基于代谢重编程探讨肾小球硬化痰瘀互结病机  

A review of the Chinese medical theory of phlegm-stasis interactions in glomerulosclerotic diseases,with particular reference to metabolic reprogramming

作　　者：胡安澜 周荣 董凯旋 陈曦 于小勇 李晓宁 HU Anlan;ZHOU Rong;DONG Kaixuan;CHEN Xi;YU Xiaoyong;LI Xiaoning(Shaanxi Provincial Hospital of Traditional Chinese Medicine,Xi’an 710003,China)

机构地区：[1]陕西省中医医院,陕西西安710003 [2]西安医学院第三附属医院,陕西西安710068

出　　处：《陕西中医》2025年第1期88-91,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82174366);陕西省科技厅社发攻关一般项目(2017SF-298);陕西省中医药管理局科研项目(2021-GJ-LC022);西安市科技计划项目[2019115613YX011SF044(9)]。

摘　　要：肾小球硬化是肾小球病变的一种病理形态学特点,也是各种肾脏疾病进展的后期表现。临床常见为蛋白尿和肾病综合征,多数患者病情为逐渐进展。激素、免疫抑制剂治疗带来的不良反应和肝肾毒性,为肾小球硬化病变在中医药治疗上带来更多6空间。代谢重编程作为一种重要的细胞适应机制,在肾小球硬化病变的病理过程中扮演着核心角色。本文通过分析代谢重编程在肾小球硬化病变中的作用机制,探讨了痰瘀互结的病理机制,并从现代医学和传统中医相结合的角度提出了治疗肾小球硬化的潜在新策略,旨在为肾小球疾病防治提供新思路和方向。Glomerular sclerosis(GS)is a prevalent consequence of glomerular injury and lesions resulting from a multitude of etiologies.It represents the primary pathological foundation for chronic renal failure.The disease is characterised by the proliferation of glomerular mesangial cells and the widening of the mesangial matrix.In the initial phase,the distribution is focal segmental,whereas in the subsequent phase,it becomes diffuse globular.Glomerulosclerosis is not referenced by name in the medical literature of previous generations.However,based on its clinical manifestations and characteristics,it can be attributed to the categories of zhenjiu and oedema in traditional Chinese medicine.The doctrine of phlegm and stasis is consistent with the development of GS,and TCM treatments guided by this doctrine have demonstrated efficacy in clinical settings.Metabolic reprogramming refers to the process by which cells adapt to different physiological or pathological states by regulating metabolic pathways and the production and utilisation of products.This regulation entails alterations in enzyme expression and activity,in addition to the synthesis,catabolism and transport of metabolites.The concept of metabolic reprogramming has been demonstrated in a variety of disease processes,including those affecting the liver and kidneys.This paper presents a discussion of the pathogenesis of glomerular sclerosis,with a particular focus on the role of metabolic reprogramming in the context of phlegm and stasis.The aim is to provide insights and directions for the treatment of glomerular diseases by combining Chinese and western medicine.

关 键 词：代谢重编程 线粒体 能量代谢 痰瘀理论 肾小球硬化 

分 类 号：R629.6[医药卫生—整形外科]