[1]李雨婷,蔡旭东,林晓蒙,等.温阳活血法改善微循环治疗糖尿病肾病研究进展[J].陕西中医,2025,46(1):139-141,封3.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.031]
　LI Yuting,CAI Xudong,LIN Xiaomeng,et al.Research progress on the improvement of microcirculation by Wenyang blood activation method in the treatment of diabetic kidney disease[J].,2025,46(1):139-141,封3.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.031]
点击复制

温阳活血法改善微循环治疗糖尿病肾病研究进展
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年1期
页码:
139-141,封3
栏目:
综 述
出版日期:
2025-01-05

文章信息/Info

Title:
Research progress on the improvement of microcirculation by Wenyang blood activation method in the treatment of diabetic kidney disease
作者:
李雨婷; 蔡旭东; 林晓蒙; 李昌霖; 段嘉敏
(浙江中医药大学附属宁波市中医院,浙江 宁波 315010)
Author(s):
LI Yuting; CAI Xudong; LIN Xiaomeng; LI Changlin; DUAN Jiamin
(Ningbo Municipal Hospital of Traditional Chinese Medcine Affiliated to Zhejiang Chinese Medical University,Ningbo 315010,China)
关键词:
糖尿病肾病;  温阳活血法;  微循环障碍;  阳虚血瘀;  肾络瘀阻;  水肿
Keywords:
Diabetic kidney disease;  Wenyang blood activation method;  Microcirculation disorders;  Yang deficiency and blood stasis type;  Obstruction of renal veins;  Edema
分类号:
R 587.2
DOI:
DOI:10.3969/j.issn.1000-7369.2025.01.031
文献标志码:
A
摘要:
糖尿病对肾脏的损伤主要是各种因素导致的微循环障碍,呈慢性进行性发展。阳虚血瘀型是糖尿病肾病临床中的常见证型,气阴不足,久而损及阳,阳气不足,运血不畅故肾络瘀阻,即出现肾脏微循环障碍,进而导致水肿、蛋白尿、肾功能不全等症状。通过总结近年来有关温阳活血法治疗糖尿病肾病的临床和实验研究,介绍了中药单体、提取成分和中药复方通过改善肾脏血流动力学异常、抑制氧化应激和炎症反应、抑制铁死亡、调节自噬等,缓解肾络瘀阻,改善糖尿病肾病肾脏微循环障碍,进而延缓病情进展,以期为糖尿病肾病的防治提供一定的辨证思路。
Abstract:
The damage of diabetes to the kidneys is mainly caused by various factors of microcirculation disorders,which is chronic and progressive.Yang deficiency and blood stasis type is a common syndrome type in the clinical practice of diabetic nephropathy,with insufficient qi and yin,which will damage yang over time,lack of yang qi,poor blood flow,and obstruction of renal veins,that is,renal microcirculation disorders,which in turn lead to symptoms such as edema,proteinuria,and renal insufficiency.By summarizing the clinical and experimental research on the treatment of diabetic nephropathy by the Wenyang blood activation method in recent years,this paper introduces the monomers,extracts and compounds of traditional Chinese medicine to alleviate renal stasis and improve renal microcirculation disorders in diabetic nephropathy by improving renal hemodynamic abnormalities,inhibiting oxidative stress and inflammatory responses,inhibiting ferroptosis,regulating autophagy,etc.,in order to provide certain syndrome differentiation ideas and reference value for the prevention and treatment of diabetic nephropathy.

参考文献/References:

