地黄活性成分干预急性肾损伤和纤维化的研究进展

Effect of Active Ingredients of Rehmanniae Radix in Intervening Acute Kidney Injury and Fibrosis： A Review

摘要:

急性肾损伤（AKI）是由各种病因引起短时间内肾功能快速减退而导致的临床综合征，迁延不愈可进一步发展为慢性肾脏病（CKD）甚至终末期肾病。尽管连续肾脏替代治疗可用于治疗重度AKI，但在很大程度上尚缺乏有效的AKI治疗药物。中医药因其多靶点、多通路的巨大优势，在治疗AKI及相关并发症方面已积累大量理论基础和实践经验。地黄作为临床常用的中药，具有清热凉血、养阴生津之功，其主要活性成分包含梓醇、毛蕊花糖苷、桃叶珊瑚苷等。该研究通过总结近年来地黄活性成分在防治AKI中的相关研究，发现改善炎症、缓解氧化应激、抑制细胞凋亡是地黄抗AKI药理活性的关键切入点，同时地黄活性成分所体现出的抗纤维化作用显示出其具有阻碍CKD进展的潜力。该研究从地黄治疗AKI的作用机制及其抗纤维化两大方面进行综述，为促进AKI新药的研发、推动地黄资源的开发利用及减少AKI向CKD的转变提供科学依据。

Abstract:

Acute kidney injury （AKI） is a clinical syndrome characterized by a rapid decline in renal function over a short period due to various etiologic factors. If left untreated， AKI can progress to chronic kidney disease （CKD） or even end-stage renal disease （ESRD）. Although continuous renal replacement therapy （CRRT） can manage severe AKI， effective pharmacological treatments for AKI remain largely unavailable. Chinese medicine， with its multi-target and multi-pathway approaches， has accumulated substantial theoretical and practical knowledge in treating AKI and related complications. Rehmanniae Radix is a commonly used Chinese medicinal， known for its functions in clearing heat， cooling blood， nourishing yin， and promoting fluid production. The primary active ingredients of Rehmanniae Radix include catalpol， acteoside， and aucubin. In this study， we summarized recent research on the effect of the active ingredients of Rehmanniae Radix in preventing and treating AKI. We found that the key mechanisms underlying its anti-AKI effects include amelioration of inflammation， alleviation of oxidative stress， and inhibition of apoptosis. Additionally， the antifibrotic properties of the active ingredients of Rehmanniae Radix suggest its potential in slowing CKD progression. We reviewed the mechanisms of Rehmanniae Radix in treating AKI and its antifibrotic effects to provide a scientific basis for developing new AKI drugs， promoting the utilization of Rehmanniae Radix resources， and reducing the transition from AKI to CKD.