[1]王小溪,王晓悦,李 瑄,等.狼疮性肾炎中西医治疗研究进展[J].陕西中医,2025,46(5):703-706.[doi:DOI:10.3969/j.issn.1000-7369.2025.05.028]
　WANG Xiaoxi,WANG Xiaoyue,LI Xuan,et al.Progress of research on the treatment of lupus nephritis with traditional Chinese and western medicine[J].,2025,46(5):703-706.[doi:DOI:10.3969/j.issn.1000-7369.2025.05.028]
点击复制

狼疮性肾炎中西医治疗研究进展
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年5期
页码:
703-706
栏目:
综 述
出版日期:
2025-05-05

文章信息/Info

Title:
Progress of research on the treatment of lupus nephritis with traditional Chinese and western medicine
作者:
王小溪1; 2; 王晓悦1; 2; 李 瑄1; 2; 季琬童1; 2; 任 桐1; 2
(1.天津中医药大学第一附属医院肾病科,天津 300193; 2.国家中医针灸临床医学研究中心,天津 300193)
Author(s):
WANG Xiaoxi1; 2; WANG Xiaoyue1; 2; LI Xuan1; 2; JI Wantong1; 2; REN Tong1; 2
(1.Department of Nephrology,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300193,China; 2.National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China)
关键词:
狼疮性肾炎;  西医治疗;  药物;  中医治疗;  辨证论治;  病机
Keywords:
Lupus nephritis;  Western medical treatment;  Drugs;  Traditional Chinese medical treatment;  Syndrome differentiation and treatment;  Pathogenesis
分类号:
R 593.242
DOI:
DOI:10.3969/j.issn.1000-7369.2025.05.028
文献标志码:
A
摘要:
狼疮性肾炎(LN)是系统性红斑狼疮(SLE)最常见的严重并发症之一,其治疗一直备受关注。因其是继发于SLE的疾病,故而相关的名称记载较少,根据主要证候和临床表现,可将其归属于“水肿、虚劳、肾脏风毒、肾痹、阴阳毒、厥证”。中医认为其病机主要为肾气亏虚、瘀血邪毒阻络。由于LN的复杂性及临床表现多变,目前本病在临床上多采取中西医结合治疗。西医治疗LN的过程中常伴有一些副作用,而中医治疗LN则注重从整体调节,辨证论治,故在临床上可综合运用西医和中医治疗方法,结合患者自身提供个体化的治疗方案。从西医和中医角度分别探讨了目前针对LN的治疗,为临床治疗该病提供了一些思路与方法。
Abstract:
Lupus nephritis(LN)is one of the most common and severe complications of systemic lupus erythematosus(SLE),and its treatment has long been a subject of considerable attention.As a secondary disease resulting from SLE,there are relatively few recorded references to it by name.Based on its main symptoms and clinical manifestations,LN can be categorized under traditional Chinese medicine(TCM)syndromes such as “edema,deficiency fatigue,kidney wind-damp toxicity,kidney obstruction,yin-yang toxicity,and cold syndrome.” TCM believes that the pathogenesis of LN primarily involves kidney Qi deficiency,blood stasis,and the obstruction of channels by toxins.Due to the complexity and variability of LN's clinical presentation,a combination of western and TCM therapies is commonly employed in clinical practice.Western medicine often comes with certain side effects in the treatment of LN,whereas TCM focuses on holistic regulation,syndrome differentiation,and treatment.Therefore,a combined approach integrating both Western and Chinese medicine is applied in clinical practice to offer individualized treatment plans based on the patient's specific condition.The treatment of LN from both western and traditional Chinese medicine perspectives is discussed,providing some insights and approaches for the clinical management of the disease.

参考文献/References:

