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基于病理生理机制的糖尿病肾病中医综合治疗研究

Research on TCM Comprehensive Treatment of DKD Based on Pathophysiological Mechanism.

作者信息

Piao Lei, Ma Jian, Zhao Na, Hou Yongqing, Wang Tehasi

机构信息

The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, People's Republic of China.

Endocrinology Department, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2025 Jul 16;18:2369-2384. doi: 10.2147/DMSO.S523094. eCollection 2025.

Abstract

Diabetic kidney disease (DKD) is the predominant etiology of end-stage renal disease (ESRD). Despite rigorous therapeutic interventions aimed at managing hyperglycemia, regulating blood pressure, and employing renin-angiotensin system inhibitors, the incidence of DKD remains high. Recent investigations have indicated a shift in the disease spectrum of DKD accompanied by significant advancements in the development of novel therapeutic options. Nevertheless, in addition to agents such as renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and mineralocorticoid receptor antagonists (MRA), there is currently no optimal strategy in contemporary medicine to effectively mitigate the progression of DKD. The application of TCM in the management of DKD has demonstrated its potential in delaying disease progression and enhancing patient quality of life, thereby playing a crucial role in the prevention and treatment of this condition. Clinical evidence supports its efficacy and safety profile. This article aimed to explore the TCM approach to DKD, focusing on aspects such as etiology, pathogenesis, syndrome differentiation, and comprehensive treatment, while also analyzing the latest research developments in the pathophysiology of DKD.

摘要

糖尿病肾病(DKD)是终末期肾病(ESRD)的主要病因。尽管采取了严格的治疗干预措施来控制血糖、调节血压并使用肾素-血管紧张素系统抑制剂,但DKD的发病率仍然很高。最近的研究表明,DKD的疾病谱发生了变化,同时新型治疗方案的开发也取得了重大进展。然而,除了肾素-血管紧张素系统抑制剂(RASi)、钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)、胰高血糖素样肽-1受体激动剂(GLP-1RA)和盐皮质激素受体拮抗剂(MRA)等药物外,当代医学目前还没有有效的策略来有效减缓DKD的进展。中医在DKD管理中的应用已显示出其在延缓疾病进展和提高患者生活质量方面的潜力,从而在该疾病的预防和治疗中发挥关键作用。临床证据支持其疗效和安全性。本文旨在探讨中医治疗DKD的方法,重点关注病因、病机、辨证论治和综合治疗等方面,同时分析DKD病理生理学的最新研究进展。

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本文引用的文献

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Pathophysiology of diabetic kidney disease: impact of SGLT2 inhibitors.糖尿病肾病的病理生理学:SGLT2 抑制剂的影响。
Nat Rev Nephrol. 2021 May;17(5):319-334. doi: 10.1038/s41581-021-00393-8. Epub 2021 Feb 5.

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