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补肾与活血类中药治疗桡骨远端骨折的临床疗效与潜在作用机制：基于Meta分析与网络药理学的联合分析

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中草药 | 数据挖掘与循证医学 2026,57(18): 7359-7375

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中草药 |数据挖掘与循证医学 2026 , 57 (18) : 7359 -7375

补肾与活血类中药治疗桡骨远端骨折的临床疗效与潜在作用机制：基于Meta分析与网络药理学的联合分析

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马常荣^1,2, 张子珺³, 刘畅^1,2, 许祎萱^1,2, 李远栋^1,2

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马常荣: 马常荣（2001—），男，甘肃人，硕士研究生，研究方向为中医药防治脊柱关节疾病的基础与临床研究。E-mail:1311821329@qq.com#共同第一作者：张子珺（2006—），男，吉林人，本科生。E-mail:3093774180@qq.com

Clinical efficacy and potential mechanisms of kidney-tonifying versus blood-activating traditional Chinese medicines in treatment of distal radius fractures: An integrated study based on Meta-analysis and network pharmacology

MA Changrong^1,2, ZHANG Zijun³, LIU Chang^1,2, XU Yixuan^1,2, LI Yuandong^1,2

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doi: 10.7501/j.issn.0253-2670.2026.18.023

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目的采用Meta分析系统评价补肾与活血类中药辅助治疗桡骨远端骨折的临床疗效，并通过网络药理学初步揭示其作用机制。方法计算机检索PubMed、Web of Science、Cochrane Library、Embase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方、维普（VIP）数据库，检索时限为建库至2026年6月，纳入补肾或活血类中药联合西医常规治疗对比单纯西医常规治疗桡骨远端骨折的临床对照研究。采用RevMan 5.4软件进行Meta分析，同时运用网络药理学筛选核心活性成分、预测靶点并进行通路富集分析。结果共纳入23项研究，合计3 377例患者。Meta分析结果显示，补肾类与活血类中药均可显著提高临床有效率、缩短骨折愈合时间、降低视觉模拟评分（visual analogue scale，VAS）、升高骨钙素水平并改善腕关节功能，两类药物总体疗效无统计学差异（P＞0.05）；活血类中药在腕关节背伸活动度改善方面更优，补肾类中药疗效更稳定、异质性更低。网络药理学筛选出肿瘤蛋白p53（tumor protein p53，TP53）、Src酪氨酸激酶（proto-oncogene tyrosine-protein kinase Src，SRC）、信号转导和转录激活因子3（signal transducer and activator of transcription 3，STAT3）等核心靶点，主要调控磷脂酰肌醇-3-羟激酶（phosphatidylinositol-3-hydroxykinase，PI3K）-蛋白激酶B（protein kinase B，Akt）、丝裂原活化蛋白激酶（mitogen-activated protein kinase，MAPK）、核因子-κB（nuclear factor-κB，NF-κB）等通路；活血类中药主要通过血管内皮生长因子（vascular endothelial growth factor，VEGF）、肿瘤坏死因子（tumor necrosis factor，TNF）、Janus激酶（Janus kinase，JAK）-STAT通路发挥抗炎、改善微循环作用，补肾类中药则通过Wnt//β-连环蛋白（β-catenin）及细胞周期通路促进成骨分化与骨代谢。结论补肾类与活血类中药辅助治疗桡骨远端骨折，疗效确切、安全性良好，均通过多成分、多靶点、多通路促进骨折愈合；早期宜选用活血类中药消肿止痛，中后期选用补肾类中药强骨促愈。

关键词

桡骨远端骨折 / 活血中药 / 补肾中药 / Meta分析 / 网络药理学 / 骨代谢

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Objective To systematically evaluate the clinical efficacy of kidney-tonifying and blood-activating traditional Chinese medicines as adjunctive therapies for distal radius fractures using a Meta-analysis, and to preliminarily explore their mechanisms of action through network pharmacology. Methods PubMed, Web of Science, Cochrane Library, Embase, CBM, CNKI, Wanfang, and VIP databases were searched from inception to June 2026 to identify clinical controlled studies comparing traditional Chinese medicine decoctions combined with conventional Western medicine versus conventional Western medicine alone for distal radius fractures. RevMan 5.4 software was used for Meta-analysis, and network pharmacology was employed to screen core active components, predict targets, and conduct pathway enrichment analysis. Results A total of 23 studies involving 3 377 patients were included. The Meta-analysis results showed that both kidney-tonifying and blood-activating traditional Chinese medicines significantly improved the clinical effective rate, shortened fracture healing time, reduced visual analog scale (VAS) pain scores, increased osteocalcin levels, and improved wrist joint function, with no statistically significant difference in overall efficacy between the two categories (all P > 0.05). Blood-activating traditional Chinese medicines showed superior improvements in wrist dorsiflexion range of motion, while kidney-tonifying traditional Chinese medicines exhibited more stable efficacy with lower heterogeneity. Network pharmacology identified core targets such as tumor protein p53 (TP53), proto-oncogene tyrosine-protein kinase Src (SRC), signal transducer and activator of transcription 3 (STAT3), primarily regulating pathways including phosphatidylinositol-3-hydroxykinase (PI3K)-protein kinase B (Akt), mitogen-activated protein kinase (MAPK), nuclear factor-κB (NF-κB). Blood-activating traditional Chinese medicines exerted anti-inflammatory and microcirculation-improving effects mainly through vascular endothelial growth factor (VEGF), tumor necrosis factor (TNF), and Janus kinase (JAK)-STAT pathways, whereas kidney-tonifying traditional Chinese medicines promoted osteogenic differentiation and bone metabolism via the Wnt/β-catenin pathway and cell cycle pathways. Conclusion Kidney-tonifying and blood-activating traditional Chinese medicines are effective and safe as adjunctive therapies for distal radius fractures, both promoting fracture healing through multi-component, multi-target, and multi-pathway mechanisms. Blood-activating traditional Chinese medicines are more suitable for relieving swelling and pain in the early stage, while kidney-tonifying traditional Chinese medicines are better for strengthening bone and promoting healing in the middle and late stages.

Key words

distal radius fracture / blood-activating traditional Chinese medicine / kidney-tonifying traditional Chinese medicine / Meta-analysis / network pharmacology / bone metabolism

引用本文

马常荣, 张子珺, 刘畅, 许祎萱, 李远栋. 补肾与活血类中药治疗桡骨远端骨折的临床疗效与潜在作用机制：基于Meta分析与网络药理学的联合分析. 中草药, 2026 , 57 (18) : 7359 -7375 . DOI: 10.7501/j.issn.0253-2670.2026.18.023

MA Changrong, ZHANG Zijun, LIU Chang, XU Yixuan, LI Yuandong. Clinical efficacy and potential mechanisms of kidney-tonifying versus blood-activating traditional Chinese medicines in treatment of distal radius fractures: An integrated study based on Meta-analysis and network pharmacology[J]. Chinese Traditional and Herbal Drugs, 2026 , 57 (18) : 7359 -7375 . DOI: 10.7501/j.issn.0253-2670.2026.18.023

基金

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天津市卫生健康委员会天津市中医药重点领域科研项目 (2026005); 河北省中医药管理局科研计划项目 (T2025087); 天津中医药大学教师队伍建设研究项目 (Y-202608); 天津中医药大学教师教学发展研究项目 (A26JF12); 天津市高等学校研究生教育改革研究计划项目 (TJYG25101)

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2026年第57卷第18期

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doi: 10.7501/j.issn.0253-2670.2026.18.023

接收时间：2026-03-24
首发时间：2026-10-29

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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