中医药介导相关信号通路治疗局灶性节段性肾小球硬化研究进展  

Research Progress in the Treatment of FSGS by Chinese Medicine Mediating Related Signaling Pathways

作　　者：张柯欣 黄思雨 张琳琪[2] ZHANG Kexin;HUANG Siyu;ZHANG Linqi(Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,Henan,China)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450099

出　　处：《辽宁中医药大学学报》2024年第11期79-84,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81973806);国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号);河南省中原千人计划-中原名医项目(FCZZX012)

摘　　要：局灶性节段性肾小球硬化(focal segmental glomerulosclerosis,FSGS)在原发性肾小球疾病中占比7%~35%。近年来发病率有逐年上升的趋势。目前认为其发病机制与血流动力学改变、细胞外基质合成与降解失调、足细胞损伤、遗传因素、免疫损伤、细胞凋亡以及高脂血症和脂质过氧化等密切相关。原发性FSGS常表现为水肿、低蛋白血症、高脂血症及高血压等症状。目前西医治疗FSGS多运用激素及免疫抑制剂等药物,临床面临西药不良反应大、缓解率低的现状。中医药具有安全性高、不良反应小等特点,近年来很多医家积极探索中医药治疗FSGS的新方法。根据疾病的临床特点,其属于中医“水肿”“虚劳”“腰痛”“血尿”等范畴。该文通过查阅相关文献总结出历年医家利用中药(雷公藤、血必净、水蛭等)治疗FSGS的信号通路:血管内皮生长因子(vascular endothelial growth factor,VEGF)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎性复合体、转化生长因子β1(TGF-β1)、尿激酶型纤溶酶原激活物受体(uPAR)、足细胞骨架蛋白(Synaptopodin、Podocalyxin)、内皮缩血管肽-1(ET-1)/血管紧张素Ⅱ(AngⅡ)/一氧化氮(NO)、Janus激酶2(JAK2)/转录活化蛋白3(STAT3)等。该文旨在总结中医药治疗FSGS的相关通路,为开发新药治疗该疾病提供新的思路。Focal segmental glomeruloscrorosis(FSGS)accounts for 7%to 35%of primary glomerular diseases.Its incidence has an increasing tendency year by year.At present,it is believed that its pathogenesis is closely related to hemodynamic changes,imbalance in extracellular matrix synthesis and degradation,podocyte damage,genetic factors,immune damage,cell apoptosis,hyperlipidemia,and lipid peroxidation.Primary FSGS often presents with symptoms such as edema,hypoproteinemia,hyperlipidemia,and hypertension.At present,Western medicine often uses drugs such as hormones and immunosuppressants to treat FSGS,and clinical practice is facing the current situation of high side effects and low clinical remission rate of Western medicine.Traditional Chinese medicine has the characteristics of high safety and minimal side effects.In recent years,many doctors have actively explored new methods of treating FSGS with traditional Chinese medicine.According to the clinical characteristics of the disease,it belongs to the categories of“edema”“consumption”“low back pain”“hematuria”in traditional Chinese medicine.By reviewing relevant literature this article summarizes the signaling pathways through which traditional Chinese medicine[such as Leigongteng,Xuebijing(血必净),Shuizhi,etc.]has been used by physicians over the years to treat FSGS:VEGF,NLRP3 inflammatory complex,TGF-β1,uPAR,podocyte cytoskeleton protein(synaptopodin,podocalyxin),ET-1/AngⅡ/NO,JAK2/STAT3,etc.This article aims to summarize the relevant pathways of traditional Chinese medicine in treating FSGS and provide new ideas for developing new drugs to treat the disease.

关 键 词：局灶性节段性肾小球硬化 信号通路 中医药 综述 延缓进展 

分 类 号：R256.5[医药卫生—中医内科学]