中药水蛭及其提取物治疗糖尿病肾病的研究进展
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摘要
糖尿病肾病是糖尿病最常见的微血管并发症之一。随着疾病的进展,晚期会出现严重的肾功能衰竭,目前临床上尚无治疗糖尿病肾病的特效药物,研究表明,水蛭及其提取物可通过对代谢紊乱、细胞因子、血液流变学、炎性反应、细胞凋亡等方面的调节作用,有效改善糖尿病肾病患者的临床症状,从而延缓病情进展,提高生活质量,本文综述了近年来相关研究进展。
Diabetic nephropathy( DN) is one of the most common microvascular complications of diabetes. With the development of the disease,patients suffer renal failure in the end stage of DN. There is no special drug for the treatment of diabetic nephropathy at present.Research indicates that leech and its extract can delay the development of the disease and improve the quality of life of diabetic nephropathy patients by acting on the metabolic disturbance,related cell factors,hemorrheology,inflammatory reaction and cell apoptosis. In this review,we focused on the treatment of leech in DN in recent years.
Diabetic nephropathy( DN) is one of the most common microvascular complications of diabetes. With the development of the disease,patients suffer renal failure in the end stage of DN. There is no special drug for the treatment of diabetic nephropathy at present.Research indicates that leech and its extract can delay the development of the disease and improve the quality of life of diabetic nephropathy patients by acting on the metabolic disturbance,related cell factors,hemorrheology,inflammatory reaction and cell apoptosis. In this review,we focused on the treatment of leech in DN in recent years.
引文
[1]ZHANG L,LONG J,JIANG W,et al.Trends in Chronic Kidney Disease in China[J].N Engl J Med,2016,375(9):905-906.
[2]ARORA MK,SINGH UK.Molecular mechanisms in the pathogenesis of diabetic nephropathy:an update[J].Vascular pharmacology.2013,58(4):259-271.
[3]ABDUALKADER A M,GHAWI A M,ALAAMA M,et al.Leech Therapeutic Applications[J].Indian J Pharm Sci,2013,75(2):127-137.
[4]危成筠,水蛭及水蛭素在肾脏病中的应用及研究进展[J].中国中医药科技,2001,8(2):136-137.
[5]毕菲菲,姚岚,王敏,等.益气养阴活血通络方治疗糖尿病肾病疗效观察[J].陕西中医,2015,36(3):304-305.
[6]饶祖华,余颖,李小青,等.芪蛭降糖胶囊治疗早期糖尿病肾病34例临床观察[J].浙江临床医学2008,10(7):909-910.
[7]许玉冰.关于蜞针法治疗糖尿病足的探讨[J].中国民间疗法,2016,24(6):19-20.
[8]马宇鹏,张中新,张延英,等.中药降糖胰生胶囊对实验性糖尿病动物模型的影响,[J].第四军医大学学报,2006,27(13):1160-1162.
[9]谈晓琴,张玉福,孙斌,等.益气养阴活血通络方治疗早期糖尿病肾病临床研究[J].陕西中医,2017,38(12):1711-1713.
[10]HIRANO T.Abnormal lipoprotein metabolism in diabetic nephropathy[J].ClinExp Nephrol,2014,18(2):206-209.
[11]TORO R,SEGURA E,NUNEZ-CORTES JM,et al.Relationship between lipoprotein(a)and micro/macro complications in type 2diabetes mellitus:a forgotten target[J].J Geriatr Cardiol,2015,12(2):93-99.
[12]杨洪雁,张香东,刘可园,等.水蛭对血瘀证家兔血脂代谢及相关基因表达的影响[J].中国现代应用药学,2013,30(9):959-963.
[13]史伟,刘春红.水蛭注射液对糖尿病肾病患者脂质异常及高凝状态的影响---附常规治疗55例对照[J].浙江中医杂志,2002,37(6):267-268.
[14]叶山东,朱禧星.内皮素和糖尿病肾脏脏病变[J]国外医学·泌尿系统分册,1997,17(1):35-37.
