浏览全部资源
扫码关注微信
湖南中医药大学第一附属医院内分泌科(湖南 长沙 410208)
Published:10 October 2024,
Received:12 December 2023,
移动端阅览
秦李娜,喻嵘.黄芩⁃黄连药对及其活性成分治疗糖尿病肾病的作用机制研究进展[J].上海中医药杂志,2024,58(10):89-94.
QIN Lina,YU Rong.Research progress on mechanisms of Huangqi⁃Huanglian herb pair and its active components in treating diabetic nephropathy[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(10):89-94.
秦李娜,喻嵘.黄芩⁃黄连药对及其活性成分治疗糖尿病肾病的作用机制研究进展[J].上海中医药杂志,2024,58(10):89-94. DOI: 10.16305/j.1007-1334.2024.2312051.
QIN Lina,YU Rong.Research progress on mechanisms of Huangqi⁃Huanglian herb pair and its active components in treating diabetic nephropathy[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(10):89-94. DOI: 10.16305/j.1007-1334.2024.2312051.
糖尿病肾病(DN)是糖尿病最常见的并发症之一,中医认为湿热内蕴是DN的关键病机,治法应以“清湿热”为主。黄芩-黄连药对是清湿热法的代表药对,现代研究表明该药对及其主要活性成分对DN具有治疗作用。梳理近年来黄芩-黄连药对及其主要活性成分的相关文献,从调节糖脂代谢紊乱、减少肾脏细胞凋亡、缓解肾脏炎症和纤维化、调节肠道微生物和调控基因转录等方面进行综述,为黄芩-黄连药对的临床运用和研发提供系统的理论依据。
Diabetic nephropathy (DN) is one of the most common complications of diabetes. Traditional Chinese Medicine (TCM) identifies internal accumulation of damp-heat as the key pathogenesis in DN, recommending "clearing damp-heat" as the primary treatment method. The herb pair of Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) is a representative pair for clearing damp-heat. Modern studies have shown that this herb pair and its main active components have therapeutic effects on DN. This article reviews recent literature on the Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) herb pair and its primary active components, summarizing the effects from various perspectives including regulating glucose and lipid metabolism disorders, reducing renal cell apoptosis, alleviating renal inflammation and fibrosis, modulating gut microbiota, and regulating gene transcription. This article provides a systematic theoretical basis for the clinical application and development of the Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) herb pair.
糖尿病肾病黄芩黄连药对小檗碱黄芩苷中药研究作用机制
diabetic nephropathyHuangqin (Scutellariae Radix)Huanglian (Coptidis Rhizoma)herb pairberberinebaicalintraditional Chinese herbal medicine researchmechanism of action
FRANCIS A, HARHAY M N, ONG A C M, et al. Chronic kidney disease and the global public health agenda: an international consensus[J/OL]. Nat Rev Nephrol, 2024[2024-06-12]. https://pubmed.ncbi.nlm.nih.gov/38570631/https://pubmed.ncbi.nlm.nih.gov/38570631/.
ZHANG L, LONG J, JIANG W, et al. Trends in chronic kidney disease in China[J]. New Engl J Med, 2016, 375(9): 905-906.
张雪辰,王镁. 中药药对治疗糖尿病肾病的药理作用及临床应用研究进展[J].中国实验方剂学杂志, 2019, 25(9): 228-234.
徐君. 黄芩-黄连药对与肠道菌群的相互作用研究[D]. 南京:南京中医药大学, 2014.
林伟刚.《伤寒杂病论》黄连黄芩药对应用规律探究[J]. 山东中医杂志, 2020, 39(1): 18-22.
王逗逗. 清热药治疗2型糖尿病用药规律及其对调节肠道菌群作用机制研究[D]. 北京:北京中医药大学, 2020.
丁学屏. 中西医结合糖尿病学[M]. 北京:人民卫生出版社, 2004: 4-6.
陈博武,孙晓燕.《圣济总录》消渴病的方药分析[J]. 时珍国医国药, 2017, 28(8): 1948-1949.
杨辰华. 刘完素开通玄府治疗消渴病学术思想探析[J]. 广州中医药大学学报, 2013, 30(5): 759-760.
仝小林. 糖络杂病论[M]. 北京:科学出版社, 2010: 10.
仝小林,黄一珊. 糖尿病肾脏疾病中医药防治研究现状及发展对策[J]. 北京中医药大学学报, 2022, 45(12): 1189-1195.
赵进喜,李继安. 中医内科学实用新教程[M]. 北京:中国中医药出版社, 2018: 341-343.
