黄芪及含黄芪经方在治疗肾病方面的药理作用及临床应用研究进展
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摘要
黄芪为临床常用中药,具有托毒生肌、补气升阳、利水消肿、益卫固表等功效。近年来黄芪及含黄芪经方在肾病方面的研究成为热点。查阅近5年国内外文献,针对黄芪及含黄芪经方的药理作用和临床应用方面的研究,进行系统地梳理与综述,旨为了解黄芪在不同复方中针对肾病的药效及其作用机制以及基于有效性合理评价黄芪资源提供理论基础,以促进黄芪治疗肾病的现代化研究进程。
Astragali Radix with the functions of promoting pus discharge and tissue regeneration, tonifying qi and elevating yang, inducing diuresis to alleviate edema, and replenishing wei and consolidating exterior, has been widely used in clinics. The study of Astragali Radix and the classical formulae containing Astragali Radix in kidney disease is a hot topic in recent years. According to vast information from literatures in the last five years, this paper systematically reviewed the pharmacological activities and clinical applications of Astragali Radix and the classical formulae containing Astragali Radix, aiming at understanding the effect and mechanism of Astragalus Radix on kidney disease in different compatibilities. This study is expected to provide the theoretical basis for the reasonable evaluation of Astragalus Radix resources based on the effectiveness and promote the modernization of Astragali Radix in the field of kidney disease.
Astragali Radix with the functions of promoting pus discharge and tissue regeneration, tonifying qi and elevating yang, inducing diuresis to alleviate edema, and replenishing wei and consolidating exterior, has been widely used in clinics. The study of Astragali Radix and the classical formulae containing Astragali Radix in kidney disease is a hot topic in recent years. According to vast information from literatures in the last five years, this paper systematically reviewed the pharmacological activities and clinical applications of Astragali Radix and the classical formulae containing Astragali Radix, aiming at understanding the effect and mechanism of Astragalus Radix on kidney disease in different compatibilities. This study is expected to provide the theoretical basis for the reasonable evaluation of Astragalus Radix resources based on the effectiveness and promote the modernization of Astragali Radix in the field of kidney disease.
引文
[1]熊明彪.黄芪的药理作用及临床研究进展[J].亚太传统医药,2013,9(10):70-71.
[2]谢席胜,汪明.冯志荣应用黄芪经方治疗肾脏病经验[J].四川中医,2015,33(4):1-2.
[3]Kim J,Moon E,Kwon S.Effect of Astragalus membranaceus extract on diabetic nephropathy[J].Endocrinol Diab Metab Case Rep,2014,2014:140063.
[4]Chen X,Wang D D,Wei T,et al.Effects of astragalosides from Radix Astragali on high glucose-induced proliferation and extracellular matrix accumulation in glomerular mesangial cells[J].Exp Therap Med,2016,11(6):2561-2566.
[5]Wang Z S,Xiong F,Xie X H,et al.Astragaloside IV attenuates proteinuria in streptozotocin-induced diabetic nephropathy via the inhibition of endoplasmic reticulum stress[J].BMC Nephrol,2015,16(1):44-52.
[6]黄晓东,沈楠,路倩,等.黄芪甲苷对糖尿病肾脏病变大鼠氧自由基代谢和转化生长因子β1 m RNA表达的影响[J].吉林大学学报:医学版,2016,42(1):48-53.
[7]Wang Y,Lin C,Ren Q,et al.Astragaloside effect on TGF-β1,SMAD2/3,andα-SMA expression in the kidney tissues of diabetic KKAy mice[J].Int J Clin Exp Pathol,2015,8(6):6828-6834.
[8]Na W,Wei R B,Li Q P,et al.Protective effects of astragaloside in rats with adriamycin nephropathy and underlying mechanism[J].Chin J Nat Med,2016,14(4):270-277.
[9]Zhou X,Sun X,Gong X,et al.Astragaloside IV from Astragalus membranaceus ameliorates renal interstitial fibrosis by inhibiting inflammation via TLR4/NF-кB in vivo and in vitro[J].Int Immunopharmacol,2017,42(1):18-24.
[10]吕松洁.黄芪杂多糖对试验型糖尿病肾病大鼠的治疗作用及其机制的研究[J].上海畜牧兽医通讯,2015(4):2-8.
