中医药治疗草酸钙肾结石作用机制研究进展  

Research Progress on Action Mechanism of Traditional Chinese Medicine Treatment of Calcium Oxalate Nephrolithiasis

作　　者：樊世琪 金劲松[2] 曹秋实[1] FAN Shiqi;JIN Jingsong;CAO Qiushi(Hubei University of Chinese Medicine,Wuhan Hubei China 430000;Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan Hubei China 430000)

机构地区：[1]湖北中医药大学,湖北武汉430000 [2]湖北省中医院,湖北武汉430000

出　　处：《中医学报》2025年第5期1039-1048,共10页Acta Chinese Medicine

基　　金：国家自然科学基金青年基金项目(82305082);第七批全国老中医学术经验继承项目;湖北省自然科学基金计划项目(2023AFB396)。

摘　　要：中医药治疗草酸钙肾结石具有显著疗效,其作用机制主要包括促进成石抑制物(如镁离子、Tamm-Horsfall蛋白及骨桥蛋白等)分泌、降低促石因子(草酸、尿钙等)水平、改善机体炎症反应和氧化应激状态等,可显著提高术后残留结石清除率,有效减轻术后并发症。中医药治疗草酸钙肾结石虽然已取得一定的疗效,但目前仍存在如下问题:中药复方机制研究不够深入,其治疗草酸钙肾结石的作用机理有待进一步阐明;单味中药及中药提取物的疗效可能受加工、配伍过程中的温度、湿度等因素的影响,易出现有效成分挥发或变性等问题,提取过程中,药物功效与化学成分间亦存在差异性,后续研究需严格控制这些干扰因素;临床研究样本量小,缺乏高质量的循证医学证据,未来需进一步开展大规模、多中心、大样本的随机对照试验,为草酸钙肾结石的中医药治疗提供更为可靠的依据。Traditional Chinese medicine(TCM)has significant efficacy in the treatment of calcium oxalate nephrolithiasis,and its mechanism of action mainly includes promoting the secretion of stone-forming inhibitors(such as magnesium ions,Tamm-Horsfall protein and osteopontin protein),reducing the level of litho-promoting factors(oxalic acid,urinary calcium,etc.),improving human body′s inflammatory response and oxidative stress,etc.,which can significantly improve the clearance rate of residual stones after surgery and effectively reduce postoperative complications.Although traditional Chinese medicine has achieved certain curative effects in the treatment of calcium oxalate kidney stones,there are still the following problems:the mechanism of traditional Chinese medicine compound is not studied deeply enough,and the mechanism of its treatment of calcium oxalate kidney stones needs to be further elucidated;The efficacy of single herbs and extracts may be affected by the temperature and humidity during processing and compatibility,and are prone to problems such as volatilization or denaturation of active ingredients.The small sample size of clinical studies and the lack of high-quality evidence-based medical evidence suggest that large-scale,multi-center,and large-sample randomized controlled trials should be carried out in the future to provide a more reliable basis for the traditional Chinese medicine treatment of calcium oxalate nephrolithiasis.

关 键 词：草酸钙肾结石 中医药 氧化应激 炎症反应 研究进展 

分 类 号：R256.5[医药卫生—中医内科学]