黄芪-丹参药对改善高血压肾损害的研究进展

Research Progress of Astragali Radix and Salviae Miltiorrhizae Radix on Improving Renal Damage in Hypertension

高血压肾损害是高血压最严重的并发症之一,也是导致终末期肾脏病的主要原因,而肾损害又可进一步促进血压升高且难以控制,形成恶性循环的局面。中医认为本虚标实是其根本病机,而肾气不固、瘀血内阻是高血压肾损害的最常见证型之一。黄芪被誉为"补气诸药之最",丹参被比喻可"功同四物",基于补气活血理论的黄芪-丹参药对主要有黄芪总苷、黄芪多糖、毛蕊异黄酮、丹酚酸、丹参酮等有效成分,诸多研究表明,在高血压肾损害进程中,黄芪-丹参药对及其有效成分,不管是有效单体、单体配伍,亦或是药对直接配伍,均可通过调节与高血压肾损害相关的多个信号转导通路来调节血压、降低尿蛋白、保护肾小管、保护肾小球滤过屏障、改善肾脏血流动力学、改善肾功能,起到降压与改善肾功能双管齐下的作用。本文着眼于高血压肾损害气虚血瘀的病因病机,基于补气活血理论,综述黄芪-丹参药对及其有效成分在治疗高血压肾损害中的研究进展,以期为黄芪-丹参药对在高血压肾损害中的进一步研究以及临床应用提供科学依据。

Hypertensive renal damage is one of the most serious complications of hypertension,and it is also the main cause of end-stage renal disease. Renal damage can further promote the rise of blood pressure and difficult to control,forming a vicious circle. Traditional Chinese medicine( TCM) considers that deficiency of the original and excess of the standard is its basic pathogenesis,and insufficient kidney-Qi and blood stasis are one of the most common syndromes of hypertensive kidney damage. Astragali Radix membranaceus is praised as the most important medicine for invigorating Qi,and Salviae Miltiorrhizae Radix is likened to " four things with the same function". Based on the theory of invigorating Qi and activating blood circulation,the effective ingredients of Astragali Radix membranaceus-Salviae Miltiorrhizae Radix are mainly astragaloside, Astragali Radix polysaccharide,mulberry isoflavone,salvianolic acid and tanshinone. Many studies have shown that in the process of hypertensive kidney damage,Astragali Radix membranaceu Its active ingredients,whether effective monomers,monomer compatibility or direct compatibility of drug pairs,can regulate blood pressure,reduce urinary protein,protect renal tubules,protect glomerular filtration barrier,improve renal hemodynamics and protect renal function by regulating multiple signal transduction pathways related to hypertensive renal damage. Lowering blood pressure and protecting renal function are two pronged functions. Based on the theory of Invigorating Qi and activating blood circulation,this paper reviews the research progress of Astragali Radix-Salviae Miltiorrhizae Radix in the treatment of hypertensive renal damage,with a view to providing scientific basis for the further study and clinical application of Radix astragali-Salviae Miltiorrhizae Radix in hypertensive renal damage.