[15]杨宝刚,王峰,刘芳如,等.水蛭对冠脉支架术后患者主要不良心血管事件和血管内皮功能的影响[J].中西医结合心脑血管病杂志,2015,13(3):340-341.
[16]顾江萍,赵玲,栗德林.水蛭对糖尿病肾病大鼠内皮素21水平的影响[J].中成药,2007,29(10):1421-1424.
[17]苏宁,罗荣敬,邝枣园,等.TGF-β1对糖尿病肾病早期ECM沉积影响的实验研究[J].中国实用医药,2007,2(31):57-60.
[18]CATANIA JM,CHEN G,PARRISH AR.Role of matrix metallopro-teinases in renal pathophysiologies[J].Am J Physiol Renal Physio,2007,292(3):905-911.
[19]姜梦真,唐田坡,任现志.黄芪、水蛭对脂多糖诱导的大鼠肾系膜细胞MMP-2及TIMP-2表达的影响[J].辽宁中医杂志,2017,44(1):193-196,226.
[20]LEE SB,KANASAKI K,KALLURI R.Circulating TGF-beta1 as a reliable biomarker for chronic kidney disease progression in the AfricanAmerican pop-ulation[J].Kidney Int,2009,76(1):10-12.
[21]傅晓骏,熊荣兵.黄芪水蛭制剂对糖尿病肾病大鼠TGF-β1表达的实验研究[J].中国中医急症,2012,21(10):1595-1597.
[22]郑宏,翟文生,任现志,等.黄芪、水蛭含药血清对大鼠肾小球系膜细胞产生TGF-β1的影响[J].天津医药,2007,35(7):509-511
[23]熊欣,彭琦,郑燕林.水蛭提取物对血管内皮细胞VEGF受体-2表达的影响[J].国际眼科杂志,2009,9(1):41-43.
[24]李小菊,卢宏达,陈卫群,等.水蛭抑制肿瘤血管生成的作用及其机制[J].肿瘤防治研究,2013,40(1):46-50.
[25]贾彦,牛英才,张英博,等.天然水蛭素对实验性肝纤维化大鼠肝脏结缔组织生长因子mRNA表达的影响[J].时珍国医国药,2009,20(1):95-97.
[26]于佩,于德民.老年糖尿病肾病患者的血液流变学分析[J].中华老年医学杂志,2002,21(1):64-65.
[27]HAAS S,SCHELLONG S.New anticoagulants:from bench to bedside[J].Hamostaseologie,2007,27(1):41-47.
[28]HUANG Y,ZHANG Y,ZHAO B,et al.Structural basis of RGD-hirudin binding to thrombin:Tyr3 and five C-terminal residues are crucial for inhibiting thrombin activity[J].BMC structural biology,2014,14(1):1-9.
[29]DUZGUN S,NISANCI M,UNLU E,The effect of recombinant hirudin on rabbit ear flaps with venous insufficiency[J].Indian journal of plastic surgery:official publication of the Association of Plastic Surgeons of India,2014,47(1):102-108.
[30]SUMAYA W,JOSHI RR,JUDGE HM,etal.Stability of Verify Now P2Y12 assay results with citrate anticoagulation as compared to hirudin anticoagulation over 20-min period[J].Platelets,2015,26(3):271-273
[31]毕礼明,陈英兰,陆曙.水蛭制剂在肾脏病中应用进展[J].中国中西医结合肾病杂志,2016,17(4):374-376.
[32]林轶群.糖尿病合并慢性肾衰竭中医门诊临床数据研究[D].北京:北京中医药大学,2017.
[33]刘应柯,程鹏,王文华,等.水蛭粉与煎剂对老龄自发性高血压大鼠血压、血脂及血流动力学的影响[J].解放军药学学报,2003,19(6):441-443.
[34]VIDT DG.Inflammation in renal disease[J].Am J Cardiol,2006,97(2A):20A-27A.
[35]MUTHUPPALANIAPPAN VM.Diabetic nephropathy[J].Medicine,2015,43(9):520-525.
[36]侯英,张艳春,李显筑.益气养阴活血法对2型糖尿病周围神经病变患者炎症因子的影响[J].光明中医,2012,27(10):2149-2151.
