雷公藤治疗肾脏疾病及其不良反应的研究进展  

Tripterygium wilfordii in Treatment of Kidney Diseases and Its Toxic and Side Effect:A Review

作　　者：李晶芳 韩蕊 殷宏庆 曹颖[1] 程旭希 宋丽丽[1] LI Jing-fang;HAN Rui;YIN Hong-qing;CAO Ying;CHENG Xu-xi;SONG Li-li(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学,天津301617

出　　处：《中国实验方剂学杂志》2021年第14期229-234,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81803961);天津教委科研计划项目(2019KJ084)。

摘　　要：近年来,随着我国中医药产业的迅速发展,中药在疾病治疗及保健养身方面的认可度也逐渐攀升,雷公藤作为一类祛风通络、除湿止痛的中药,临床上常用来治疗急、慢性肾小球肾炎、类风湿性关节炎等疾病,但雷公藤的不良反应事件也频频发生,导致雷公藤无法在临床上广泛使用,现有的研究逐渐确证雷公藤及其有效成分对肾脏的相关功能具有双向作用,本文结合临床应用举例及近十几年的文献报道,从雷公藤对肾脏双向作用的物质基础、发生肾损害和肾保护的作用机制等方面进行总结,主要包括雷公藤的主要成分雷公藤多苷、雷公藤甲素等发挥作用,通过影响免疫调节作用,丝裂原活化蛋白激酶(MAPK)通路、改变肾脏转运蛋白的表达及功能等途径对肾脏产生保护或不良反应,以此来综述雷公藤治疗肾脏疾病及其不良反应的研究进展,并讨论了雷公藤治疗肾脏疾病及其不良反应的产生与给药时间、给药剂量以及机体状态等方面的密切联系,以期为雷公藤治疗肾脏疾病相关研究提供新的思路,也为雷公藤的临床安全应用提供参考。In recent years,with the rapid development of traditional Chinese medicine industry in China,the efficacy of Chinese medicinals in treating disease and maintaining health has been increasingly recognized.Tripterygium wilfordii,a Chinese medicinal for expelling wind,dredging collaterals,removing dampness,and relieving pain,is commonly used for treating acute and chronic glomerulonephritis,rheumatoid arthritis,and other diseases.However,the frequent occurrence of adverse reactions has limited its wide application in clinical practice.The existing studies have gradually confirmed that T.wilfordii and its active ingredients exert the bidirectional effects on kidney function.This paper reviewed the related clinical applications and articles published in the past decades and summarized the material basis for its bidirectional effects and the specific action mechanisms in renal protection and renal damage.It was found that the main active ingredients in T.wilfordii were tripterygium glycosides and triptolide,which exerted the protective or toxic and side effects on kidney by regulating immunity,influencing mitogen-activated protein kinases(MAPK)pathway,and changing the expression and function of renal transporters.Besides,the roles of administration time,dosage,and body status in the exertion of protective or toxic and side effects by T.wilfordii were also discussed.The review aimed to provide new ideas for the research on the treatment of kidney diseases with T.wilfordii and its safety application.

关 键 词：雷公藤 肾保护 肾损害 双向作用 化学成分 

分 类 号：R2-0[医药卫生—中医学] R22