cn/zhengce/zhengceku/202411/content_6989859.htm .
国家卫生健康委员会 , 国家中医药管理局 . 关于印发国家基本药物目录(2018年版)的通知:国卫药政发 〔2018〕 31 号[EB/OL].( 2018-10-25 ) [ 2025-06-06 ]. http://www.nhc.gov.cn/yaozs/s7656/201810/c18533e22a3940d08d996b588d9416 31.shtml http://www.nhc.gov.cn/yaozs/s7656/201810/c18533e22a3940d08d996b588d941631.shtml .
洪政茹 . 正清风痛宁注射液定向透药治疗LDH风寒湿痹证的疗效评价及炎症因子的影响 [D]. 长沙 : 湖南中医药大学 , 2023 .
谭利琴 , 谭升星 , 郑伟 , 等 . 正清风痛宁中医定向透药疗法联合身痛逐瘀汤对腰椎间盘突出症的临床疗效观察 [J]. 中国医学创新 , 2021 , 18 ( 23 ): 90 - 93 .
KOMATSU T , KATSUYAMA S , TAKANO F , et al . Possible involvement of the mu opioid receptor in the antinociception induced by sinomenine on formalin-induced nociceptive behavior in mice [J]. Neurosci Lett , 2019 , 699 : 103 - 108 .
GAO T , SHI T , WANG D Q , et al . Repeated sinomenine administration alleviates chronic neuropathic pain-like behaviours in rodents without producing tolerance [J]. Scand J Pain , 2014 , 5 ( 4 ): 249 - 255 .
LIN Y , LI H , PENG J , et al . Decrease of morphine-CPP by sinomenine via mediation of tyrosine hydroxylase, NMDA receptor subunit 2B and opioid receptor in the zebrafish brain [J]. Pak J Pharm Sci , 2021 , 34 ( 5 ): 1659 - 1665 .
LI D , ZHONG Z , KO C N , et al . From mundane to classic: Sinomenine as a multi-therapeutic agent [J]. Br J Pharmacol , 2023 , 182 ( 10 ): 2159 - 2180 .
CUI M , LI Y , LI J , et al . Construction of various lipid carriers to study the transdermal penetration mechanism of sinomenine hydrochloride [J]. J Microencapsul , 2024 , 41 ( 3 ): 157 - 169 .
KANG Y , SHEN W , PAN S , et al . Prescription design of sinomenine gel based on molecular dynamics simulations [J]. Int J Mol Sci , 2024 , 25 ( 23 ): 12863
林桦楠 , 陈海鹏 , 丘宏龙 , 等 . 针灸联合正清风痛宁离子导入治疗慢性腰背肌筋膜炎36例 [J]. 中国中医骨伤科杂志 , 2015 , 23 ( 1 ): 41 - 43 .
张冬 , 钟露苗 , 杜娟 , 等 . 6 269例正清风痛宁注射液临床病例回顾性用药特点与安全性分析 [J]. 中医药导报 , 2022 , 28 ( 10 ): 172 - 176 .
洪政茹 , 朱亮亮 , 常裕绅 , 等 . 正清风痛宁定向透药联合塞来昔布治疗腰椎间盘突出症的临床疗效 [J]. 中医药导报 , 2023 , 29 ( 5 ): 99 - 102 .
谭利琴 , 陈平 , 吴春根 , 等 . 正清风痛宁联合塞来昔布及甲钴胺对腰椎间盘突出症患者疼痛及腰椎功能的影响 [J]. 药品评价 , 2021 , 18 ( 9 ): 558 - 560 .
邓校征 . 正清风痛宁缓释片治疗腰椎骨关节炎的临床研究 [D]. 长沙 : 湖南中医药大学 , 2012 .
LIN S S , LIU C X , ZHANG J H , et al . Efficacy and safety of sinomenine preparation for ankylosing spondylitis: a systematic review and meta-analysis of clinical randomized controlled trials [J]. Evid Based Complement Alternat Med , 2020 , 2020 : 4593412 .