[37]林建明,程世平,刘加林,等,水蛭对狼疮性肾炎患者血浆内皮素和可溶性白介素-2受体的影响[J].疑难病杂志,2009,8(9):535-537.
[38]张翠,康广盛,刘薇.含大黄、水蛭等中药复方对肾大部切除大鼠肾脏保护作用的研究[J].中国实验方剂学杂志,2004,10(1):31-34.
[39]姜梦真,任惠娟,徐蕾,等.黄芪、水蛭有效成分对大鼠肾小球系膜细胞凋亡的影响[J].中成药,2017,39(5):902-906.
[40]任现志,蒋淑敏,翟文生.黄芪、水蛭、水蛭素及水蛭黄芪配方含药血清对大鼠肾小球系膜细胞生长周期及凋亡的影响[J].中华中医药杂志,2009,24(5):625-627.
[2]ARORA MK,SINGH UK.Molecular mechanisms in the pathogenesis of diabetic nephropathy:an update[J].Vascular pharmacology.2013,58(4):259-271.
[3]ABDUALKADER A M,GHAWI A M,ALAAMA M,et al.Leech Therapeutic Applications[J].Indian J Pharm Sci,2013,75(2):127-137.
[4]危成筠,水蛭及水蛭素在肾脏病中的应用及研究进展[J].中国中医药科技,2001,8(2):136-137.
[5]毕菲菲,姚岚,王敏,等.益气养阴活血通络方治疗糖尿病肾病疗效观察[J].陕西中医,2015,36(3):304-305.
[6]饶祖华,余颖,李小青,等.芪蛭降糖胶囊治疗早期糖尿病肾病34例临床观察[J].浙江临床医学2008,10(7):909-910.
[7]许玉冰.关于蜞针法治疗糖尿病足的探讨[J].中国民间疗法,2016,24(6):19-20.
[8]马宇鹏,张中新,张延英,等.中药降糖胰生胶囊对实验性糖尿病动物模型的影响,[J].第四军医大学学报,2006,27(13):1160-1162.
[9]谈晓琴,张玉福,孙斌,等.益气养阴活血通络方治疗早期糖尿病肾病临床研究[J].陕西中医,2017,38(12):1711-1713.
[10]HIRANO T.Abnormal lipoprotein metabolism in diabetic nephropathy[J].ClinExp Nephrol,2014,18(2):206-209.
[11]TORO R,SEGURA E,NUNEZ-CORTES JM,et al.Relationship between lipoprotein(a)and micro/macro complications in type 2diabetes mellitus:a forgotten target[J].J Geriatr Cardiol,2015,12(2):93-99.
[12]杨洪雁,张香东,刘可园,等.水蛭对血瘀证家兔血脂代谢及相关基因表达的影响[J].中国现代应用药学,2013,30(9):959-963.
[13]史伟,刘春红.水蛭注射液对糖尿病肾病患者脂质异常及高凝状态的影响---附常规治疗55例对照[J].浙江中医杂志,2002,37(6):267-268.
[14]叶山东,朱禧星.内皮素和糖尿病肾脏脏病变[J]国外医学·泌尿系统分册,1997,17(1):35-37.
[15]杨宝刚,王峰,刘芳如,等.水蛭对冠脉支架术后患者主要不良心血管事件和血管内皮功能的影响[J].中西医结合心脑血管病杂志,2015,13(3):340-341.
[16]顾江萍,赵玲,栗德林.水蛭对糖尿病肾病大鼠内皮素21水平的影响[J].中成药,2007,29(10):1421-1424.
[17]苏宁,罗荣敬,邝枣园,等.TGF-β1对糖尿病肾病早期ECM沉积影响的实验研究[J].中国实用医药,2007,2(31):57-60.
[18]CATANIA JM,CHEN G,PARRISH AR.Role of matrix metallopro-teinases in renal pathophysiologies[J].Am J Physiol Renal Physio,2007,292(3):905-911.
[19]姜梦真,唐田坡,任现志.黄芪、水蛭对脂多糖诱导的大鼠肾系膜细胞MMP-2及TIMP-2表达的影响[J].辽宁中医杂志,2017,44(1):193-196,226.
