肾虚证临床与动物实验研究进展

Clinical and Animal Experimental Research on Kidney Deficiency Syndrome： A Review

摘要:

肾虚证是中医临床常见的一种证候，随着科学技术的进步，肾虚证在临床与动物实验方面取得了显著的进展。肾虚证及“肾”本质研究涉及大量生理病理基础，与人体的多个生理病理环节密切相关，其中神经内分泌免疫网络与之关联最为密切。然而，肾虚证现代研究仍然存在诸多挑战，如临床诊断标准及评价指标的专家共识，动物实验模型的优化等。近10年来，在临床与动物实验方面涌现大量关于肾虚证的文献报道，其中病证结合文献居多，且多聚焦在肾阳虚、肾阴虚两方面，涉及许多病理机制的探讨。肾虚证相关机制研究涵盖了多条信号通路及多种生化指标，信号通路如磷脂酰肌醇3-激酶/蛋白激酶B/核因子E₂相关因子2（PI3K/Akt/Nrf2）信号通路、Toll样受体4/髓样分化因子88/核转录因子-κB（TLR4/MyD88/NF-κB）信号通路、Janus激酶2/信号转导与转录激活因子3（JAK2/STAT3）信号通路、骨保护素/核转录因子-κB受体活化因子配体/NF-κB的受体激活因子（OPG/RANKL/RANK）信号通路等，生化指标如cAMP/环磷酸鸟苷（cGMP）比值、Na⁺-K⁺-ATP酶活性、Ca²⁺-Mg²⁺-ATP酶活性、促肾上腺皮质激素（ACTH）、多皮质酮（CORT）、17羟皮质类固醇（17-OHCS）及其他一些性激素指标，其对于肾阳虚或肾阴虚的诊断具有重要参考价值。现对近10年来肾虚证相关文献进行整理挖掘，以期为肾虚证研究提供借鉴与参考。

Abstract:

Kidney deficiency syndrome is a common clinical syndrome in traditional Chinese medicine （TCM）. With the progress of science and technology， clinical and animal experiments on kidney deficiency syndrome have made remarkable progress. Research on kidney deficiency and the nature of "kidney" involves a large number of physiological and pathological bases， which are closely related to physiological and pathological links in the human body， among which the neuroendocrine-immune network shares the closest relationship. However， there are still many challenges in modern research on kidney deficiency syndrome， such as expert consensus on clinical diagnostic criteria and evaluation indexes and optimization of animal experimental models. In the past decade， a large number of clinical and animal experiments have been reported in the literature on kidney deficiency syndrome， among which the literature focusing on the combination of disease and syndrome is predominant， and most of them focus on kidney Yang deficiency and kidney Yin deficiency， involving the exploration of many pathological mechanisms. Research on the mechanisms related to kidney deficiency syndrome encompasses multiple signaling pathways and various biochemical indicators， including the phosphatidylinositol 3-kinase/protein kinase B/nuclear factor-erythroid 2-relatedfactor-2（PI3K/Akt/Nrf2） signaling pathway， the Toll-like receptor 4/myeloid differentiation factor88/nuclear factor-κB（TLR4/MyD88/NF-κB） signaling pathway， the Janus kinase 2/signal transducer and activator of transcription 3（JAK2/STAT3） signaling pathway， Osteoprotectin/nuclear factor-κB receptor activator ligand/receptor activator of nuclear factor-κB （OPG/RANKL/RANK） signaling pathway. The biochemical indicators cover the cyclic adenosine monophosphate/cyclic guanosine monophosphate （cAMP/cGMP） ratio， Na⁺-K⁺-ATPase activity， Ca²⁺-Mg²⁺-ATPase activity， adrenocorticotropic hormone （ACTH）， polycorticosterone （CORT）， 17-OHCS， and other sex hormone indicators， providing crucial reference values for diagnosing kidney Yang deficiency or kidney Yin deficiency. The literature related to kidney deficiency syndrome over the past decade was collated and excavated， with a view to providing a reference for research on kidney deficiency syndrome.