张献之,李靖,张正媚,等. 国医大师吕仁和教授治疗糖尿病肾病用药经验的数据挖掘研究[J]. 中国中西医结合肾病杂志, 2023, 24(8): 720-722.
周少峰,李丹婷,蔡雨孜,等. 王耀献从湿热理论谈肾脏病湿热证特点与治疗[J]. 中医学报, 2023, 38(9): 1918-1924.
ZHAO J, TOSTIVINT I, XU L, et al. Efficacy of combined abelmoschus manihot and irbesartan for reduction of albuminuria in patients with type 2 diabetes and diabetic kidney disease: a multicenter randomized double-blind parallel controlled clinical trial[J]. Diabetes Care, 2022, 45(7): e113-e115.
薛亚,朱为康,李雁,等.《伤寒论》中黄芩的本草考证[J]. 上海中医药杂志, 2021, 55(5): 33-37.
任丽江,孙长鑫,杨胜男,等. 基于本草著作与《伤寒杂病论》解析黄芩、黄连、黄柏功用[J]. 中国实验方剂学杂志, 2023, 29(22): 171-180.
张莹,杨艳芳,吴和珍. 黄连的本草考证[J]. 中国药房, 2021, 32(13): 1634-1638.
曹振东,胡琪祥,韩天雄,等. 颜乾麟从“湿热”论治糖尿病经验撷英[J]. 上海中医药大学学报, 2014, 28(3): 1-3.
李文歌,李平,王明,等. 糖尿病肾病中西医诊治的思路与方法[J]. 中国中西医结合肾病杂志, 2023, 24(9): 844-846.
林龙飞,陈功森,李慧,等. 黄芩-黄连煎煮共沉淀的物质基础、形貌以及对煎煮液体内过程的影响研究[J]. 中国中药杂志, 2023, 48(21): 5790-5797.
KIM H Y, KIM J H. Chemical influence of Scutellaria baicalensis—Coptis chinensis pair on the extraction efficiencies of flavonoids and alkaloids at different extraction times and temperatures[J]. Separations, 2023, 10(2): 131.
CUI X, QIAN D W, JIANG S, et al. Scutellariae Radix and Coptidis Rhizoma improve glucose and lipid metabolism in T2DM rats via regulation of the metabolic profiling and MAPK/PI3K/Akt signaling pathway[J]. Int J Mol Sci, 2018, 19(11): 3634.
TUTTLE K R, AGARWAL R, ALPERS C E, et al. Molecular mechanisms and therapeutic targets for diabetic kidney disease[J]. Kidney Int, 2022, 102(2): 248-260.
靳贺超,顾悦,张圆圆,等. 细胞焦亡与坏死性凋亡在糖尿病肾病中的作用及中医药干预研究进展[J]. 中国实验方剂学杂志, 2022, 28(3): 58-67.
任妍林,王定坤,董慧,等. 小檗碱治疗糖尿病肾病的研究进展[J]. 中国中药杂志, 2017, 42(3): 438-442.
HANAI K, BABAZONO T, UCHIGATA Y. Effects of statins on the kidneys in patients with type 2 diabetes[J]. Clin Exp Nephrol, 2017, 21(4): 633-642.
HARJUTSALO V, GROOP P H. Epidemiology and risk factors for diabetic kidney disease[J]. Adv Chronic Kidney D, 2014, 21(3): 260-266.
路娜娜,孟飞燕,白静. 瑞舒伐他汀对血脂正常的早期糖尿病肾病患者疗效及内皮功能的影响[J].中国循证心血管医学杂志, 2022, 14(10): 1256-1258.
黄小英,岳仁宋,张博荀,等. 黄芩-黄连煎剂对2型糖尿病大鼠肝脏TLR4/NF-κB炎症信号通路的影响[J].中华中医药杂志, 2022, 37(3): 1672-1675.
刘王振祖,钱晓婧,张家祺,等. 基于脂质组学研究黄芩-黄连药对的降脂作用[J]. 中国中药杂志, 2023, 48(24): 6711-6720.
YIN J, YE J, JIA W. Effects and mechanisms of berberine in diabetes treatment[J]. Acta Pharm Sin B, 2012, 2(4): 327-334.
RONG Q, HAN B, LI Y, et al. Berberine reduces lipid accumulation by promoting fatty acid oxidation in renal tubular epithelial cells of the diabetic kidney[J]. Front Pharmacol, 2022, 12: 729384.
孙洁,任建功,罗晖,等. 黄芩苷对2型糖尿病肾病大鼠survivin表达的影响[J]. 时珍国医国药, 2019, 30(1): 59-61.
