中药药对治疗糖尿病肾病的药理作用及临床应用研究进展

Research Progress on Pharmacological Effect and Clinical Application of Traditional Chinese Medicinal Pair in Treatment of Diabetic Nephropathy

中药药对是中医临证方剂配伍中画龙点睛之所在,目前关于中药治疗糖尿病肾病的相关研究较多,但主要聚焦在疗效观察和处方总结等方面,缺乏对中药作用机制的深入研究和归纳总结。中药药对与方剂相比化学成分少、组方形式单一、作用机制简单、干扰因素较少等。近年来中医在应用药对治疗糖尿病肾病方面积累了丰富的临床实践经验,不少研究者十分注重组方配伍时药对的应用及其作用规律,通过药对配伍实现多方面的优化组合,进一步提高中药复方的治疗效果。为了明确中药药对治疗糖尿病肾病的作用途径及靶点,本文通过系统地查阅和整理国内外相关文献资料,拟对近10年来经临床观察与动物实验证实对糖尿病肾病确有疗效的,以中医临证分型具有"调补脾肾""利水渗湿""活血化瘀"和"收敛固涩"功效的四类药对的组成规律及现代实验研究现状进行整理分析,总结其配伍原则与药物的化学成分、药代动力学变化及药对各中药不同配伍比例时化学成分的变化规律,以期为上述药对进一步的应用、研究及开发提供参考。

Medicinal pair is the cornerstone in compatibility of traditional Chinese medicine prescriptions in clinical application. At present,there are many related studies on Chinese medicine for diabetic nephropathy,but they mainly focus on efficacy observation and prescription summary,lacking in-depth study and summary of the mechanism of action of traditional Chinese medicine( TCM). As compared with prescriptions,Chinese medicinal pair has fewer chemical components,a single form,simple mechanism of action,and fewer interference factors. In recent years,TCM has accumulated rich clinical practice experience in the treatment of diabetic nephropathy.Many researchers pay great attention to the application of medicinal pairs in the compatibility of prescriptions and their action rules. Through the compatibility of medicinal pairs,the optimized combinations can be achieved from various aspects to further improve the therapeutic effect of TCM compound. In order to clarify the ways and targets of Chinese medicinal pairs in treatment of diabetic nephropathy,relevant articles at home and abroad were systemically reviewed in this paper. For the clinical observation and animal experiments of the past 10 years,four types of medicines with "invigorating the spleen and the kidney","clearing damp and promoting diuresis""activating blood and removing stasis" and "securing and astringing" with curative effect for diabetic nephropathy,were mentioned in this article. The composition rules and the progress of experimental researches of these medicinal pairs were analyzed,while the compatibility principles,chemical compositions,and pharmacokinetic changesof the medicinal pairs were summarized to provide some references for their further application, researches and development.