中药干预化疗肾损伤研究进展  

Research progress of traditional Chinese medicine intervention in chemotherapy renal injury

作　　者：刘叶元 祁亚锋 张茂福 李欣钰 沈雁云 刘瑜 张尚祖 李洋洋 张利英 张志明 LIU Yeyuan;QI Yafeng;ZHANG Maofu;LI Xinyu;SHEN Yanyun;LIU Yu;ZHANG Shangzu;LI Yangyang;ZHANG Liying;ZHANG Zhiming(Gansu University of Traditional Chinese Medicine,College of Clinical Chinese Medicine,Lanzhou 730000,Gansu,China;Gansu University of Traditional Chinese Medicine,College of Integrative Medicine,Lanzhou 730000,Gansu,China;Gansu Provincial Hospital of Chinese Medicine,Oncology Department,Lanzhou 730050,Gansu,China)

机构地区：[1]甘肃中医药大学中医临床学院,甘肃兰州730000 [2]甘肃中医药大学中西医结合学院,甘肃兰州730000 [3]甘肃省中医院肿瘤科,甘肃兰州730050

出　　处：《中国临床药理学与治疗学》2025年第4期556-569,共14页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：高端人才承担省级科技计划基金资助项目(“长江学者奖励计划”)(22ZD1FA001);甘肃省科技重大专项基金资助项目(甘科技[2022]1号-25);国家自然科学基金资助项目(82260882)。

摘　　要：肾损伤是临床应用化疗药物常见的不良反应之一,是导致患者化疗不能全周期进行的主要原因。化疗肾损伤病理机制十分复杂,主要涉及氧化应激、炎症反应、细胞死亡、线粒体功能障碍、能量代谢以及调节转运蛋白等多种机制,引起肾小管或肾小球病理损伤。目前针对化疗肾损伤的治疗尚无特异性的药理干预措施,而中医药作为祖国医学的瑰宝,在防治化疗肾损伤方面具有整体调节、多靶向、不良反应小、无明显药物依赖性等优势。近年来中药活性成分、中药提取物、复方等通过多组分、多方向干预化疗肾损伤的相关研究越来越多,且取得了一定进展。大量研究表明,中医药防治化疗肾损伤的潜在机制包括抑制氧化应激、减轻炎症反应以及抑制细胞凋亡等。虽然探讨中医药治疗化疗肾损伤发生发展的作用机制研究较多,但尚缺乏系统综述。基于此,从化疗肾损伤的发生机制及中药干预等方面进行归纳总结,为其临床治疗及新药创新探索提供理论支持。Renal injury is one of the common adverse reactions in the clinical application of chemotherapy drugs,which is the main reason why the chemotherapy can not be carried out in the whole cycle.The pathological mechanism of chemotherapy-induced renal injury is very complicated,mainly involving oxidative stress,inflammatory response,apoptosis,mitochondrial dysfunction,and regulation of transporters,causing pathological damage to renal tubules or glomeruli.At present,there is no specific pharmacological intervention for the treatment of chemotherapy-induced renal injury.As a treasure of traditional Chinese medicine,traditional Chinese medicine has the advantages of overall regulation,multi-targeting,small adverse reactions and no obvious drug dependence in the prevention and treatment of chemotherapy-induced renal injury.In recent years,there have been more and more studies on the intervention of chemotherapy-induced renal injury by multi-component and multi-directional intervention of active components,extracts and compounds of traditional Chinese medicine,and some progress has been made.A large number of studies have shown that the potential mechanisms of traditional Chinese medicine in preventing and treating renal injury induced by chemotherapy include inhibiting oxidative stress,reducing inflammatory response and inhibiting apoptosis.Although there are many studies on the mechanism of action of traditional Chinese medicine in the treatment of chemotherapy induced renal injury,there is still a lack of systematic review.Based on this,this paper summarizes the mechanism of renal injury induced by chemotherapy and the intervention of traditional Chinese medicine,so as to provide theoretical support for its clinical treatment and new drug innovation.

关 键 词：化疗 肾损伤 机制 中药 研究进展 

分 类 号：R692[医药卫生—泌尿科学] R932[医药卫生—外科学]