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1.桂林市中医医院,广西 桂林 541000
2.广西中医药大学 附属瑞康医院,南宁 530000
Received:20 July 2024,
Accepted:15 October 2024,
Published Online:22 October 2024,
Published:05 April 2025
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罗佳,蒋背乐,贺秋香等.黄葵胶囊在糖尿病肾病中的应用进展[J].中国实验方剂学杂志,2025,31(07):314-324.
LUO Jia,JIANG Beile,HE Qiuxiang,et al.Application of Huangkui Capsules in Diabetic Kidney Disease: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):314-324.
罗佳,蒋背乐,贺秋香等.黄葵胶囊在糖尿病肾病中的应用进展[J].中国实验方剂学杂志,2025,31(07):314-324. DOI: 10.13422/j.cnki.syfjx.20250594.
LUO Jia,JIANG Beile,HE Qiuxiang,et al.Application of Huangkui Capsules in Diabetic Kidney Disease: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):314-324. DOI: 10.13422/j.cnki.syfjx.20250594.
糖尿病肾病(DKD)是一种高血糖所致的肾脏疾病,为糖尿病最常见的微血管并发症之一。由于糖尿病的高发,DKD的发病率也呈逐年上升趋势,DKD现已成为全球性的公共卫生问题。DKD的发病与氧化应激、炎症、肾脏纤维化、线粒体自噬活性下降等机制相关,在多种复杂的机制下发展而成。中医上认为DKD的发病与“湿热”二字息息相关,因此,在临证用药时需把握好清热利湿这一治疗大法。黄葵胶囊(HKC)具有清利湿热、解毒消肿的功效,因其对DKD的独特疗效,HKC常常被应用于DKD的治疗当中。HKC借助多种的药代动力学及药效动力学过程在DKD的治疗上发挥作用,在多项实验室研究中发现其治疗DKD的具体机制包括增加线粒体自噬、减少线粒体损伤、减轻肾脏纤维化、控制炎症反应、抑制氧化应激反应等,能够实现减少肾脏损伤、促进肾功能的目的。多项的临床研究也验证了单独应用HKC即可通过抗炎、抗氧化应激、抗肾脏纤维化、降低尿蛋白等方式发挥肾脏保护功能。由于DKD并非单一出现肾功能的损伤,往往伴有血压、血脂、血液循环、机体免疫等各个方面的问题,因此将HKC与其他药物进行联用,往往能收获更加全面的效果,提高各种药物的优势,提高治疗效果。降压、降脂、改善血管循环、抑制免疫、抗氧化应激等药物与HKC的联用均获得了较好的疗效。除此之外,HKC在临床上还常常与其他中成药联合使用。HKC在DKD治疗中的应用已经取得了一定的进展,但仍有许多值得深入研究的地方,包括对于HKC作用机制的研究还不够全面,对其在临床应用中的长期效果和安全性研究较为缺乏,在与某类药物联用时药物品种较为单一,这些问题值得加以关注。最后,还需要关注HKC在临床实践中的推广和应用障碍问题,让HKC在临床上得到更好的应用,也更好地为患者解决实际问题。
Diabetic kidney disease (DKD) is a kidney disease caused by hyperglycemia,which is one of the most common microvascular complications of diabetes. Due to the high incidence of diabetes,the incidence of DKD has also increased year by year,and DKD has become a global public health problem. The pathogenesis of DKD is related to mechanisms such as oxidative stress,inflammation,renal fibrosis,and decreased mitophagy activity,which are developed under a variety of complex mechanisms. In traditional Chinese medicine,it is believed that the incidence of DKD is closely related to damp heat. Therefore,it is necessary to grasp the treatment method of clearing heat and removing dampness in clinical medication. Huangkui Capsules (HKC) have the effect of clearing damp heat,detoxifying, and detumescence. Because of its unique curative effect on DKD,HKC is often used in the treatment of DKD. HKC plays a role in the treatment of DKD with a variety of pharmacokinetic and pharmacodynamic processes. In many laboratory studies,it has been found that the specific mechanisms of HKC in the treatment of DKD include increasing mitophagy,reducing mitochondrial damage,reducing renal fibrosis,controlling inflammatory response,and inhibiting oxidative stress,which can achieve the purpose of reducing renal damage and promoting renal function. Some clinical studies have also verified that the application of HKC alone can exert renal protective function through anti-inflammatory,anti-oxidative stress,anti-renal fibrosis effects,as well as reduction of urinary protein. Since DKD is not a single injury of renal function,it is often accompanied by problems in blood pressure,blood lipids,blood circulation,body immunity, and other aspects. Therefore,the combination of HKC with other drugs can often achieve more comprehensive results,improve the advantages of various drugs,and improve the therapeutic effect. The combination of drugs such as antihypertensive,lipid-lowering, vascular circulation improvement,immunity inhibition,and anti-oxidative stress with HKC has achieved good results. In addition,HKC is often used in combination with other Chinese patent medicines in clinics. The application of HKC in the treatment of DKD has made some progress,but there are still many places worthy of further study,and the research on the mechanism of HKC is not comprehensive enough. The research on its long-term effect and safety in clinical application is relatively lacking,and the drug variety is relatively single when combined with certain drugs. These problems deserve further attention. Finally,it is necessary to pay attention to the promotion and application of HKC in clinical practice so that HKC can be better applied in clinical practice and better solve practical problems for patients.
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