[20]LEE SB,KANASAKI K,KALLURI R.Circulating TGF-beta1 as a reliable biomarker for chronic kidney disease progression in the AfricanAmerican pop-ulation[J].Kidney Int,2009,76(1):10-12.
[21]傅晓骏,熊荣兵.黄芪水蛭制剂对糖尿病肾病大鼠TGF-β1表达的实验研究[J].中国中医急症,2012,21(10):1595-1597.
[22]郑宏,翟文生,任现志,等.黄芪、水蛭含药血清对大鼠肾小球系膜细胞产生TGF-β1的影响[J].天津医药,2007,35(7):509-511
[23]熊欣,彭琦,郑燕林.水蛭提取物对血管内皮细胞VEGF受体-2表达的影响[J].国际眼科杂志,2009,9(1):41-43.
[24]李小菊,卢宏达,陈卫群,等.水蛭抑制肿瘤血管生成的作用及其机制[J].肿瘤防治研究,2013,40(1):46-50.
[25]贾彦,牛英才,张英博,等.天然水蛭素对实验性肝纤维化大鼠肝脏结缔组织生长因子mRNA表达的影响[J].时珍国医国药,2009,20(1):95-97.
[26]于佩,于德民.老年糖尿病肾病患者的血液流变学分析[J].中华老年医学杂志,2002,21(1):64-65.
[27]HAAS S,SCHELLONG S.New anticoagulants:from bench to bedside[J].Hamostaseologie,2007,27(1):41-47.
[28]HUANG Y,ZHANG Y,ZHAO B,et al.Structural basis of RGD-hirudin binding to thrombin:Tyr3 and five C-terminal residues are crucial for inhibiting thrombin activity[J].BMC structural biology,2014,14(1):1-9.
[29]DUZGUN S,NISANCI M,UNLU E,The effect of recombinant hirudin on rabbit ear flaps with venous insufficiency[J].Indian journal of plastic surgery:official publication of the Association of Plastic Surgeons of India,2014,47(1):102-108.
[30]SUMAYA W,JOSHI RR,JUDGE HM,etal.Stability of Verify Now P2Y12 assay results with citrate anticoagulation as compared to hirudin anticoagulation over 20-min period[J].Platelets,2015,26(3):271-273
[31]毕礼明,陈英兰,陆曙.水蛭制剂在肾脏病中应用进展[J].中国中西医结合肾病杂志,2016,17(4):374-376.
[32]林轶群.糖尿病合并慢性肾衰竭中医门诊临床数据研究[D].北京:北京中医药大学,2017.
[33]刘应柯,程鹏,王文华,等.水蛭粉与煎剂对老龄自发性高血压大鼠血压、血脂及血流动力学的影响[J].解放军药学学报,2003,19(6):441-443.
[34]VIDT DG.Inflammation in renal disease[J].Am J Cardiol,2006,97(2A):20A-27A.
[35]MUTHUPPALANIAPPAN VM.Diabetic nephropathy[J].Medicine,2015,43(9):520-525.
[36]侯英,张艳春,李显筑.益气养阴活血法对2型糖尿病周围神经病变患者炎症因子的影响[J].光明中医,2012,27(10):2149-2151.
[37]林建明,程世平,刘加林,等,水蛭对狼疮性肾炎患者血浆内皮素和可溶性白介素-2受体的影响[J].疑难病杂志,2009,8(9):535-537.
[38]张翠,康广盛,刘薇.含大黄、水蛭等中药复方对肾大部切除大鼠肾脏保护作用的研究[J].中国实验方剂学杂志,2004,10(1):31-34.
[39]姜梦真,任惠娟,徐蕾,等.黄芪、水蛭有效成分对大鼠肾小球系膜细胞凋亡的影响[J].中成药,2017,39(5):902-906.
[40]任现志,蒋淑敏,翟文生.黄芪、水蛭、水蛭素及水蛭黄芪配方含药血清对大鼠肾小球系膜细胞生长周期及凋亡的影响[J].中华中医药杂志,2009,24(5):625-627.