[11]胡营杰,陈沙沙,王广洋,等.黄芪有效组分对大鼠肾小球系膜细胞血小板源性生长因子-BB表达的影响[J].中华中医药杂志,2016,31(7):2797-2799.
[12]Ji L,Chen X L,Zhong X,et al.Astragalus membranaceus up-regulate Cosmc expression and reverse Ig A dys-glycosylation in Ig A nephropathy[J].BMC Compl Altern Med,2014,14(1):195-201.
[13]傅天啸,黄益麒,马红珍.黄芪注射剂对糖尿病肾病大鼠肾脏脂联素表达的实验研究[J].中国中西医结合肾病杂志,2017,18(2):106-109.
[14]李梦乔,刘宇翔,罗勇兵.防己黄芪汤临床研究进展[J].实用中西医结合临床,2016,16(7):92-94.
[15]陈春艳,王闻婧,纪宝华,等.防己黄芪汤对阿霉素肾病大鼠蛋白尿和肾组织Nephrin的作用[J].中国中医急症,2013,22(3):361-362.
[16]王闻婧,陈春艳,符强.防己黄芪汤对阿霉素肾病大鼠肾组织Podocin表达的影响[J].中医药学报,2014,42(6):57-59.
[17]符强,黄亚仙,王闻婧.防己黄芪汤对阿霉素肾病大鼠肾组织乙酰肝素酶表达的影响[J].中国中医急症,2016,25(3):387-389.
[18]乔铁,马进,刘丽,等.防己黄芪汤对阿霉素肾病大鼠蛋白尿及水通道蛋白2的影响[J].中医药信息,2015,32(4):17-19.
[19]彭敏,张莹雯.当归补血汤对糖尿病肾病的辅助治疗作用[J].河北中医,2016,38(11):1702-1705.
[20]Ye T S,Zhang Y W,Zhang X M.Protective effects of Danggui Buxue Tang on renal function,renal glomerular mesangium and heparanase expression in rats with streptozotocin-induced diabetes mellitus[J].Exp Therap Med,2016,11(6):2477-2483.
[21]张曼玲,王秀萍,李亚容,等.当归补血汤对糖尿病肾病大鼠GRP78的影响[J].中国中西医结合肾病杂志,2016,17(10):858-861.
[22]姚琼,叶太生,黄蓓.当归补血汤不同配比对高糖作用下大鼠肾组织系膜细胞增殖的影响[J].湖北中医杂志,2015,37(10):11-13.
[23]徐伶俐.闫镛教授应用参芪地黄汤治疗糖尿病肾病经验[J].中国中医药现代远程教育,2017,15(12):83-85.
[24]朱勤,陈洪宇.参芪地黄汤对阿霉素肾病大鼠足细胞Nephrin蛋白和m RNA表达的影响[J].中华中医药学刊,2015,33(2):296-299.
[25]史佳丽.参芪地黄汤对Ig A肾病模型大鼠肾小球足细胞保护作用的研究[D].杭州:浙江中医药大学,2014.
[26]闫世杰.补中益气汤浅析[J].河南中医,2017,37(9):1670-1672.
[27]郭继光,张海燕,李朝鹏,等.补中益气汤对阿霉素诱导的大鼠肾病的作用[J].河北大学学报:自然科学版,2015,35(3):298-304.
[28]Pal A,Kaskel F.History of nephrotic syndrome and evolution of its treatment[J].Frontiers Pediatrics,2016,4:56-61.
[29]张雷,徐福胜,乔梁,等.黄芪注射液对原发性肾病综合征患者红细胞,网织红细胞及血小板参数的影响[J].海南医学院学报,2016,22(2):157-159.
[30]崔冰,任永朋,李星锐,等.黄芪颗粒对肾病综合征患者免疫力的影响[J].中医研究,2017,30(1):19-21.
[31]孙成峰.黄芪注射液治疗原发性肾病综合征的临床疗效观察[J].中国处方药,2015,13(9):47-48.
[32]龚骁.黄芪注射液治疗原发性肾病综合征64例临床观察[J].中国实用医药,2014,9(6):128-129.