[1] Microvascular Complications and Foot Care.Standards of medical care in diabetes-2021[J].Diabetes Care,2021,44(Suppl 1):s151-s167.
[2] LI Y,NING Y,SHEN B,et al.Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019:An analysis of the Global Burden of Disease Study 2019[J].Clin Kidney J,2023,16(2):312-321.
[3] QUERFELD U,MAK R H,PRIES A R.Microvascular disease in chronic kidney disease:The base of the iceberg in cardiovascular comorbidity[J].Clin Sci(Lond),2020,134(12):1333-1356.
[4] PENG L,ZHANG C,XIAO G.Astragalus polysaccharide alleviates angiotensin II-induced glomerular podocyte dysfunction by inhibiting the expression of RARRES1 and LCN2[J].Clin Exp Pharmacol Physiol,2023,50(6):504-515.
[5] 代广玉,修丽梅.糖尿病肾病中医辨证分型研究进展[J].陕西中医,2021,42(1):131-133.
[6] 胡筱娟,李群,李婷,等.糖尿病肾病中医证型与瘀血证相关性研究[J].陕西中医,2012,33(11):1487-1488.
[7] 胡筱娟,秦艳,刘恬园.基于肾络瘀阻病机与糖尿病肾病相关性临床研究[J].陕西中医,2015,36(12):1614-1616.
[8] 刘芳,张立祥,王慧敏,等.养生益肾汤对糖尿病肾病患者血清细胞因子水平及肾功能的影响[J].陕西中医,2022,43(4):476-478.
[9] 肖遥,赵进喜.赵进喜治疗糖尿病肾病经验[J].中华中医药杂志,2018,33(1):159-162.
[10] 李辉.健脾固肾方辅治糖尿病肾病脾肾阳虚型临床分析[J].实用中医药杂志,2022,38(4):622-624.
[11] 尚乘,刘春莹,谭颖颖,等.真武汤合补阳还五汤治疗脾肾阳虚型糖尿病肾病临床研究[J].现代中医药,2022,42(5):98-101.
[12] 张婧.探讨益气温肾散结法治疗糖尿病肾病阳虚证的临床疗效及作用机制[D].北京:北京中医药大学,2020.
[13] 朱虹,朱泽伦,黄家宜,等.栝蒌瞿麦丸组方意义探析[J].实用中医内科杂志,2022,36(5):113-115.
[14] 刘潇,孙晓燕,高瑞华,等.益气温阳活血方联合西医常规治疗对早期糖尿病肾病微炎症状态及血管内皮功能的影响[J].甘肃中医药大学学报,2016,33(6):56-59.
[15] 杨超茅,李园园,张顺宵,等.肠道菌群与局部肾素-血管紧张素系统对糖尿病肾病的影响及中医药研究进展[J].中国实验方剂学杂志,2023,29(15):242-248.
[16] 戴临风,张焕,陈旭,等.真武汤对糖尿病肾病大鼠肾功能、蛋白尿和血液流变学的影响[J].中国现代药物应用,2024,18(2):171-174.
[17] 邵天瑞.基于Wnt/β-catenin信号通路探讨补阳还五汤对2型糖尿病肾病大鼠肾脏保护作用的机制研究[D].天津:天津中医药大学,2022.
[18] MA L,WU F,SHAO Q,et al.Baicalin alleviates oxidative stress and inflammation in diabetic nephropathy via Nrf2 and MAPK signaling pathway[J].Drug Des Devel Ther,2021,15:3207-3221.
[19] SHI Y,SHI X,ZHAO M,et al.Pharmacological potential of Astragali Radix for the treatment of kidney diseases[J].Phytomedicine,2024,123:155196.
[20] ZHANG Q,LIU X,SULLIVAN M A,et al.Protective effect of Yi Shen Pai Du formula against diabetic kidney injury via inhibition of oxidative stress,inflammation,and epithelial-to-mesenchymal transition in db/db mice[J].Oxid Med Cell Longev,2021,2021:7958021.
[21] ROBERTSON R P.Nrf2 and Antioxidant response in animal models of type 2 diabetes[J].Int J Mol Sci,2023,24(4):235-238.
[22] 赵哲,陈光顺,白敏,等.基于Nrf2/HO-1/GPX4信号通路探讨真武汤改善脾肾阳虚型糖尿病肾病小鼠的作用机制[J].中国实验方剂学杂志,2024,30(15):29-37.
[23] 张海力,李靖,王世长,等.中医药治疗糖尿病肾病最新进展[J].中国中西医结合肾病杂志,2019,20(9):831-833.
[24] WU Q,GUAN Y B,ZHANG K J,et al.Tanshinone ⅡA mediates protection from diabetes kidney disease by inhibiting oxidative stress induced pyroptosis[J].J Ethnopharmacol,2023,316:116667.
[25] 翁育芳,魏荣乐,宋文龙,等.补阳还五汤对糖尿病肾病早期大鼠肾组织IL-12、IFN-γ等表达的作用研究[J].实用中医内科杂志,2022,36(3):59-61,132,136.
[26] WANG Y,BI R,QUAN F,et al.Ferroptosis involves in renal tubular cell death in diabetic nephropathy[J].Eur J Pharmacol,2020,888:173574.
[27] CHEN Y,HUANG G,QIN T,et al.Ferroptosis:A new view on the prevention and treatment of diabetic kidney disease with traditional Chinese medicine[J].Biomed Pharmacother,2024,170:115952.
[28] HUANG D,SHEN P,WANG C,et al.Calycosin plays a protective role in diabetic kidney disease through the regulation of ferroptosis[J].Pharm Biol,2022,60(1):990-996.
[29] FORCINA G C,DIXON S J.GPX4 at the Crossroads of lipid homeostasis and ferroptosis[J].Proteomics,2019,19(18):e1800311.
[30] YAMAHARA K,YASUDA M,KUME S,et al.The role of autophagy in the pathogenesis of diabetic nephropathy[J].J Diabetes Res,2013,2013:193757.
[31] YAN L,XU X,FAN Y,et al.Tangshen decoction enhances podocytes autophagy to relieve diabetic nephropathy through modulation of p-AMPK/p-ULK1 Signaling[J].Evid Based Complement Alternat Med,2022,2022:3110854.
[32] 杨帆,张晓云,高俊侠,等.加减补阳还五汤通过SIRT1途径激活自噬改善糖尿病肾病小鼠肾组织损伤[J].天津中医药,2024,41(4):495-502.