MIYAGI M , UCHIDA K , INOUE S , et al . A high body mass index and the vacuum phenomenon upregulate pain-related molecules in human degenerated intervertebral discs [J]. Int J Mol Sci , 2022 , 23 ( 6 ): 2973
RIBEIRO H , RODRIGUES I , NAPOLEAO L , et al . Non-steroidal anti-inflammatory drugs (NSAIDs), pain and aging: Adjusting prescription to patient features [J]. Biomed Pharmacother , 2022 , 150 : 112958 .
LUO J F , YAO Y D , CHENG C S , et al . Sinomenine increases the methylation level at specific GCG site in mPGES-1 promoter to facilitate its specific inhibitory effect on mPGES-1 [J]. Biochim Biophys Acta Gene Regul Mech , 2022 , 1865 ( 3 ): 194813 .
ZHANG Y Y , YAO Y D , LUO J F , et al . Microsomal prostaglandin E(2) synthase-1 and its inhibitors: molecular mechanisms and therapeutic significance [J]. Pharmacol Res , 2022 , 175 : 105977 .
CHEN X , HODGES P W , JAMES G , et al . Do markers of inflammation and/or muscle regeneration in lumbar multifidus muscle and fat differ between individuals with good or poor outcome following microdiscectomy for lumbar disc herniation? [J]. Spine (Phila Pa 1976) , 2021 , 46 ( 10 ): 678 - 686 .
TU H , LI Y L . Inflammation balance in skeletal muscle damage and repair [J]. Front Immunol , 2023 , 14 : 1133355 .
LI X C , LUO S J , FAN W , et al . Macrophage polarization regulates intervertebral disc degeneration by modulating cell proliferation, inflammation mediator secretion, and extracellular matrix metabolism [J]. Front Immunol , 2022 , 13 : 922173 .
ZHU R L , ZHI Y K , YI L , et al . Sinomenine regulates CD14/TLR4, JAK2/STAT3 pathway and calcium signal via alpha7nAChR to inhibit inflammation in LPS-stimulated macrophages [J]. Immunopharmacol Immunotoxicol , 2019 , 41 ( 1 ): 172 - 177 .
王金凤 , 王枫 , 刘杰 , 等 . 青藤碱通过JAK/STAT通路调控巨噬细胞极化改善胶原诱导性关节炎大鼠炎症和骨破坏的作用研究 [J/OL]. 中药药理与临床 , 2025 [ 2025-05-21 ]. https://link.cnki.net/doi/10.13412/j.cnki.zyyl.20250414.001 https://link.cnki.net/doi/10.13412/j.cnki.zyyl.20250414.001 .
ZHI Y K , LI J , YI L , et al . Sinomenine inhibits macrophage M1 polarization by downregulating α7nAChR via a feedback pathway of α7nAChR/ERK/Egr-1 [J]. Phytomedicine , 2022 , 100 : 154050 .
YIN N , XIONG Y , TAO W , et al . Sinomenine alleviates lipopolysaccharide-induced inflammatory responses in RAW264.7 macrophages [J]. Immunopharmacol Immunotoxicol , 2020 , 42 ( 2 ): 147 - 155 .
LU G , ZHANG C , LI K , et al . Sinomenine ameliorates IL-1β-induced intervertebral disc degeneration in rats through suppressing inflammation and oxidative stress via Keap1/Nrf2/NF‑κB signaling pathways [J]. J Inflamm Res , 2023 , 16 : 4777 - 4791 .
LI J M , DENG H S , YAO Y D , et al . Sinomenine ameliorates collagen-induced arthritis in mice by targeting GBP5 and regulating the P2X7 receptor to suppress NLRP3-related signaling pathways [J]. Acta Pharmacol Sin , 2023 , 44 ( 12 ): 2504 - 2524 .
GONG C Y , CHENG P , ZHANG H H . Roles of NLRP3 inflammasome in intervertebral disc degeneration [J]. Osteoarthritis Cartilage , 2021 , 29 ( 6 ): 793 - 801 .
XU W , WANG X , TU Y , et al . Plant-derived alkaloid sinomenine potentiates glucocorticoid pharmacodynamics in mitogen-activated human peripheral blood mononuclear cells by regulating the translocation of glucocorticoid receptor [J]. Phytother Res , 2019 , 33 ( 1 ): 187 - 196 .
