基于“肾主水”探讨AVP-V2R-AQP2轴与肾病阴虚水肿的关系  

To explore the relationship between AVP-V2R-AQP2 axis and Yin deficiencyedema of nephropathy based on “kidney governing water”

作　　者：邱依婷 孙欣如 刘梦超 赵文景[2] 王悦芬[2] QIU Yiting;SUN Xinru;LIU Mengchao;ZHAO Wenjing;WANG Yuefen(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]首都医科大学附属北京中医医院肾病科,北京100010

出　　处：《陕西中医》2025年第1期72-75,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82374366);北京市中医药科技发展资金项目(JJ-2020-46);北京市属医院科研培育计划项目(PZ2022022)。

摘　　要：肾病阴虚水肿常见于肾脏病中、后期患者,有着难治性、顽固性的特点,并且随着病情进展、利尿药物的应用而逐渐加重,临床关注度低,治疗措施有限,治疗效果不佳。血管升压素(AVP)-加压素受体2(V2R)-水通道蛋白2(AQP2)轴是机体调节水盐平衡的关键通路,且与肾脏排泄钠失常直接相关。根据中医“象”思维,认为“肾主水”理论推导的肾病阴虚水肿发病机制与AVP-VR2-AQP2轴导致肾病阴虚水肿相类似。故本文将基于“肾主水”理论,结合王悦芬教授临床经验,从中、西医不同的角度及运用中医药调控AVP-VR2-AQP2轴治疗肾病阴虚水肿等方面,深入探讨“肾主水”、AVP-V2R-AQP2轴、肾病阴虚水肿三者之间的联系,进一步认识“肾主水”机制,探讨AQP2作为肾病阴虚水肿新型生物标志物的可能,为肾病阴虚水肿的治疗提供新思路,为中医药现代化研究提供可靠依据。Nephropathy Yin deficiency edema is common in patients with kidney disease in the middle and late stage,with refractory and intractable characteristics,and with the progression of the disease,the application of diuretic drugs and gradually aggravated,low clinical attention,limited therapeutic measures,poor therapeutic effect.arginine vasopressin(AVP)-vasopressin type 2 receptor(V2R)-aquaporin 2(AQP2)axis is a key pathway regulating water and salt balance in the body,and is directly related to the abnormal excretion of sodium by the kidney.According to the“elephant”thinking of Chinese medicine,the pathogenesis of Yin deficiency edema of nephropathy derived from the theory of“kidney governing water”is similar to that of Yin deficiency edema of nephropathy caused by AVP-VR2-AQP2 axis.Therefore,based on the theory of“kidney governing water”and Professor WANG Yuefen’s clinical experience,this paper will further explore the relationship between“kidney governing water”,AVP-V2R-AQP2 axis and Yin deficiency edema of kidney disease by regulating AVP-VR2-AQP2 axis from different perspectives of Chinese medicine and western medicine,and further understand the mechanism of“kidney governing water”.To explore the possibility of AQP2 as a new biomarker for Yin deficiency edema of nephropathy,to provide a new idea for the treatment of Yin deficiency edema of nephropathy,and to provide a reliable basis for the modernization of traditional Chinese medicine.

关 键 词：肾病阴虚水肿 肾主水 血管升压素-加压素受体2-水通道蛋白2轴 水液代谢 水钠潴留 存阴 

分 类 号：R256.51[医药卫生—中医内科学]