中药复方防治实验性糖尿病肾病的研究进展

Research Progress of Chinese Herb Compound on Treatment of Experimental Diabetic Nephropathy

摘要:

糖尿病肾病(diabetic nephropathy, DN)是糖尿病的主要微血管并发症之一,DN对患者身体造成的损伤一般较为严重,甚至需要透析治疗的方法来延续生命.长期高血糖会导致慢性代谢异常和血流动力学改变,引起胞内信号转导通路、转录因子、细胞因子、趋化因子和生长因子的调节变化,导致肾脏结构畸形的发生,进而发展成DN.近年来,中药复方防治实验性糖尿病肾病的研究文献增多,显示出中药复方在防治DN方面所具有的一定优势.通过对较有代表性的研究文献进行分析和总结,对DN主要发病机制的六大方面进行梳理,如调控异常糖代谢、抑制氧化应激反应、调节肾血管血流动力学、组织因子和细胞因子的活化、肾小球超微结构变化、改善肾功能等方面,以期为DN的临床治疗及创新药物的研究开发提供参考.结果表明,近年来针对实验性DN的中药复方研究围绕DN发病的核心机制,主要通过影响糖异常代谢、氧化应激作用和肾血管血流动力学改变等方面展开,达到控制DN大鼠过高的血糖,抑制体内氧化应激状况,调整肾脏血管血液动力学的目的,最终改善DN的临床症状,如降低尿蛋白、尿素氮含量和肌酐等指标.通过对研究文献的整理分析,显示中药复方在防治实验性DN方面具有明显的效果,而且处方的构成具有一定的规律性,需要进一步深入研究.

Abstract:

Diabetic nephropathy(DN)is one of the major microvascular complications of diabetes and the most common cause of chronic kidney failure requiring dialysis. Prolonged hyperglycemia leads to chronic metabolic and hemodynamic changes that modulate the intracellular signaling pathways, transcription factors, cytokines, chemokines, and growth factors, promoting structural abnormalities in the kidney and the development and progression of DN. In recent years, the literatures on Chinese medicine compound in prevention and treatment of experimental diabetic nephropathy gradually increased, and Chinese medicine compound show certain advantage in combating DN. To summarize the major research progress on Chinese medicine compound in controlling DN in recent years, from six aspects of the pathogenesis of DN, we analyzed and classified the latest research achievements of Chinese medicine compound in experimental DN and probed into the mechanism of these compounds, including regulating abnormal glucose metabolism, oxidative stress and renal vascular hemodynamics and so on in rats. We hope to provide some references for clinical research and develope innovative drug for prevention and treatment of DN. Overview of the research literatures on Chinese medicine compound suggested that Chinese medicine compound could reduce glycaemic index, inhibit oxidative stress in vivo, adjust the renal vascular hemodynamics, and improve kidney function in DN indicators like reducing urinary albumin, urea nitrogen and creatinine and so on. Based on the research literatures, Chinese medicine compound has obvious effect in the aspect of prevention and treatment of experimental DN, and there is some regularity in composition of these prescriptions. The further mechanism needs more in-depth studies.