黄芪治疗高血压肾病研究进展  

Research Progress of Huangqi(Astragali Radix)in Treatment of Hypertensive Nephropathy

作　　者：李世杰 张诗雨 李雪[1] 崔琳[1] 高原[1] 谢世阳[1] 邢作英[1] 王幼平[1] LI Shijie;ZHANG Shiyu;LI Xue;CUI Lin;GAO Yuan;XIE Shiyang;XING Zuoying;WANG Youping(First Affiliated Hospital,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中华中医药学刊》2024年第5期108-112,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82074194)。

摘　　要：高血压是导致慢性肾脏病的主要原因之一。现代医学认为,肾素-血管紧张素-醛固酮系统的激活、交感神经兴奋性的升高、血管内皮功能障碍、氧化应激和炎症反应是导致高血压肾病的主要病理学机制,而肾脏纤维化是其最常见的病理学特征。目前认为,控制血压是治疗高血压肾病的关键,在临床治疗中通常通过应用降压药控制高血压肾病的发生和发展。但是,有研究报道指出,强化降压对改善高血压所导致的肾功能损害和肾脏纤维化并未达到预期的效果。因此,探明高血压肾病的发病机制并寻求新的治疗方法具有重要的临床意义。中医学认为,高血压肾病以气虚血瘀为基本病机,益气活血为其主要治法。黄芪具有补气及“逐恶血”的作用,常用于益气活血方中。诸多研究表明,黄芪及其制剂具有多种药理学作用,其中包括调节血压、抑制氧化应激和炎症反应、调节血管活性物质和保护血管内皮细胞及抑制纤维化。与单纯西药治疗相比,联合中药在治疗慢性肾脏病方面更具优势。然而,针对黄芪治疗高血压肾病,尚缺乏系统的阐述。因此,从传统医学及现代医学方面系统地论述黄芪治疗高血压肾病的药理学机制,从而为更好地促进黄芪及其制剂在高血压肾病的临床应用提供坚实的药理学依据。Hypertension is one of the main causes of chronic kidney disease.Modern medicine considers activation of the re⁃nin-angiotensin-aldosterone system,elevated sympathetic excitability,vascular endothelial dysfunction,oxidative stress and in⁃flammation as the main pathological mechanisms contributing to hypertensive nephropathy,and renal fibrosis as its most common pathological feature.Currently,it is considered that blood pressure control is the key to the treatment of hypertensive nephropa⁃thy,and the development and progression of hypertensive nephropathy is usually controlled by the application of antihypertensive drugs in clinical treatment.However,several studies have reported that intensive blood pressure lowering has not achieved the ex⁃pected effect on improving an impairment of renal function and renal fibrosis caused by hypertension.Therefore,it is clinically important to explore the mechanisms of hypertensive nephropathy and seek novel therapeutic approaches.Based on traditional Chinese medicine,the basic mechanism underlying hypertensive nephropathy is thought to be characterized by Qi deficiency and blood stasis,and the main therapy is invigorating Qi and activating blood.Huangqi(Astragali Radix)has the actions of invigorat⁃ing Qi and clearing the evil blood,so it is often used in the invigorating Qi and activating blood formulae.Numerous studies have shown that Huangqi(Astragali Radix)and its preparations have a variety of pharmacological effects,including regulation of blood pressure,inhibition of oxidative stress and inflammatory responses,regulation of vasoactive substances and protection of vascular endothelial cells and inhibition of fibrosis.The combination of traditional Chinese and Western medicine is more advantageous in the treatment of chronic kidney disease compared with Western medicine treatment alone.However,there is a lack of systematic elaboration for the treatment of hypertensive nephropathy with Huangqi(Astragali Radix).Therefore,this article aims to systemat⁃ically discu

关 键 词：黄芪 高血压肾病 肾素-血管紧张素-醛固酮系统 氧化应激 炎症 

分 类 号：R282.710.7[医药卫生—中药学]