[33]聂静涛.防己黄芪汤对原发性肾病综合征水肿期患者的疗效及对24 h尿蛋白,血清白蛋白,血脂的影响[J].实用临床医药杂志,2017,21(1):48-51.
[34]汪永国.参芪地黄汤对难治性肾病综合征患者肾功能的影响[J].西部中医药,2016,29(5):76-78.
[35]Sun G,Li C,Cui W,et al.Review of herbal traditional chinese medicine for the treatment of diabetic nephropathy[J].J Diab Res,2016,2016:5749857.
[36]蔡然,崔建华.黄芪注射液对早期糖尿病肾病患者尿白蛋白及细胞因子的影响[J].现代中西医结合杂志,2016,25(28):3117-3119.
[37]董晓光,赵旭涛.黄芪对早期糖尿病肾病患者内皮素及降钙素基因相关肽的影响[J].临床医药文献电子杂志,2016,3(20):3957-3958.
[38]董萍,安琳.参芪地黄汤治疗早期糖尿病肾病35例临床观察[J].天津中医药,2017,34(4):239-241.
[39]侯小雪,杨秀炜,周微,等.加味当归补血汤对糖尿病肾病临床疗效及血清免疫因子水平影响研究[J].辽宁中医药大学学报,2017,19(12):115-118.
[40]袁艳丽.补阳还五汤对早期糖尿病肾病患者血脂水平及血液流变学指标的影响[J].河南医学研究,2017,26(19):3574-3575.
[41]Suzuki H,Suzuki Y,Novak J,et al.Development of animal models of human Ig A nephropathy[J].Drug Discov Today:Disease Models,2014,11(1):5-11.
[42]梁一鸣.黄芪颗粒对Ig A肾病患者血清中MCP-1,TNF-α和IL-6水平的影响[J].新中医,2015,47(5):115-117.
[43]沈世忠,杨忠民,蔡佳盈,等.黄芪注射液对Ig A肾病患者免疫球蛋白分子异常糖基化及Cosmc基因表达的影响[J].中国老年学杂志,2017,37(11):2788-2789.
[44]燕玉军.黄芪桂枝五物汤治疗脾肾阳虚型Ig A肾病的临床分析[J].光明中医,2017,32(5):619-621.
[45]刘垠浩,陈丽贞,蓝元隆,等.补阳还五汤加减治疗Ig A肾病35例临床观察[J].湖南中医杂志,2016,32(10):68-70.
[46]吴宇红,陈茂盛,卢冰.黄芪当归合剂联合基础治疗对Ig A肾病的疗效观察[J].浙江中医杂志,2013,48(6):412-413.
[47]杜凯琼.中西医结合治疗高血压肾病74例[J].中医临床研究,2017,9(20):59-60.
[48]郭佳音,裴克,朱晶晶,等.黄芪注射液联合厄贝沙坦治疗高血压肾病的效果及作用机制分析[J].中国当代医药,2017,24(7):76-78.
[49]郭炜.黄芪注射液治疗原发性高血压肾损害的系统评价[J].山东中医药大学学报,2013,37(5):375-377.
[50]马丽.高血压肾病患者血清胱抑素C含量变化与加味参芪地黄汤疗效的关系探讨[J].中华中医药学刊,2015,33(10):2526-2528.
[2]谢席胜,汪明.冯志荣应用黄芪经方治疗肾脏病经验[J].四川中医,2015,33(4):1-2.
[3]Kim J,Moon E,Kwon S.Effect of Astragalus membranaceus extract on diabetic nephropathy[J].Endocrinol Diab Metab Case Rep,2014,2014:140063.
[4]Chen X,Wang D D,Wei T,et al.Effects of astragalosides from Radix Astragali on high glucose-induced proliferation and extracellular matrix accumulation in glomerular mesangial cells[J].Exp Therap Med,2016,11(6):2561-2566.
[5]Wang Z S,Xiong F,Xie X H,et al.Astragaloside IV attenuates proteinuria in streptozotocin-induced diabetic nephropathy via the inhibition of endoplasmic reticulum stress[J].BMC Nephrol,2015,16(1):44-52.
[6]黄晓东,沈楠,路倩,等.黄芪甲苷对糖尿病肾脏病变大鼠氧自由基代谢和转化生长因子β1 m RNA表达的影响[J].吉林大学学报:医学版,2016,42(1):48-53.
