抗纤灵方抗肾纤维化作用研究进展
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摘要
肾纤维化是一切肾脏疾病后期的共同病理改变,是多细胞因子、多信号通路、多因素驱动的慢性肾脏疾病。它包括肾脏间质纤维化、肾小管硬化、肾小球硬化,最终导致肾功能衰竭。肾脏从健康,到损伤,到逐步失去功能,病变过程与肾功能恶化程度及慢性肾脏病的预后密切相关。肾纤维化在临床上并无有效的西药可以治疗,上海中医药大学附属曙光医院何立群教授通过几十年长期实践经验总结出抗纤灵方,丹参15 g,桃仁12 g,当归12 g,牛膝9 g,制大黄15 g组成,功效健脾益气、清化湿热、活血化瘀、扶正泻浊,通过扩张血管,影响细胞因子、炎症因子的合成与分泌,可改善肾小管纤维化,多途径、多靶点、多方位保护肾功能;通过显著改善慢性肾纤维化患者乏力浮肿等症状,降低患者的血肌酐、尿素氮和尿蛋白,延缓慢性肾纤维化的进展。文中采用5/6肾切除、缺血再灌注损伤、阿霉素诱导肾病、单侧输尿管结扎等不同的造模方式,对抗纤灵方拮抗肾纤维化的作用机制进行了深入探讨和总结归纳,进一步为今后的临床和科研提供新的思路和方向。
Renal fibrosis is a common pathological change in the later stages of all kidney diseases. It is a multi-cytokine,multi-signal pathway,multi-factor driven chronic kidney disease. It includes renal interstitial fibrosis,tubular sclerosis and glomerular sclerosis,which eventually leads to chronic renal failure. From health through injury to loss of function,the disease process is closely related to the degree of deterioration of renal function and the prognosis of chronic kidney disease. There is no effective western medicine for the treatment of renal fibrosis. Professor HE Liqun from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine has summarized the Kangxianling decoction through decades of long-term practical experience. It has the effects in strengthening the spleen and replenishing Qi,clearing away dampness and heat,promoting blood circulation and removing phlegm,and strengthening turbidity. It is composed of Salviae Miltiorrhizae Radix et Rhizoma 15 g,Persicae Semen 12 g,Angelicae Sinensis Radix 12 g,Achyranthis Bidentatae Radix 9 g,Rhei Radix et Rhizoma 15 g. Kangxianling can affect the synthesis and secretion of cytokines and inflammatory factors by expanding blood vessels,and can improve renal tubular fibrosis. It has a good multi-channel,multi-target and multi-directional protective effect on renal function. It also can delay the progress of chronic renal fibrosis by significantly alleviating such symptoms as fatigue and edema in patients with chronic renal fibrosis,and reducing serum creatinine,urea nitrogen and urine protein. In this paper,5/6 nephrectomy,ischemia reperfusion injury,adriamycin-induced nephropathy,unilateral ureteral obstruction and other different modeling methods are listed.The mechanism of Kangxianling decoction in antagonizing renal fibrosis is discussed and summarized,which further provided new ideas and directions for future clinical and scientific research.
Renal fibrosis is a common pathological change in the later stages of all kidney diseases. It is a multi-cytokine,multi-signal pathway,multi-factor driven chronic kidney disease. It includes renal interstitial fibrosis,tubular sclerosis and glomerular sclerosis,which eventually leads to chronic renal failure. From health through injury to loss of function,the disease process is closely related to the degree of deterioration of renal function and the prognosis of chronic kidney disease. There is no effective western medicine for the treatment of renal fibrosis. Professor HE Liqun from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine has summarized the Kangxianling decoction through decades of long-term practical experience. It has the effects in strengthening the spleen and replenishing Qi,clearing away dampness and heat,promoting blood circulation and removing phlegm,and strengthening turbidity. It is composed of Salviae Miltiorrhizae Radix et Rhizoma 15 g,Persicae Semen 12 g,Angelicae Sinensis Radix 12 g,Achyranthis Bidentatae Radix 9 g,Rhei Radix et Rhizoma 15 g. Kangxianling can affect the synthesis and secretion of cytokines and inflammatory factors by expanding blood vessels,and can improve renal tubular fibrosis. It has a good multi-channel,multi-target and multi-directional protective effect on renal function. It also can delay the progress of chronic renal fibrosis by significantly alleviating such symptoms as fatigue and edema in patients with chronic renal fibrosis,and reducing serum creatinine,urea nitrogen and urine protein. In this paper,5/6 nephrectomy,ischemia reperfusion injury,adriamycin-induced nephropathy,unilateral ureteral obstruction and other different modeling methods are listed.The mechanism of Kangxianling decoction in antagonizing renal fibrosis is discussed and summarized,which further provided new ideas and directions for future clinical and scientific research.
引文
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[5]熊荣兵,张婷,何立群,等.中药肾毒宁颗粒对慢性肾衰大鼠肾保护作用及其机制的实验研究[J].中国中医急症,2017,26(5):775-778.
[6]钟利平,麻志恒,余柯娜,等.抗纤灵方对5/6肾切除小鼠肾衰模型肾纤维化作用及机制研究[J].时珍国医国药,2015,26(7):1547-1549.
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[12]张长明,周家俊,何立群,等.从血管活性因子角度研究抗纤灵方改善肾功能抑制肾纤维化的作用机制[J].中华中医药杂志,2014,29(2):405-407.
[13]张长明,周家俊,何立群,等.抗纤灵方对CKD3~4期患者疗效及机制的临床多中心随机对照研究[J].辽宁中医杂志,2013,40(1):122-124.
[14]吉晶,何立群.抗纤灵方对肾纤维化大鼠TGF-β1/Smad信号通路表达的影响[J].中国实验方剂学杂志,2019,25(1):69-75.
[15]吉晶,何立群.抗纤灵方对肾纤维化大鼠肾功能及肾组织ECM表达的影响[J].中国实验方剂学杂志,2019,25(1):63-68.
[16]陈建,应汝炯,盛昭园,等.抗纤灵方对肾纤维化小鼠肾组织CD68、CD45、VCAM-1表达的影响[J].中医杂志,2018,59(9):781-785.
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