DONG H C , LI P N , CHEN C J , et al . Sinomenine attenuates cartilage degeneration by regulating miR-223-3p/NLRP3 inflammasome signaling [J]. Inflammation , 2019 , 42 ( 4 ): 1265 - 1275 .
WANG X , LIU Y , ZHANG H , et al . Sinomenine alleviates dorsal root ganglia inflammation to inhibit neuropathic pain via the p38 MAPK/CREB signalling pathway [J]. Eur J Pharmacol , 2021 , 897 : 173945 .
LEE J Y , YOON S Y , WON J , et al . Sinomenine produces peripheral analgesic effects via inhibition of voltage-gated sodium currents [J]. Neuroscience , 2017 , 358 : 28 - 36 .
KAMALI A , ZIADLOU R , LANG G , et al . Small molecule-based treatment approaches for intervertebral disc degeneration: current options and future directions [J]. Theranostics , 2021 , 11 ( 1 ): 27 - 47 .
XU J , SHAO T , LOU J , et al . Aging, cell senescence, the pathogenesis and targeted therapies of intervertebral disc degeneration [J]. Front Pharmacol , 2023 , 14 : 1172920 .
GAO Z , LIN Y , ZHANG P , et al . Sinomenine ameliorates intervertebral disc degeneration via inhibition of apoptosis and autophagy in vitro and in vivo [J]. Am J Transl Res , 2019 , 11 ( 9 ): 5956 - 5966 .
王倩 , 卢子昂 , 李利和 , 等 . 青藤碱可有效抑制白细胞介素1β介导的髓核细胞凋亡 [J]. 中国组织工程研究 , 2024 , 28 ( 2 ): 224 - 230 .
PAN C C , SIMON P , ESPINOZA ORIAS A A , et al . Lumbar facet joint subchondral bone density in low back pain and asymptomatic subjects [J]. Skeletal Radiol , 2020 , 49 ( 4 ): 571 - 576 .
WU Y , LIN Z , YAN Z , et al . Sinomenine contributes to the inhibition of the inflammatory response and the improvement of osteoarthritis in mouse-cartilage cells by acting on the Nrf2/HO-1 and NF‑κB signaling pathways [J]. Int Immunopharmacol , 2019 , 75 : 105715 .
ZHOU B , LU X , TANG Z , et al . Influence of sinomenine upon mesenchymal stem cells in osteoclastogenesis [J]. Biomed Pharmacother , 2017 , 90 : 835 - 841 .
IBANEZ L , GUILLEM-LLOBAT P , MARIN M , et al . Connection between mesenchymal stem cells therapy and osteoclasts in osteoarthritis [J]. Int J Mol Sci , 2022 , 23 ( 9 ): 4693 .
CHE T , ROTH B L . Molecular basis of opioid receptor signaling [J]. Cell , 2023 , 186 ( 24 ): 5203 - 5219 .
LI W , GONG Y , LIU J , et al . Peripheral and central pathological mechanisms of chronic low back pain: a narrative review [J]. J Pain Res , 2021 , 14 : 1483 - 1494 .
FINNERUP N B , KUNER R , JENSEN T S . Neuropathic pain: from mechanisms to treatment [J]. Physiol Rev , 2021 , 101 ( 1 ): 259 - 301 .
MEDRANO-ESCALADA Y , PLAZA-MANZANO G , FERNANDEZ-DE-LAS-PENAS C , et al . Structural, functional and neurochemical cortical brain changes associated with chronic low back pain [J]. Tomography , 2022 , 8 ( 5 ): 2153 - 2163 .
ZHANG T , ZHANG M , CUI S , et al . The core of maintaining neuropathic pain: crosstalk between glial cells and neurons (neural cell crosstalk at spinal cord) [J]. Brain Behav , 2023 , 13 ( 2 ): e2868 .
