基于中医阴阳学说探讨巨噬细胞极化在糖尿病肾脏疾病中的作用  

Discussion on the Effects of Macrophage Polarization on Diabetic Kidney Disease Based on TCM Yin-yang Theory

作　　者：朱玲玲 谭莹[1,2] 佘云 余江毅 严倩华[1] ZHU Lingling;TAN Ying;SHE Yun;YU Jiangyi;YAN Qianhua(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China;Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学,江苏南京210023

出　　处：《中国中医药信息杂志》2024年第10期19-23,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金(82004286);江苏省中医药管理局项目(ZT202206);江苏省研究生实践创新计划项目(SJCX23_0873)。

摘　　要：糖尿病肾脏疾病(DKD)是糖尿病严重的微血管并发症之一,免疫紊乱介导的慢性低度炎症是DKD发生的重要机制。巨噬细胞作为免疫炎症反应的重要参与者,可在不同的微环境下极化为促炎的M1表型和抑炎的M2表型。二者在功能上相互拮抗,且在DKD不同发展阶段可相互转化,与中医“阴阳学说”阴阳对立制约、互根互用、消长平衡、相互转化的内涵相似。M1、M2表型巨噬细胞比例失衡是导致DKD炎症反应和肾纤维化的重要因素。本文基于中医阴阳学说,阐释巨噬细胞极化对DKD的影响,提出以“损其有余”和“补其不足”为基本治则,调节巨噬细胞极化状态,恢复阴阳平衡,以期为DKD临床治疗提供思路。Diabetic kidney disease(DKD)is one of the serious microvascular complications of diabetes.Immune disorder-mediated chronic inflammation is an essential mechanism underlying the occurrence of DKD.Macrophages,as important participants in the immune-inflammatory response,can polarize into the pro-inflammatory M1 phenotype and anti-inflammatory M2 phenotype under different microenvironments.The two are functionally antagonistic to each other.They can be transformed into each other in different developmental stages of DKD,which is similar to the connotation of yin and yang in the theory of“yin-yang theory”in TCM,such as restriction of opposites,mutual root and mutual use,balance of growth and decline,and mutual transformation.The imbalance of M1 and M2 macrophages is an important factor leading to DKD inflammatory response and renal fibrosis.Therefore,based on the yin-yang theory in TCM,this article clarified the effects of macrophage polarization on DKD,and proposed that the basic treatment method is to“tonify deficiency and damage excess”to adjust the polarization of macrophages and restore the balance of yin and yang,in order to provide ideas for the clinical treatment of DKD.

关 键 词：巨噬细胞极化 糖尿病肾脏疾病 阴阳学说 

分 类 号：R259.872[医药卫生—中西医结合] R277.52[医药卫生—中医内科学]