基于轴探讨糖尿病肾病中医发病机制及治疗靶点  

Discussion on the Pathogenesis and Treatment Target of Traditional Chinese Medicine of Diabetes Based on AGEs-RAGE Axis

作　　者：张宗金 王悦芬[1] 赵文景[1] 崔方强 孟元[1] 沈存[1] 孙雪艳 王梦迪 刘梦超 ZHANG Zongjin;WANG Yuefen;ZHAO Wenjing;CUI Fangqiang;MENG Yuan;SHEN Cun;SUN Xueyan;WANG Mengdi;LIU Mengchao(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《世界中医药》2020年第23期3704-3709,共6页World Chinese Medicine

基　　金：北京市自然科学基金项目(7172096)。

摘　　要：糖尿病肾病(Diabetes Nephropathy,DN)是糖尿病(Diabetes Mellitus,DM)患者常见的微血管并发症,也是引起终末期肾脏病的主要原因之一。高糖环境下,非酶糖化反应生成的晚期糖基化终末产物(Advanced Glycationend Products,AGEs)和晚期糖基化终末产物受体(Receptors for Advanced Glycation End Products,RAGE)的相互结合和作用是DN发生和进展的重要原因之一。研究发现,作用于AGEs-RAGE轴的不同位点可以改善DN的症状,中医药通过抑制非酶糖化,减少AGEs形成和抑制RAGE方面改善DN,AGEs-RAGE轴在DN发病中具有伏邪特征。基于近几年实验研究热点,结合AGEs-RAGE轴进行总结论述,阐释“邪伏膜原”发病机制假说及中医治疗DN的作用机制。Diabetes nephropathy(DN)is a common microvascular complication in patients with diabetes mellitus(DM),and it is also one of the main causes of end-stage renal disease.In high sugar environment,the interaction of advanced glycation end products(AGEs)and receptors(RAGE)produced by non-enzymatic glycation is one of the important reasons for the occurrence and progress of DN.It is found that different sites acting on AGEs-RAGE axis could improve DN symptoms.Traditional Chinese medicine(TCM)could improve DN by inhibiting non-enzymatic saccharification,reducing AGEs formation and inhibiting RAGE.AGEs-RAGE axis has the characteristics of incubating pathogens in DN.Based on the hotspot of experimental research in recent years,combined with AGEs-RAGE axis,we explain the pathogenesis hypothesis of“pathogen hidden in the pleurodiaphragmatic interspace”and the mechanism of TCM in the treatment of DN.

关 键 词：糖尿病肾病 非酶糖化 晚期糖基化终末产物-晚期糖基化终末产物受体轴 氧化应激 晚期糖基化终末产物抑制剂 晚期糖基化终末产物交联破坏剂 晚期糖基化终末产物-晚期糖基化终末产物受体通路阻断剂 抗氧化剂 中医治疗 邪伏膜原 

分 类 号：R242[医药卫生—中医临床基础] R587.2[医药卫生—中医学]