中医药干预氧化应激治疗Ⅳ型心肾综合征研究进展

Review on Traditional Chinese Medicine Intervention for Oxidative Stress in the Treatment of TypeⅣCardiorenal Syndrome

Ⅳ型心肾综合征,病变涉及心肾两脏,治疗时间长、费用高,死亡率高。现代研究表明,Ⅳ型心肾综合征(cardiorenal syndrome-4, CRS4)的发生发展与多种病理机制相关,而氧化应激在心脏、肾脏和其他系统中的作用得到了广泛关注,研究CRS4氧化应激作用机制具有重要意义。氧化应激调控CRS4型的作用机制与Nrf2、NF-κB、JAK/STAT3以及JNK等信号通路有关,这些通路通过减少炎症反应,抑制心肾氧化应激反应,减少活性氧(reactive oxygen species, ROS)的形成,防止内皮功能障碍,逆转左心室肥厚和心肾纤维。研究证实一些中药活性成分及复方具有抗氧化作用,可以通过减少ROS的形成,调控氧化应激通路,抑制Ⅳ型心肾综合征氧化应激反应的发生,从而发挥防治CRS4的作用,但目前缺乏对该领域的系统性整理和归纳。因此,梳理了相关文献,分析阐释了中医药通过调控氧化应激防治CRS4的作用机制,以期为临床研究与药物开发提供新思路。

TypeⅣcardiorenal syndrome,with lesions involving the heart and kidney,has a long and costly treatment time and a high mortality rate.Modern studies have shown that the development of cardiorenal syndrome-4(CRS4)is associated with a variety of pathological mechanisms,and the role of oxidative stress in the heart,kidneys,and other systems has received widespread attention,so it is of great significance to study the mechanism of CRS4 oxidative stress.The mechanism of action of oxidative stress-regulated CRS type 4 is related to signaling pathways such as Nrf2,NF-κB,JAK/STAT3,and JNK,which prevent endothelial dysfunction by reducing inflammatory responses,inhibiting cardiac and renal oxidative stress,and preventing endothelial dysfunction by decreasing left ventricular hypertrophy and cardiorenal fibers.Studies have confirmed that some active ingredients and compound formulas of traditional Chinese medicine Possesses antioxidant effects,which can inhibit the occurrence of oxidative stress in cardiorenal syndrome typeⅣby reducing the formation of reactive oxygen species(ROS)and regulating the oxidative stress pathway,thus playing a role in preventing and controlling CRS4.However,there is a lack of systematic collation and generalization in this field.Therefore,relevant literature was reviewed,and the mechanism of action by which traditional Chinese medicine regulates oxidative stress to prevent and treat CRS4 was analyzed and elucidated,aiming to provide new insights for clinical research and drug development.