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1.广西中医药大学 附属国际壮医医院,南宁 530219
2.广西中医药大学 第一附属医院,南宁 530213
Published:20 May 2023,
Published Online:13 March 2023,
Received:30 October 2022,
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罗佳,李统宇,农复香等.高尿酸血症肾病中医与中西医结合研究进展[J].中国实验方剂学杂志,2023,29(10):274-282.
LUO Jia,LI Tongyu,NONG Fuxiang,et al.Hyperuricemic Nephropathy in Traditional Chinese Medicine and Integrated Traditional Chinese and Western Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(10):274-282.
罗佳,李统宇,农复香等.高尿酸血症肾病中医与中西医结合研究进展[J].中国实验方剂学杂志,2023,29(10):274-282. DOI: 10.13422/j.cnki.syfjx.20231693.
LUO Jia,LI Tongyu,NONG Fuxiang,et al.Hyperuricemic Nephropathy in Traditional Chinese Medicine and Integrated Traditional Chinese and Western Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(10):274-282. DOI: 10.13422/j.cnki.syfjx.20231693.
高尿酸血症肾病(HN)是一种临床常见的继发性肾损害,具有早期隐匿性、持续进展性等特征。中医认识HN,多从宏观角度出发,认为HN是因为感受外邪的同时机体内伤,二者合而发病,其病机多为本虚标实、虚实夹杂。西医认识HN则更多的从微观角度出发,认为HN的发生是炎症反应、氧化应激、肾素-血管紧张素-醛固酮系统(RAAS)激活、代谢异常等共同作用的结果。在中医辨证分型上,HN可分为4型,即湿热内蕴证、湿浊中阻证、脾肾两虚证和肾阴亏虚证,拟方用药时需根据所辩证型分别施以清热利湿、袪湿化浊、补益脾肾或补肾滋阴等相关治法。除了中药方剂之外,中药单药及其提取物、中成药、中医外治等均在HN的治疗过程中发挥了显著的疗效,有效推动了中医药治疗HN的进程。与此同时,中西医结合的方式在治疗HN上亦发挥了良好的作用,丰富了HN的治疗方案。由于HN同普通肾病如急慢性肾小球肾炎、肾病综合征比较,具有其特殊性,因此在临床过程中应做到谨慎鉴别、明确诊断。该文系统整理了中医、中西医结合关于高血酸血症肾病的研究成果,对HN的机制及治疗进行综述,以期为HN治疗的系统化、理论化提供一定的依据,进一步指导临床。
Hyperuricemic nephropathy (HN), a secondary renal damage common in clinical practice, is characterized by early concealing and continuous progression. The understanding of HN in traditional Chinese medicine (TCM) is from a macroscopic perspective. According to the TCM theory, HN is caused by the combination of external pathogens and internal injuries, with the main pathogenesis being root deficiency combined with superficial excess and deficiency-excess in complexity. In western medicine, the understanding of HN is from the microscopic perspective, which holds that the occurrence of HN is the result of inflammation, oxidative stress, renin-angiotensin-aldosterone system (RAAS) activation, and metabolic abnormalities. The TCM syndromes of HN include internal dampness and heat, obstruction in dampness and turbidity, deficiency of spleen and kidney, and deficiency of kidney yin. Accordingly, the prescriptions should clear heat and dampness, remove dampness and turbidity, tonify spleen and kidney, and nourish kidney yin, respectively. In addition to TCM prescriptions, single herbal medicines and their extracts, Chinese patent medicines, and external applications of Chinese medicines have played a significant role in the treatment of HN, promoting the application of TCM in the treatment of HN. Moreover, the integrated traditional Chinese and western medicine has also played a role in the treatment of HN, enriching the treatment schemes of HN. Different from common kidney diseases such as acute and chronic glomerulonephritis and nephrotic syndrome, HN with particularity should be carefully differentiated in clinical practice. This article systematically summarizes the research progress in the treatment of traditional Chinese medicine and integrated traditional Chinese and western medicine on hyperuricemic nephropathy with TCM and integrated traditional Chinese and western medicine, aiming to enrich the system and theory of HN treatment and further guide the clinical practice.
高尿酸血症肾病中医中西医结合研究进展
hyperuricemia nephropathytraditional Chinese medicineintegrated traditional Chinese and western medicineresearch progress
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