[7]Wang Y,Lin C,Ren Q,et al.Astragaloside effect on TGF-β1,SMAD2/3,andα-SMA expression in the kidney tissues of diabetic KKAy mice[J].Int J Clin Exp Pathol,2015,8(6):6828-6834.
[8]Na W,Wei R B,Li Q P,et al.Protective effects of astragaloside in rats with adriamycin nephropathy and underlying mechanism[J].Chin J Nat Med,2016,14(4):270-277.
[9]Zhou X,Sun X,Gong X,et al.Astragaloside IV from Astragalus membranaceus ameliorates renal interstitial fibrosis by inhibiting inflammation via TLR4/NF-кB in vivo and in vitro[J].Int Immunopharmacol,2017,42(1):18-24.
[10]吕松洁.黄芪杂多糖对试验型糖尿病肾病大鼠的治疗作用及其机制的研究[J].上海畜牧兽医通讯,2015(4):2-8.
[11]胡营杰,陈沙沙,王广洋,等.黄芪有效组分对大鼠肾小球系膜细胞血小板源性生长因子-BB表达的影响[J].中华中医药杂志,2016,31(7):2797-2799.
[12]Ji L,Chen X L,Zhong X,et al.Astragalus membranaceus up-regulate Cosmc expression and reverse Ig A dys-glycosylation in Ig A nephropathy[J].BMC Compl Altern Med,2014,14(1):195-201.
[13]傅天啸,黄益麒,马红珍.黄芪注射剂对糖尿病肾病大鼠肾脏脂联素表达的实验研究[J].中国中西医结合肾病杂志,2017,18(2):106-109.
[14]李梦乔,刘宇翔,罗勇兵.防己黄芪汤临床研究进展[J].实用中西医结合临床,2016,16(7):92-94.
[15]陈春艳,王闻婧,纪宝华,等.防己黄芪汤对阿霉素肾病大鼠蛋白尿和肾组织Nephrin的作用[J].中国中医急症,2013,22(3):361-362.
[16]王闻婧,陈春艳,符强.防己黄芪汤对阿霉素肾病大鼠肾组织Podocin表达的影响[J].中医药学报,2014,42(6):57-59.
[17]符强,黄亚仙,王闻婧.防己黄芪汤对阿霉素肾病大鼠肾组织乙酰肝素酶表达的影响[J].中国中医急症,2016,25(3):387-389.
[18]乔铁,马进,刘丽,等.防己黄芪汤对阿霉素肾病大鼠蛋白尿及水通道蛋白2的影响[J].中医药信息,2015,32(4):17-19.
[19]彭敏,张莹雯.当归补血汤对糖尿病肾病的辅助治疗作用[J].河北中医,2016,38(11):1702-1705.
[20]Ye T S,Zhang Y W,Zhang X M.Protective effects of Danggui Buxue Tang on renal function,renal glomerular mesangium and heparanase expression in rats with streptozotocin-induced diabetes mellitus[J].Exp Therap Med,2016,11(6):2477-2483.
[21]张曼玲,王秀萍,李亚容,等.当归补血汤对糖尿病肾病大鼠GRP78的影响[J].中国中西医结合肾病杂志,2016,17(10):858-861.
[22]姚琼,叶太生,黄蓓.当归补血汤不同配比对高糖作用下大鼠肾组织系膜细胞增殖的影响[J].湖北中医杂志,2015,37(10):11-13.
[23]徐伶俐.闫镛教授应用参芪地黄汤治疗糖尿病肾病经验[J].中国中医药现代远程教育,2017,15(12):83-85.
[24]朱勤,陈洪宇.参芪地黄汤对阿霉素肾病大鼠足细胞Nephrin蛋白和m RNA表达的影响[J].中华中医药学刊,2015,33(2):296-299.
[25]史佳丽.参芪地黄汤对Ig A肾病模型大鼠肾小球足细胞保护作用的研究[D].杭州:浙江中医药大学,2014.
[26]闫世杰.补中益气汤浅析[J].河南中医,2017,37(9):1670-1672.
