基于肾小管病变探讨糖尿病肾病的中医药防治

Prevention and Treatment of Diabetic Kidney Disease with Traditional Chinese Medicine Based on Diabetic Tubulopathy

糖尿病肾病(Diabetic kidney disease,DKD)是糖尿病(Diabetes mellitus,DM)常见的慢性并发症之一,也是慢性肾脏病(Chronic kidney disease,CKD)包括终末期肾脏病(End-stage renal disease,ESRD)在内的首要病因,更是糖尿病患者早发死亡的重要危险因素。糖尿病肾小管病(Diabetic tubulopathy,DT)作为DKD的重要启动点,对于DKD的早期预防及诊治具有重要的意义。研究发现中医药通过积极防治DT可有效延缓DKD病程进展,达到早预防、早治疗、预后好的效果。其机制主要是通过作用于不同的靶点及通路,对DKD患者受损的肾小管起到改善和保护的作用,进而减轻肾脏损伤、改善患者临床症状、延缓病程进展。本文就近年来DKD肾小管损伤的机制及中医药基于肾小管病变对DKD的防治进展进行综述。

Diabetic kidney disease(DKD)is one of the common chronic complications of diabetes mellitus(DM),the primary cause of chronic kidney disease(CKD),including end-stage renal disease(ESRD),and an important risk factor for early death in diabetic patients.As an important starting point of DKD,diabetic tubulopathy(DT)is important for the early prevention and treatment of DKD.It is found that traditional Chinese medicine can effectively delay the course of DKD through the active prevention and treatment of DT,and achieve early prevention,early treatment and good prognosis.The mechanism is mainly to improve and protect the damaged renal tubules in patients in various periods through different targets and pathways,so as to reduce kidney injury,improve the clinical symptoms of patients and delay the course of the disease.This paper reviews the mechanism of renal tubular injury in diabetic kidney disease and the progress of traditional Chinese medicine in the prevention and treatment of diabetic kidney disease based on diabetic tubulopathy in recent years.