[1] ATHANASSIOU P,ATHANASSIOU L.Current treatment approach,emerging therapies and new horizons in systemic lupus erythematosus[J].Life(Basel),2023,13:(7)1496.
[2] 中国狼疮肾炎诊断和治疗指南编写组.中国狼疮肾炎诊断和治疗指南[J].中华医学杂志,2019(44):3441-3455.
[3] MAHAJAN A,AMELIO J,GAIRY K,et al.Systemic lupus erythematosus,lupus nephritis and end-stage renal disease:A pragmatic review mapping disease severity and progression[J].Lupus,2020,29(9):1011-1020.
[4] 赵亚峰,边静,李娜梅,等.狼疮性肾炎患者中医证型与临床病理分析[J].陕西中医,2019,40(11):1555-1558.
[5] PARIKH S V,ALMAANI S,BRODSKY S,et al.Update on lupus nephritis:Core Curriculum 2020[J].Am J Kidney Dis,2020,76(2):265-281.
[6] 韦佩祺,苏梓健,梁芳,等.microRNA在系统性红斑狼疮中的作用机制研究进展[J].陕西医学杂志,2023,52(2):238-241.
[7] CHEN Y C,KUO P Y,CHOU Y C,et al.Up-regulated expression of pro-apoptotic long noncoding RNA lincRNA-p21 with enhanced cell apoptosis in lupus nephritis[J].Int J Mol Sci,2020,22(1):301.
[8] KDIGO 2024 Clinical Practice Guideline for the management of LUPUS NEPHRITIS[J].Kidney Int,2024,105(1s):S1-S69.
[9] DIMA A,JURCUT C,CHASSET F,et al.Hydroxychloroquine in systemic lupus erythematosus:Overview of current knowledge[J].Ther Adv Musculoskelet Dis,2022,14:1759720x211073001.
[10] 朱洁丽,姬静静,方险锋,等.玉屏风联合糖皮质激素治疗过敏性紫癜的疗效观察以及对相关炎症因子表达的影响[J].分子诊断与治疗杂志,2023,15(9):1583-1586,1590.
[11] PORTA S,DANZA A,ARIAS SAAVEDRA M,et al.Glucocorticoids in systemic lupus erythematosus.ten questions and some issues[J].J Clin Med,2020,9(9):2709.
[12] ELAZIZ M M A,GAMAL S M,FAYED A,et al.High-and low-dose cyclophosphamide in Egyptian lupus nephritis patients:A multicenter retrospective analysis[J].Z Rheumatol,2024,83(Suppl 1):115-123.
[13] WIJAYARATNE D R,ATUKORALA I G,GUNAWARDENA N S,et al.Low-versus High-dose cyclophosphamide in Class Ⅲ/Ⅳ Lupus nephritis:A Retrospective study from south Asia[J].Indian J Nephrol,2023,33(1):40-45.
[14] 李莉.吗替麦考酚酯联合泼尼松对狼疮性肾炎患者血清指标的影响[J].当代医学,2022,28(4):173-175.
[15] ZHANG X,HUANG H,GAO D,et al.Comparison of the effectiveness and safety of mycophenolate mofetil and cyclophosphamide in lupus nephritis:Evidence from a real-world study[J].Rheumatol Ther,2023,10(5):1199-1213.
[16] 李丽,蒋芙蓉,赵丽英,等.血清肿瘤坏死因子受体相关因子3和卵泡抑素样蛋白1检测对系统性红斑狼疮患者吗替麦考酚酯治疗无效的预测价值[J].陕西医学杂志,2024,53(9):1254-1258.
[17] 陈承斌,朱世浪,韦筱荷.吗替麦考酚酯、环磷酰胺分别联合激素诱导缓解狼疮性肾炎的效果比较[J].大医生,2023,8(21):18-20.
[18] 国家皮肤与免疫疾病临床医学研究中心(北京协和医院),中国医师协会风湿免疫科医师分会,中国研究型医院学会风湿免疫专业委员会,等.钙调磷酸酶抑制剂治疗风湿免疫性疾病临床应用专家共识[J].中华内科杂志,2023(11):1266-1281.
[19] DONG Y,SHI J,WANG S,et al.The efficacy of immunosuppressive drugs induction therapy for lupus nephritis:A systematic review and network meta-analysis[J].Ren Fail,2023,45(2):2290365.
[20] PAL A,CHAUDHURY A R,BHUNIA A,et al.A randomized controlled trial comparing remission induction with modified multitarget therapy with intravenous cyclophosphamide in proliferative lupus nephritis[J].Indian J Nephrol,2023,33(5):340-347.
