中西医治疗特发性膜性肾病研究进展  

Research Progress on Integrated Traditional Chinese and Western Medicine Therapy for Idiopathic Membranous Nephropathy

作　　者：李和丹 赵爱萍[2] LI Hedan;ZHAO Aiping(Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian,China,350100;Fujian Provincial People′s Hospital,Fuzhou,Fujian,China,350004)

机构地区：[1]福建中医药大学,福建福州350100 [2]福建中医药大学附属人民医院,福建福州350004

出　　处：《河南中医》2025年第4期640-648,共9页Henan Traditional Chinese Medicine

基　　金：阮诗玮全国名老中医药专家传承工作室建设项目{国中医药人教函[2022]75号}。

摘　　要：特发性膜性肾病(idiopathic membranous nephropathy,IMN)是一种自身免疫性疾病,中西医结合治疗IMN可充分发挥各自的优势,起到协同作用,提高疗效,降低不良反应发生率。目前,在临床选择用药方面存在以下问题:(1)西医治疗主要依赖糖皮质激素和免疫抑制剂,但这些药物会引发一些不良反应,包括肾毒性、感染风险和高复发率,尤其是长期使用可能导致患者承受较重的经济负担;(2)尽管中医药在改善临床症状和减轻西药不良反应方面显示出一定的疗效,但其作用机制复杂,缺乏足够的临床证据支持,且治疗过程较长,尚需更多的研究以确定其最佳使用方案和剂量;(3)中西医结合疗法缺乏系统化研究,虽然中西医结合治疗IMN显示出良好的应用前景,但相关研究多为小规模临床试验,缺乏系统性和大样本研究来验证其广泛适用性。今后,应聚焦于探讨IMN的发病机制,特别是在分子水平上寻找新的靶点,以推动精准靶向治疗的发展。同时,应通过大规模的临床研究,优化中西医结合治疗方案,制定标准化的治疗指南。此外,个体化和精准化治疗也是今后重要的研究方向。Idiopathic membranous nephropathy(IMN) is an autoimmune disease.Integrated traditional Chinese and Western medicine therapy for IMNcan give full play to their respective advantages,exert a synergistic effect,improve therapeutic efficacy and reduce the incidence of adverse reactions.At present,there are the following problems in the clinical selection of drugs:(1) Western medicine treatment mainly relies on glucocorticoids and immunosuppressants,but these drugs can cause some adverse reactions,including nephrotoxicity,infection risk and high recurrence rate.Especially long-term use may lead to additional health risks for patients;(2) Although TCM has shown certain efficacy in improving symptoms and reducing adverse reactions of Western medicine,its mechanism of action is complex,lacks sufficient clinical evidence support,and the treatment process is long.More research is needed to determine the best usage plan and dosage;(3) Integrated traditional Chinese and Western medicine lacks systematic research:Although the combination of traditional Chinese and Western medicine in the treatment of IMN shows good prospects,most of the related research is small-scale clinical trials,lacking systematic and large-sample studies to verify its wide applicability.The results of various studies vary greatly,and further research is needed to determine its long-term efficacy and safety.In the future,efforts should be focused on further exploring the pathogenesis of IMN,especially seeking new targets at the molecular level to promote the development of precise targeted therapy.Meanwhile,it is necessary to optimize the integrated traditional Chinese and Western medicine treatment plan through large-scale clinical research and formulate standardized treatment guidelines.Additionally,individualized and precise treatment will become an important research direction.

关 键 词：特发性膜性肾病 支持疗法 免疫抑制治疗 中药汤剂 中成药 中医外治法 单味中药 中西医结合疗法 

分 类 号：R277.592[医药卫生—中医学]