丹参治疗高血压肾病的作用机制研究进展

Mechanism and research progress of Salvia miltiorrhiza in treatment of hypertensive nephropathy

高血压肾病已经成为导致终末期肾病的第二大原因。现代医学认为,高血压肾病与血管内皮功能障碍、氧化应激和炎症反应密不可分,而肾脏纤维化是其最常见的病理学特征。目前认为,高血压肾病的关键是控制血压,临床治疗中通常应用降压药来控制高血压肾病的发生和发展。但是,有研究报道指出,强化降压会减缓但不会阻止肾脏损伤的进程。因此,寻求新的阻止肾脏损伤进程的治疗方法具有重要的临床意义。大量研究证明,活血化瘀类中药及其制剂联合西医常规治疗更有利于提高治疗高血压肾病的有效性。丹参具有活血祛瘀而不伤证之效。诸多研究表明,丹参及其制剂具有多种药理学作用,其中包括调节血压、调节血脂、抑制氧化应激和炎症反应和保护血管内皮细胞及抑制纤维化。然而,针对丹参治疗高血压肾病尚缺乏系统的阐述。从传统医学及现代医学方面系统地论述丹参治疗高血压肾病的药理学机制,从而为更好地促进丹参及其制剂在高血压肾病的临床应用提供坚实的药理学依据。

Hypertensive nephropathy has become the second major cause of end-stage kidney disease.Modern medicine believes that hypertensive nephropathy is inseparable from vascular endothelial dysfunction,oxidative stress and inflammatory response,and renal fibrosis is its most common pathological feature.At present,it is believed that the key to hypertensive nephropathy is to control blood pressure.In clinical treatment,the occurrence and development of hypertensive nephropathy is usually controlled by applying antihypertensive drugs.However,some studies have pointed out that strengthening blood pressure reduction will slow down but will not prevent the process of kidney damage.Therefore,looking for new treatment has important clinical significance.In recent years,a large number of RCTs have proved that many traditional Chinese medicine injection for promoting blood circulation and removing blood stasis combined with conventional Western medicine treatment is more beneficial to improve the effectiveness of treating hypertensive nephropathy.Danshen(Salvia miltiorrhiza Bge.) has the effect of activating blood and removing blood stasis without hurting syndrome.Many studies have shown that S.miltiorrhiza and its preparations have a variety of pharmacological effects,including regulating blood pressure,regulating blood lipids,inhibiting oxidative stress and inflammatory reactions,protecting vascular endothelial cells and inhibiting fibrosis.However,there is still a lack of systematic explanation for the treatment of hypertensive kidney disease.Therefore,this article aims to systematically discuss the pharmacological mechanism of S.miltiorrhiza in the treatment of hypertensive nephropathy from the aspects of traditional Chinese medicine and modern medicine,so as to provide a solid pharmacological basis for better promoting the clinical application of S.miltiorrhiza and its preparations in hypertensive nephropathy.