[27]郭继光,张海燕,李朝鹏,等.补中益气汤对阿霉素诱导的大鼠肾病的作用[J].河北大学学报:自然科学版,2015,35(3):298-304.
[28]Pal A,Kaskel F.History of nephrotic syndrome and evolution of its treatment[J].Frontiers Pediatrics,2016,4:56-61.
[29]张雷,徐福胜,乔梁,等.黄芪注射液对原发性肾病综合征患者红细胞,网织红细胞及血小板参数的影响[J].海南医学院学报,2016,22(2):157-159.
[30]崔冰,任永朋,李星锐,等.黄芪颗粒对肾病综合征患者免疫力的影响[J].中医研究,2017,30(1):19-21.
[31]孙成峰.黄芪注射液治疗原发性肾病综合征的临床疗效观察[J].中国处方药,2015,13(9):47-48.
[32]龚骁.黄芪注射液治疗原发性肾病综合征64例临床观察[J].中国实用医药,2014,9(6):128-129.
[33]聂静涛.防己黄芪汤对原发性肾病综合征水肿期患者的疗效及对24 h尿蛋白,血清白蛋白,血脂的影响[J].实用临床医药杂志,2017,21(1):48-51.
[34]汪永国.参芪地黄汤对难治性肾病综合征患者肾功能的影响[J].西部中医药,2016,29(5):76-78.
[35]Sun G,Li C,Cui W,et al.Review of herbal traditional chinese medicine for the treatment of diabetic nephropathy[J].J Diab Res,2016,2016:5749857.
[36]蔡然,崔建华.黄芪注射液对早期糖尿病肾病患者尿白蛋白及细胞因子的影响[J].现代中西医结合杂志,2016,25(28):3117-3119.
[37]董晓光,赵旭涛.黄芪对早期糖尿病肾病患者内皮素及降钙素基因相关肽的影响[J].临床医药文献电子杂志,2016,3(20):3957-3958.
[38]董萍,安琳.参芪地黄汤治疗早期糖尿病肾病35例临床观察[J].天津中医药,2017,34(4):239-241.
[39]侯小雪,杨秀炜,周微,等.加味当归补血汤对糖尿病肾病临床疗效及血清免疫因子水平影响研究[J].辽宁中医药大学学报,2017,19(12):115-118.
[40]袁艳丽.补阳还五汤对早期糖尿病肾病患者血脂水平及血液流变学指标的影响[J].河南医学研究,2017,26(19):3574-3575.
[41]Suzuki H,Suzuki Y,Novak J,et al.Development of animal models of human Ig A nephropathy[J].Drug Discov Today:Disease Models,2014,11(1):5-11.
[42]梁一鸣.黄芪颗粒对Ig A肾病患者血清中MCP-1,TNF-α和IL-6水平的影响[J].新中医,2015,47(5):115-117.
[43]沈世忠,杨忠民,蔡佳盈,等.黄芪注射液对Ig A肾病患者免疫球蛋白分子异常糖基化及Cosmc基因表达的影响[J].中国老年学杂志,2017,37(11):2788-2789.
[44]燕玉军.黄芪桂枝五物汤治疗脾肾阳虚型Ig A肾病的临床分析[J].光明中医,2017,32(5):619-621.
[45]刘垠浩,陈丽贞,蓝元隆,等.补阳还五汤加减治疗Ig A肾病35例临床观察[J].湖南中医杂志,2016,32(10):68-70.
[46]吴宇红,陈茂盛,卢冰.黄芪当归合剂联合基础治疗对Ig A肾病的疗效观察[J].浙江中医杂志,2013,48(6):412-413.
[47]杜凯琼.中西医结合治疗高血压肾病74例[J].中医临床研究,2017,9(20):59-60.
[48]郭佳音,裴克,朱晶晶,等.黄芪注射液联合厄贝沙坦治疗高血压肾病的效果及作用机制分析[J].中国当代医药,2017,24(7):76-78.
[49]郭炜.黄芪注射液治疗原发性高血压肾损害的系统评价[J].山东中医药大学学报,2013,37(5):375-377.
[50]马丽.高血压肾病患者血清胱抑素C含量变化与加味参芪地黄汤疗效的关系探讨[J].中华中医药学刊,2015,33(10):2526-2528.