氧化应激是推动多种慢性疾病发生与演进的核心病理环节，其特征是活性氧过度积累与内源性抗氧化防御失衡。葛根素作为从葛根Puerariae Lobatae Radix中提取的天然异黄酮苷类化合物，具有多靶向抗氧化活性。研究表明，葛根素可通过直接清除自由基、激活内源性抗氧化系统、抑制促氧化酶、调控核因子E2相关因子2、丝裂原活化蛋白激酶、蛋白激酶B等关键信号通路及改善线粒体、内质网和溶酶体等细胞器功能等机制，显著缓解氧化应激及铁死亡、焦亡与凋亡等细胞死亡过程。围绕葛根素的多靶向抗氧化机制、临床应用现状、药动学挑战及新型递药系统的研究进展进行系统总结，为推动葛根素成为治疗氧化应激相关疾病的精准靶向药物提供理论依据。

Oxidative stress is a central pathological process driving the onset and progression of multiple chronic diseases, characterized by excessive accumulation of reactive oxygen species and imbalance of endogenous antioxidant defenses. Puerarin, a natural isoflavone glycoside extracted from Gegen (Puerariae Lobatae Radix), exhibits potent multi-target antioxidant activities. Accumulating evidence indicates that puerarin alleviates oxidative stress and cell death processes such as ferroptosis, pyroptosis and apoptosis by directly scavenging free radicals, activating endogenous antioxidant systems, inhibiting pro-oxidant enzymes, modulating key signaling pathways such as nuclear factor erythroid 2-related factor 2 (Nrf2), mitogen-activated protein kinase (MAPK), and protein kinase B (Akt), and improving the functional homeostasis of cellular organelles including mitochondria, endoplasmic reticulum, and lysosomes. This review systematically summarizes the multi-target antioxidant mechanisms of puerarin, its current clinical applications, pharmacokinetic limitations, and recent advances in novel drug delivery systems, aiming to provide a theoretical basis for the development of puerarin as a precision-targeted therapeutic agent for oxidative stress-related diseases.

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国家自然科学青年基金资助项目（82305019）；河南省科技攻关项目（242102311252）