基于肠道微生态探讨黄芪扶正调衡治疗糖尿病肾病的研究进展

Strenthening and balancing effects of Astragalus in treatment of diabetic kidney disease based on intestinal microecology:research progress

肠道微生态环境在糖尿病肾病的发生发展中发挥着不可或缺的作用。黄芪是临床治疗糖尿病肾病的常用药物之一,其既能上调有益菌的丰富度,又能维护肠道屏障功能。如果将肠道菌群失调而产生的有害菌群及其衍生物视为“邪气”,将肠上皮屏障以及肠道能量代谢和免疫功能视作“正气”,则邪盛正亏是肠道微生态被破坏而导致糖尿病患者肾脏进一步损伤的主要原因。将中药黄芪作为治疗手段,以肠道菌群为纽带,形成“药-菌-人”三位一体的动态调节机制,从而使糖尿病肾病患者达到人菌共存、正邪相安的平衡状态。因此,本文基于肠道微生态探讨黄芪修护肠上皮屏障的机制,提升自身免疫力以“扶正”,调节肠道微生态环境的稳定以“调衡”,进而治疗并延缓糖尿病肾病,以期为临床治疗糖尿病肾病提供新的思路和理论依据。

The intestinal microecological environment plays an indispensable role in the occurrence and development of diabetic kidney disease.Astragalus is one of the commonly used drugs in the clinical treatment of diabetic kidney disease,which can not only upregulate the richness of the unbalanced flora,but also maintain the intestinal barrier function.For example,if the harmful flora and the derivatives it produced due to the imbalance of intestinal flora are regarded as"evil qi",and the intestinal epithelial barrier,as well as the intestinal energy metabolism and immune function are regarded as"vital qi",then the evil prosperity and positive energy deficiency are the main reasons for the further damage of kidney in diabetic patients due to the destruction of intestinal microecology.With astragalus,the traditional Chinese medicine,as the treatment means and intestinal flora as the link,the"drug-bacteria-human"trinity dynamic adjustment mechanism is formed in order to make diabetic kidney disease patients achieve a status of the balance and coexistence of human and bacteria as well as good and evil.Therefore,based on microecology,this paper discusses the mechanism of astragalus in repairing the intestinal epithelial barrier,improving its immunity to"fuzheng",regulating the stability of intestinal microecological environment to"adjust the balance",and then treating and delaying diabetic kidney disease,in hope to provide new ideas and theoretical basis for clinical treatment.