黄芪治疗糖尿病肾病的研究进展

Research Progress on the Treatment of Diabetic Nephropathy with Astragalus

糖尿病肾病(diabetes kidney disease, DKD)是糖尿病最严重的微血管并发症之一,已成为全球慢性肾脏病和终末期肾病的主要原因,其早期临床表现为肾小球高滤过、进行性蛋白尿和伴有小管间质纤维化的联合性肾小球损伤。目前糖尿病肾病的发病机制并未阐明,现有研究数据表明,血液动力学因素、遗传因素、组织缺氧、炎性细胞浸润、糖脂代谢紊乱等均能引起糖尿病肾病。西医对于治疗糖尿病肾病方面仅可缓解其临床症状,而对于控制病情进展方面效果不佳。随着国内外对糖尿病性肾病的研究及国家对祖国传统中医学的发展与支持,发现传统中医药对控制糖尿病肾病病情进展具有独特优势。黄芪味甘、性微温,具有补气升阳、利水消肿、生津养血的功效。其在治疗DKD中使用频次最高,主要成分是多糖、黄酮类和皂苷类化合物等。黄芪具有多种药理作用,包括调节免疫、降血糖、抗氧化、保护肾脏等作用。在我国临床治疗DN中,黄芪作为主要代表被广泛使用,取得了许多良好的临床效果。故本文通过总结分析黄芪的药理学功效,以及相关临床研究,以求寻找新的组方,有效改善CKD患者的临床症状和肾功能。Diabetic kidney disease is one of the most serious microvascular complications of diabetes, and has become a major cause of chronic kidney disease and end-stage renal disease worldwide. Its early clinical manifestations are glomerular hyperfiltration, progressive proteinuria, and combined glomerular injury accompanied by tubulointerstitial fibrosis. At present, the pathogenesis of diabetic kidney disease has not been clarified. Existing research data indicate that hemodynamic factors, genetic factors, tissue hypoxia, inflammatory cell infiltration, glycolipid metabolism disorders, etc. can all cause diabetic kidney disease. Western medicine can only relieve the clinical symptoms of diabetic kidney disease in terms of treatment, but has poor effect in controlling the progression of the disease. With the research on diabetic nephropathy at home and abroad and the development and support of traditional Chinese medicine in China, it is found that traditional Chinese medicine has unique advantages in controlling the progression of diabetic nephropathy. Astragalus has sweet taste and mild temperature. It has the effect of invigorating qi and raising Yang, reducing swelling and promoting blood circulation. It is the most frequently used in the treatment of DKD, and its main components are polysaccharides, flavonoids and saponins. Astragalus has a variety of pharmacological effects, including immune regulation, blood sugar lowering, antioxidant, kidney protection and so on. In the clinical treatment of DN in China, Astragalus, as the main representative, is widely used and has achieved many good clinical effects. Therefore, this paper summarized and analyzed the pharmacological efficacy of Astragalus and related clinical studies in order to find a new formula to effectively improve the clinical symptoms and renal function of patients with CKD.