摘要
炎症反应是糖尿病肾脏病进展过程中的关键机制,多因素刺激所导致的信号通路激活可介导炎症介质的产生、表达及相互作用,其中核因子(nuclear factor-kappa B,NF-κB)通路是炎症反应的重要通路之一,该通路的激活可诱导下游多种炎症介质的表达,通过促巨噬细胞聚集、加强肾脏血管收缩、加重肾小球高滤过状态及促进肾小球硬化等途径导致肾功能损伤及纤维化。现代医学治疗糖尿病肾脏病以降血糖、降血压、抗氧化、抗肾脏纤维化药物等为主,存在作用机制单一、胃肠道不良反应等不足。中医药在治疗糖尿病肾脏病方面具有其独特优势,且目前已有多种中药及复方被证明可通过NF-κB通路治疗糖尿病肾脏病。但目前研究尚存在不足之处:(1)中药复方以多靶点、多通路为特点,且一些中药单体的代谢产物尚不明确,其具体作用机制复杂,未来尚需对其有效成分进一步研究;(2)许多研究的样本量较小,这可能会对结果的可靠性产生影响,因此,需要更大规模的临床试验和动物实验,以进一步证实研究结果的可靠性。
Inflammatory response is a key mechanism in the progression of diabetes nephropathy.The activation of signal pathways caused by multifactor stimulation can mediate the production,expression,and interaction of inflammatory mediators,including nuclear factor-kappa B(NF-κB)Pathway is one of the important pathways in inflammatory response.Activation of that pathway can induce the expression of various downstream inflammatory mediators,leading to renal function damage and fibrosis through pathways such as promoting macrophage aggregation,enhancing renal vasoconstriction,exacerbating glomerular hyperfiltration,and promoting glomerulosclerosis.Modern medicine mainly treats diabetes nephropathy with hypoglycemic,hypotensive,antioxidant,anti-renal fibrosis drugs,etc.However,there are deficiencies such as single mechanism of action,gastrointestinal adverse reactions,etc.Traditional Chinese medicine has its unique advantages in treating diabetes nephropathy,what′s more,many Chinese medicines and compounds have been proved effective to treat diabetes nephropathy based on NF-κB signaling pathway.However,there are still shortcomings in current research:(1)Traditional Chinese medicine formulas are characterized by multiple targets and pathways as well as metabolic products of some monomers are not yet clear.Their specific mechanisms of action are complex,and further research on their effective ingredients is needed in the future;(2)In many studies,sample sizes are small,which may affect reliability of the results.Therefore,larger scale clinical and animal experiments are needed to verify and further confirm reliability of the research results.
作者
陈言
冯志海
吕娜
刘昱君
刘峙岐
CHEN Yan;FENG Zhihai;LYU Na;LIU Yujun;LIU Zhiqi(The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou Henan China 450000;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450000;Henan Province Chinese Medicine Research Institute Affiliated Hospital,Zhengzhou Henan China 450003)
出处
《中医学报》
CAS
2024年第11期2386-2392,共7页
Acta Chinese Medicine
基金
河南省首批中医药青苗人才培养项目(CZ0193-33)。