YANG Q , CHEN Q , ZHANG K B , et al . Sinomenine alleviates neuroinflammation in chronic cerebral hypoperfusion by promoting M2 microglial polarization and inhibiting neuronal pyroptosis via exosomal miRNA-223-3p [J]. Acta Neuropathol Commun , 2025 , 13 ( 1 ): 48 .
FAN H , YANG Y , BAI Q , et al . Neuroprotective effects of sinomenine on experimental autoimmune encephalomyelitis via anti-inflammatory and Nrf2-dependent anti-oxidative stress activity [J]. Neuromolecular Med , 2023 , 25 ( 4 ): 545 - 562 .
NI H , LIU M , CAO M , et al . Sinomenine regulates the cholinergic anti-inflammatory pathway to inhibit TLR4/NF‑κB pathway and protect the homeostasis in brain and gut in scopolamine-induced Alzheimer's disease mice [J]. Biomed Pharmacother , 2024 , 171 : 116190 .
LUO J , ZHU Y , YU Y , et al . Sinomenine treats rheumatoid arthritis by inhibiting MMP9 and inflammatory cytokines expression: bioinformatics analysis and experimental validation [J]. Sci Rep , 2024 , 14 ( 1 ): 12786 .
TONG X , XIAO L , XIN Y . TFDP1 overexpression promotes apoptosis of nucleus pulposus cells in intervertebral disc degeneration through regulating ADAM15/MMP9 axis [J]. Gen Physiol Biophys , 2025 , 44 ( 1 ): 63 - 71 .
WANG J W , ZHU L , SHI P Z , et al . 1,25(OH) 2 D 3 mitigates oxidative stress-induced damage to nucleus pulposus-derived mesenchymal stem cells through PI3K/Akt pathway [J]. Oxid Med Cell Longev , 2022 , 2022 : 1427110 .
HU J , YAN Q , JIANG H , et al . A decrease in IL-33 regulates matrix degradation and apoptosis in intervertebral disc degeneration via HIF-1α [J]. Am J Transl Res , 2021 , 13 ( 11 ): 12724 - 12733 .
YUAN M , ZHAO B , JIA H , et al . Sinomenine ameliorates cardiac hypertrophy by activating Nrf2/ARE signaling pathway [J]. Bioengineered , 2021 , 12 ( 2 ): 12778 - 12788 .
XIA B , LI Q , WU J , et al . Sinomenine confers protection against myocardial ischemia reperfusion injury by preventing oxidative stress, cellular apoptosis, and inflammation [J]. Front Pharmacol , 2022 , 13 : 922484 .
蒋香云 , 朱丽 , 陈勇 , 等 . 离子导入技术促进盐酸青藤碱透皮递送的影响因素研究 [J]. 中成药 , 2021 , 43 ( 6 ): 1409 - 1414 .
鄢森 , 滕健 , 孙彤彤 , 等 . 电致孔方式对盐酸青藤碱经皮渗透的促进作用 [J]. 中国实验方剂学杂志 , 2021 , 27 ( 17 ): 146 - 151 .
鄢欢 , 颜苗 , 邓阳 , 等 . 青藤碱电致孔给药的药动学及在关节腔中浓度的研究 [J]. 中南药学 , 2014 , 12 ( 6 ): 518 - 520 .
CHEN X , WU Y , JIA R , et al . Antioxidant activity and the therapeutic effect of sinomenine hydrochloride-loaded liposomes-in-hydrogel on atopic dermatitis [J]. Int J Mol Sci , 2024 , 25 ( 14 ): 7676 .
CHEN J , LONG W , DONG B , et al . Hexagonal liquid crystalline system containing cinnamaldehyde for enhancement of skin permeation of sinomenine hydrochloride [J]. Pharm Dev Technol , 2022 , 27 ( 6 ): 684 - 694 .
GAO F , DAI Z , ZHANG T , et al . Synthesis and biological evaluation of novel sinomenine derivatives as anti-inflammatory and analgesic agent [J]. RSC Adv , 2022 , 12 ( 46 ): 30001 - 30007 .
0
Views
0
下载量
0
CSCD
0
CNKI被引量
Publicity Resources
Related Articles
Related Author
Related Institution
沪公网安备 31011502015228号