摘要
慢性肾脏病(chronic kidney disease,CKD)是由各种原因引起的以肾脏结构损害和功能障碍为主要表现的慢性疾病,其进展呈进行性、不可逆性。自噬是清除衰老细胞和受损的胞质蛋白的自稳机制,自噬失调则会加速肾脏病的进展,这与中医阴阳平衡理论有着相似的内涵。因此,自噬可能是CKD中阴阳平衡的微观基础。CKD初期,自噬水平尚稳定,宜选方用药遵循调和;中后期肾中自噬水平异常,络脉不和,当调和肾络、心肾平调。当前研究已证实一些中药成分及复方制剂可以通过调节自噬保护肾脏,自噬不足时,当“益火之源”,选用性味辛温、苦寒的温阳益气、活血泄浊之品提升自噬水平、加快代谢效率,维持细胞更新与凋亡的平衡;自噬过度时,应“壮水之主”,选用酸甘、苦咸之品等益肾填精、补血祛瘀之品降低自噬水平,通过“滋补”或“去瘀生新”的方式避免细胞凋亡与损伤,从而延缓CKD进展。
Chronic kidney disease(CKD)is a chronic disease caused by various reasons,with structural damage and dysfunction of the kidney as the primary manifestation,and its progression is progressive and irreversible.Autophagy is a self-stabilizing mechanism that removes senescent cells and damaged cytoplasmic proteins,and dysregulation of autophagy accelerates the progression of kidney disease,which has similar connotations to the theory of balance of yin and yang in traditional Chinese medicine.Therefore,autophagy may be the microcosmic basis for the balance of yin and yang in CKD.In the early stage of CKD,the autophagy level is still stable,and it is appropriate to follow the formula and medication to be regulated;in the middle and late stages,the autophagy level in the kidney is abnormal,and the collaterals are not in harmony,so it is necessary to regulate the collaterals of the kidney and the heart and kidneys to regulate them evenly.It was proved that some Chinese medicine ingredients and compound preparations can protect the kidney by regulating autophagy in recent research.When autophagy is insufficient,the source of fire should be benefited.The products of warming yang and benefiting qi,activating blood circulation,and draining turbidity with pungent warm and bitter flavors should enhance autophagy,accelerate the metabolism,and maintain the balance between cell renewal and apoptosis.When the level of autophagy is too high,the balance of autophagy cell renewal and apoptosis should be maintained.When autophagy is excessive,we should“strengthen the main body of water”and use sour,sweet,bitter,and salty products to benefit the kidney and fill in essence,tonify blood,and eliminate stasis to reduce autophagy levels and avoid apoptosis and damage to cells by“nourishing”or“removing stasis and generating new cells”,thus delaying CKD.This will prevent cell apoptosis and damage by“nourishing”or“removing stasis and generating new cells”,thus slowing the progress of CKD.
作者
朱可芯
吴敏
卞芝琳
韩世亮
冯晨
候帅
谢圣芳
ZHU Kexin;WU Min;BIAN Zhilin;HAN Shiliang;FENG Chen;HOU Shuai;XIE Shengfang(Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,China)
出处
《环球中医药》
CAS
2024年第8期1573-1579,共7页
Global Traditional Chinese Medicine
基金
国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号)
江苏省卫生健康委重点项目(ZD2021042)
2022年江苏省研究生实践创新计划(SJCX22_0833)。
关键词
自噬
慢性肾脏病
阴阳理论
中医药
autophagy
chronic kidney disease
yin-yang theory
traditional Chinese medicine
