摘要
随着糖尿病发病率的不断攀升,糖尿病肾脏疾病(DKD)给全球带来了沉重的疾病负担。尽管现有的预防和治疗策略能在一定程度上延缓DKD的进展,但患者进展至终末期肾病的风险依然居高不下。自2011年国际透析大会首次引入“肠-肾轴”概念以来,肠道菌群在DKD发病机制中的研究日益受到关注。该文综述了当前肠道菌群的研究现状,探讨了其参与DKD发病的相关机制,并总结了基于“肠-肾轴”理论对DKD进行防治的临床方法。发现通过饮食调节、摄入益生菌/益生元、使用二甲双胍及新型降糖药物,以及应用中药复方等多种手段,可以有效改善肠道菌群结构,影响代谢产物的生成,并修复肠道黏膜屏障。这些措施能够进一步调控肠道固有免疫和炎症反应,从而干预DKD的疾病进程。尽管传统水煎口服给药方式及中药复方成分的复杂性对机制研究带来了挑战,但越来越多的证据表明,中药可能通过调节肠道菌群间接影响DKD的发生与发展。这一发现为中药在DKD治疗中的潜在机制提供了新的视角,有望为DKD的预防和治疗提供新的思路和方法。
With the rising incidence of diabetes,diabetic kidney disease(DKD)has become a significant global health burden.Although current prevention and treatment strategies can partially delay the progression of DKD,the risk of patients advancing to end-stage renal disease remains high.Since the concept of the"gut-kidney axis"was first introduced at the International Congress on Dialysis in 2011,research on the role of gut microbiota in the pathogenesis of DKD has received increasing attention.This review summarizes the current research on gut microbiota,explores the mechanisms through which it contributes to DKD development,and outlines clinical approaches for DKD prevention and treatment based on the"gut-kidney axis"theory.Evidence indicates that dietary interventions,intake of probiotics or prebiotics,use of metformin and novel antidiabetic drugs,and application of traditional Chinese medicine(TCM)compound formulas can effectively improve gut microbiota composition,influence metabolite production,and restore the intestinal mucosal barrier.These interventions can further regulate intestinal innate immunity and inflammatory responses,thereby modulating the progression of DKD.Despite challenges posed by the traditional oral administration of water-decocted TCM compound formulas and the complexity of their ingredients,increasing evidence suggests that TCM may indirectly affect the occurrence and development of DKD by modulating gut microbiota.This finding provides a new perspective on the potential mechanisms of TCM in DKD treatment and may offer novel strategies for DKD prevention and therapy.
作者
王颖超
陈晔欣
张华
刘江腾
阮智超
潘星如
黄为钧
赵进喜
WANG Yingchao;CHEN Yexin;ZHANG Hua;LIU Jiangteng;RUAN Zhichao;PAN Xingru;HUANG Weijun;ZHAO Jinxi(Beijing Aerospace General Hospital,Beijing 100076,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100070,China)
出处
《中国实验方剂学杂志》
北大核心
2026年第7期310-320,共11页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(8247152547)
北京市自然科学基金项目(7222278)
北京中医药大学揭榜挂帅项目(2024-JYBJBZD-011)。
关键词
糖尿病肾脏疾病
肠道菌群
肠-肾轴
中医药干预
研究进展
diabetic kidney disease
gut microbiota
gut-kidney axis
traditional Chinese medicine intervention
research progress
