中药延缓慢性肾功能衰竭进展的机制和效果

Mechanisms and effects of Chinese herbal medicine delaying progression of chronic renal failure

中药延缓慢性肾功能衰竭(chronic renal failure,CRF)进展的机制主要是指中药改善肾小球硬化和肾间质纤维化的作用,譬如,通过影响肾小球血流动力,减轻足细胞损伤,抑制转化生长因子-β表达,调整脂质代谢紊乱来改善肾小球硬化;通过减轻巨噬细胞浸润,抑制肾小管上皮细胞转分化,降低尿蛋白毒性来改善肾间质纤维化等。中药延缓CRF进展的临床效果主要体现在改善肾功能和某些并发症等方面,其治疗方法包括中药复方口服、中药保留灌肠、中药复方口服联合中药保留灌肠以及结肠透析联合中药保留灌肠等。另外,对于晚期CRF患者所出现的钙/磷代谢失衡、微炎症状态以及尿毒症毒素蓄积,中药也有一定的改善作用。

In this review,firstly,it has been discussed the mechanisms of Chinese herbal medicine ameliorating glomerulosclerosis and renal interstitial fibrosis during the progression of chronic renal failure（CRF）by improving glomerular hemodynamics turbulence,podocyte injury,transforming growth factor（TGF）-β over-expression,hyperlipidemia,macrophage infiltration,tubular epithelial myofibroblast transdifferentiation,and nephrotoxicity of proteinuria.Secondly,it has been reported the clinical effects of Chinese herbal medicine improving renal function and some clinical complications in the patients with progressive CRF through various treatments including oral administration or coloclysis of Chinese herbal medicine,oral administration combined with coloclysis of Chinese herbal medicine,and colonic dialysis combined with coloclysis of Chinese herbal medicine.Finally,it has been reviewed the beneficial influences of Chinese herbal medicine on metabolic dysequilibrium of calcium and phosphonium,microinflammatory state,and uremic toxins in patients with uremia.