[21] FU Q,WU C,DAI M,et al.Leflunomide versus azathioprine for maintenance therapy of lupus nephritis:A prospective,multicentre,randomised trial and long-term follow-up[J].Ann Rheum Dis,2022,81(11):1549-1555.
[22] 刘玉,汤一榕,陈冰双.来氟米特、激素及羟氯喹联合治疗重症狼疮性肾炎效果观察[J].中外医学研究,2019,17(32):36-38.
[23] 李孟建.来氟米特治疗狼疮肾炎患者的临床研究[J].中国临床药理学杂志,2019,35(16):1735-1738.
[24] DESAI S B,AHDOOT R,MALIK F,et al.New guidelines and therapeutic updates for the management of lupus nephritis[J].Curr Opin Nephrol Hypertens,2024,33(3):344-353.
[25] ABDELKARIM A K O,ELTAHIRM N I A,ELAGIB E M,et al.Efficacy and safety of rituximab therapy for lupus nephritis among SLE female patients; A retrospective hospital-based study[J].Open Access Rheumatol,2022,14:301-308.
[26] 张冰,王绍杰.伏环孢素[J].中国药物化学杂志,2022,32(1):80.
[27] MENN-JOSEPHY H,HODGE L S,BIRARDI V,et al.Efficacy of voclosporin in proliferative lupus nephritis with high levels of proteinuria[J].Clin J Am Soc Nephrol,2024,19(3):309-318.
[28] RAMSKOLD D,PARODIS I,LAKSHMIKANTH T,et al.B cell alterations during BAFF inhibition with belimumab in SLE[J].E Bio Medicine,2019,40:517-527.
[29] 王敏,王明霞,邹婵娟,等.贝利尤单抗治疗活动性狼疮性肾炎的临床疗效及不良反应[J].中国医学前沿杂志(电子版),2023,15(11):65-70.
[30] ZHANG S,QIU Q,ZENG S,et al.Response to belimumab among patients with refractory lupus nephritis:A real-world observational retrospective multicenter study[J].Clin Rheumatol,2024,43(1):199-208.
[31] 周涵,梁伟,丁国华.贝利尤单抗在狼疮肾炎中的临床应用[J].临床肾脏病杂志,2022,22(10):861-865.
[32] 姜晨光,汲泓.系统性红斑狼疮中医病名之论[J].风湿病与关节炎,2022,11(4):59-61.
[33] 王珂,张春戬.狼疮性肾炎中医诊治浅析[J].中国现代医生,2023,61(11):142-145.
[34] 宋庆良,伍劲华,马春成.名中医伍劲华治疗狼疮性肾炎经验总结[J].亚太传统医药,2023,19(6):134-137.
[35] 朱安琪,刘春莹.刘春莹主任医师治疗狼疮性肾炎经验摭拾[J].陕西中医,2020,41(7):951-953.
[36] 郝锦秋,徐云生,付新利.张鸣鹤治疗系统性红斑狼疮肾损害临证经验[J].中国医药导报,2022,19(1):132-135.
[37] 李仕仪,林燕.曹式丽治疗狼疮性肾炎经验[J].河南中医,2022,42(7):1026-1031.
[38] 戎蓉,连博,范兴刚.益气补肾汤联合免疫抑制剂治疗狼疮性肾炎疗效评价[J].辽宁中医药大学学报,2023,25(11):170-173.
[39] 朱德礼,李建平,张元丽,等.参芪地黄汤联合来氟米特治疗气阴两虚型狼疮性肾炎临床研究[J].陕西中医,2023,44(8):1069-1073.

相似文献/References:

[1]赵亚峰,边静,李娜梅,等.狼疮性肾炎患者中医证型与临床病理分析*[J].陕西中医,2019,(11):1555.
　ZHAO Yafeng,BIAN Jing,LI Namei,et al.TCM Syndrome types and clinical pathological analysis of patients with lupus nephritis[J].,2019,(5):1555.
[2]杨 昕,李和根.肺癌辨证分型研究进展[J].陕西中医,2021,(9):1313.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.043]
　YANG Xin,LI Hegen.Progress in syndrome differentiation of lung cancer[J].,2021,(5):1313.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.043]
[3]朱德礼,李建平,张元丽,等.参芪地黄汤联合来氟米特治疗气阴两虚型狼疮性肾炎临床研究[J].陕西中医,2023,(8):1069.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.016]
　ZHU Deli,LI Jianping,ZHANG Yuanli,et al.Clinical observation of Shenqi Dihuang decoction combined with leflunomide in treating lupus nephritis with deficiency of Qi and Yin[J].,2023,(5):1069.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.016]

备注/Memo

备注/Memo:
[基金项目]国家自然科学基金资助项目(81873151)
更新日期/Last Update: 2025-05-08