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肾性贫血的传统及补充替代医学疗法:文献综述

Conventional and complementary alternative medicine therapies for renal anemia: a literature review.

作者信息

Lu Ching-Ming, Hsu Yuan-Hsuan, Lin I-Hsin, Kuo Ko-Lin, Liao Jian-Fu, Huang Hui-Fen, Lu Ping-Hsun

机构信息

School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan.

Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.

出版信息

Front Endocrinol (Lausanne). 2025 Jan 22;15:1342873. doi: 10.3389/fendo.2024.1342873. eCollection 2024.

Abstract

Renal anemia stems mainly from chronic inflammation with elevated hepcidin levels, iron deficiency, and reduced red blood cell lifespan. Inadequate erythropoietin (EPO) production, worsened kidney function, leads to symptoms such as low energy, fatigue, and impaired physical function, significantly affecting patients' quality of life. We conducted a comprehensive search across electronic databases including PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Airiti library, and Wanfang, to compile recent clinical trials and pilot studies on conventional and complementary alternative medicine approaches for renal anemia. This discussion focuses on the hypoxia-inducible factor prolyl hydroxylase domain (HIF-PHD) axis theory, from lab research to clinical applications. It explores non-extracorporeal treatments for renal anemia, including pharmaceutical interventions, dietary strategies, and complementary and alternative medicine (CAM). The article details the effects of Roxadustat, Ferumoxytol, and Epodion. Clinical studies show that modulating the gut microbiome can reduce inflammation and improve renal anemia. Clinical trials suggest that CAM therapy can improve renal anemia through mechanisms such as enhanced iron metabolism, anti-inflammatory effects, reduced hepcidin levels, and increased EPO and HIF expressions. By synthesizing this information, the review aims to furnish valuable insights and treatment recommendations aimed at ameliorating renal anemia in individuals grappling with chronic kidney disease.

摘要

肾性贫血主要源于慢性炎症伴铁调素水平升高、缺铁以及红细胞寿命缩短。促红细胞生成素(EPO)生成不足,肾功能恶化,会导致精力不足、疲劳和身体功能受损等症状,严重影响患者的生活质量。我们全面检索了包括PubMed、Embase、Cochrane图书馆、中国知网、华艺数位图书馆和万方在内的电子数据库,以汇总有关肾性贫血的传统医学和补充替代医学方法的最新临床试验和试点研究。本讨论聚焦于缺氧诱导因子脯氨酰羟化酶结构域(HIF-PHD)轴理论,从实验室研究到临床应用。它探讨了肾性贫血的非体外治疗方法,包括药物干预、饮食策略以及补充替代医学(CAM)。文章详细介绍了罗沙司他、铁氧还蛋白和依泊汀的作用。临床研究表明,调节肠道微生物群可减轻炎症并改善肾性贫血。临床试验表明,补充替代医学疗法可通过增强铁代谢、抗炎作用、降低铁调素水平以及增加EPO和HIF表达等机制改善肾性贫血。通过综合这些信息,本综述旨在提供有价值的见解和治疗建议,以改善慢性肾脏病患者的肾性贫血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4cf/11797209/10dcfff8491d/fendo-15-1342873-g001.jpg

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