基于“阴阳自和”理论探讨足细胞自噬在糖尿病肾脏疾病中的作用  

Exploration of the Role of Podocyte Autophagy in Diabetic Kidney Disease Based on the Theory of“Yin and Yang Harmony”

作　　者：程玥凤 于嘉祥 吴怡[2] 张瀚文[1] 曲超 张笑蕊 石岩[1] 张文顺 CHENG Yuefeng;YU Jiaxiang;WU Yi;ZHANG Hanwen;QU Chao;ZHANG Xiaorui;SHI Yan;ZHANG Wenshun(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning Institute of Traditional Chinese Medicine,Shenyang 110034,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属第二医院,辽宁省中医药研究院,辽宁沈阳110034

出　　处：《辽宁中医药大学学报》2024年第7期55-59,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)项目(2013CB532004);辽宁省“兴辽英才计划”青年拔尖人才项目(XLYC2007121);辽宁省应用基础研究计划项目(2023JH2/101300094);辽宁省科技厅博士科研启动课题项目(2021-BS-183,2023-BS-141);中医脏象理论及应用教育部重点实验室开放基金项目(zyzχ2109)。

摘　　要：自噬是一种双向调节机制,指降解代谢产物,自我更新,生成能量的过程。在糖尿病肾脏疾病(diabetic kidney disease,DKD)发生发展过程中,足细胞构成肾小球滤过屏障,其自噬功能缺陷,可破坏滤过屏障,导致蛋白尿的产生以及肾小球硬化。从中医角度分析,这一过程蕴含了中医“阴阳自和”的理论内涵。DKD异常为本虚标实之证,以脾肾阴阳自和能力下降为本,气血阴阳失调日久,痰瘀毒胶结为标。适量的足细胞自噬能够降解废物——“阴”,生成能量——“阳”,保证机体微环境的阴阳自和,与阴阳消长、阴阳自和维持阴平阳秘的中医平衡过程不谋而同。故文章从“阴阳自和”角度探讨足细胞自噬在DKD过程中的作用,拟为防治DKD提供一些新思路。Autophagy is a two-way regulatory mechanism,which refers to the process of degrading metabolites,self-renewal and generating energy.In the development of diabetic kidney disease(DKD),podocytes constitute the glomerular filtration barrier,and their autophagy dysfunction can destroy the filtration barrier,resulting in proteinuria and glomerulosclerosis.From the perspective of traditional Chinese medicine,this process contains the theoretical connotation of“Yin and Yang harmony”in traditional Chinese medicine.DKD abnormality is the syndrome of deficiency in origin and excess in superficiality,which is based on the decrease of Yin and Yang self-harmony ability of spleen and kidney,the imbalance of Qi,blood,Yin and Yang for a long time,and the cementation of phlegm,blood stasis and toxin as the standard.An appropriate amount of podocyte autophagy can degrade the waste“Yin”,generate energy“Yang”,and ensure the self-harmony of Yin and Yang in the microenvironment of the body,which is the same as the balance process of Yin and Yang in traditional Chinese medicine.Therefore,the role of podocyte autophagy in the process of DKD is discussed from the perspective of“Yin and Yang harmony”,which is intended to provide some new ideas for the prevention and treatment of DKD.

关 键 词：阴阳自和 足细胞自噬 糖尿病肾脏疾病 

分 类 号：R256.5[医药卫生—中医内科学]