相似文献/References:

[1]张华贞.复方黄芪汤加减联合骨化三醇治疗糖尿病肾病疗效及对患者血糖、肾功的影响*[J].陕西中医,2019,(6):767.
[2]程红卫,成晓萍.阎晓萍从脾论治糖尿病肾病经验总结*[J].陕西中医,2019,(6):790.
[3]黄聪丽,王治新△.益气滋肾活血通络方治疗早中期糖尿病肾病临床研究[J].陕西中医,2019,(10):1390.
　HUANG Congli,WANG Zhixin..Clinical efficacy analysis of Yiqi Zishen Huoxue Tongluo decoctionon early and medium stage of diabetic nephropathy[J].,2019,(1):1390.
[4]玉山江·艾克木,哈丽达·木沙△,地丽尼嘎尔.西红康联合还原型谷胱甘肽治疗2型糖尿病肾病Ⅲ期气阴两虚夹瘀证疗效及对患者微炎症状态、抗氧化的影响*[J].陕西中医,2020,(3):338.
　Yushanjiang·Aikemu,Halida·Musha,Dilinigaer..Efficacy of adjuvant therapy of Xihongkang on type 2 diabetic nephropathy Ⅲ phase with syndrome of Qiyin Liangxu Jiayu type and its effect on micro inflammation and antioxidant role[J].,2020,(1):338.
[5]马民凯,马红建,陈新苗.通络散结汤对3期糖尿病肾病患者GFR、UAER、β2-MG、Cys-C及微炎症状态的影响*[J].陕西中医,2020,(10):1432.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.025]
[6]田娟娟,陈 强,周欣欣,等.益气养阴活血法治疗糖尿病肾病理论探究*[J].陕西中医,2020,(12):1781.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.026]
[7]代广玉,修丽梅.糖尿病肾病中医辨证分型研究进展[J].陕西中医,2021,(1):131.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.036]
[8]赵 亚,张勉之,樊威伟,等.国医大师张大宁治疗糖尿病肾病用药经验[J].陕西中医,2021,(6):773.[doi:DOI:10.3969/j.issn.1000-7369.2020.06.025]
[9]张 蕊,王子承,蒋荣莉,等.防己黄芪汤加味治疗糖尿病肾病疗效及对患者糖脂代谢、氧化应激的影响[J].陕西中医,2021,(8):1049.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.015]
　ZHANG Rui,WANG Zicheng,JIANG Rongli,et al.Effect of Fangji Huangqi decoction on diabetic nephropathy and its influence on glucose and lipid metabolism and oxidative stress[J].,2021,(1):1049.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.015]
[10]方锦颖,王一冲,神原优滋(日本),等.基于网络药理学和分子对接探究肾康注射液治疗糖尿病肾病作用机制[J].陕西中医,2021,(12):1798.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.039]

备注/Memo

备注/Memo:
基金项目:浙江省自然科学基金资助项目(LY20H270004); 浙江省中医药科技计划项目(2024ZL142); 宁波市公益性科技计划项目(2022S083); 宁波市重点技术研发项目(2023Z165)
更新日期/Last Update: 2025-01-09