SUSZTAK K, RAFF A C, SCHIFFER M, et al. Glucose-induced reactive oxygen species cause apoptosis of podocytes and podocyte depletion at the onset of diabetic nephropathy[J]. Diabetes, 2006, 55(1): 225-233.
QIN X, ZHAO Y, GONG J, et al. Berberine protects glomerular podocytes via inhibiting Drp1-mediated mitochondrial fission and dysfunction[J]. Theranostics, 2019, 9(6): 1698-1713.
JUSZCZAK F, CARON N, MATHEW A V, et al. Critical role for AMPK in metabolic disease-induced chronic kidney disease[J]. Int J Mol Sci, 2020, 21(21): 7994.
JIN Y, LIU S, MA Q, et al. Berberine enhances the AMPK activation and autophagy and mitigates high glucose-induced apoptosis of mouse podocytes[J]. Eur J Pharmacol, 2017, 794: 106-114.
ZHANG G, ZOU X, HUANG Y, et al. Mesenchymal stromal cell-derived extracellular vesicles protect against acute kidney injury through anti-oxidation by enhancing Nrf2/ARE activation in rats[J]. Kidney Blood Press Res, 2016, 41(2): 119-128.
尹青桥,夏瑗瑜,陈杰,等. 黄芩苷对糖尿病肾病小鼠肾小管上皮细胞凋亡的影响[J].中国现代医学杂志, 2020, 30(5): 8-13.
LI Q, VERMA I M. NF-κB regulation in the immune system[J]. Nat Rev Immunol, 2002, 2(10): 725-734.
ZHANG L, ZANG C S, CHEN B, et al. Renalase regulates renal tubular injury in diabetic nephropathy via the p38MAPK signaling pathway[J]. FASEB J, 2023, 37(10): e23188.
NIETO M A, HUANG R Y, JACKSON R A, et al. EMT: 2016[J]. Cell, 2016, 166(1): 21-45.
LEE J H, MASSAGUÉ J. TGF-β in developmental and fibrogenic EMTs[J]. Semin Cancer Biol, 2022, 86(Pt 2):136-145.
WU J S, SHI R, LU X, et al. Combination of active components of Xiexin decoction ameliorates renal fibrosis through the inhibition of NF-κB and TGF-β1/Smad pathways in db/db diabetic mice[J]. PLoS One, 2015, 10(3): e0122661.
WU J S, LIU Y, SHI R, et al. Effects of combinations of Xiexin decoction constituents on diabetic nephropathy in rats[J]. J Ethnopharmacol, 2014, 157: 126-133.
沈岚,俞立强,熊佩华. 六味地黄汤合黄连解毒汤对糖尿病肾病大鼠的肾脏保护作用及相关机制[J]. 南京中医药大学学报, 2013, 29(6): 553-557.
张雅静. 前列地尔联合黄连解毒汤对糖尿病肾病患者肾功能及炎症因子的影响[J]. 慢性病学杂志, 2020, 21(3): 418-420.
ZHANG W, XU J H, YU T, et al. Effects of berberine and metformin on intestinal inflammation and gut microbiome composition in db/db mice[J]. Biomed Pharmacother, 2019, 118: 109131.
QIN X, JIANG M, ZHAO Y, et al. Berberine protects against diabetic kidney disease via promoting PGC-1α-regulated mitochondrial energy homeostasis[J]. Br J Pharmacol, 2020, 177(16): 3646-3661.
SATOH T, KIDOYA H, NAITO H, et al. Critical role of Trib1 in differentiation of tissue-resident M2-like macrophages[J]. Nature, 2013, 495(7442): 524-528.
ZHANG B, ZHANG X, ZHANG C, et al. Berberine improves the protective effects of metformin on diabetic nephropathy in db/db mice through Trib1-dependent inhibiting inflammation[J]. Pharm Res, 2021, 38(11): 1807-1820.
MA L, WU F, SHAO Q, et al. Baicalin alleviates oxidative stress and inflammation in diabetic nephropathy via Nrf2 and MAPK signaling pathway[J]. Drug Des Dev Ther, 2021: 3207-3221.
JIANG Q, LIU P, WU X, et al. Berberine attenuates lipopolysaccharide-induced extracelluar matrix accumulation and inflammation in rat mesangial cells: involvement of NF-κB signaling pathway[J]. Mol Cell Endocrinol, 2011, 331(1): 34-40.
ACOSTA-MARTINEZ M, CABAIL M Z. The PI3K/Akt pathway in meta-inflammation[J]. Int J Mol Sci, 2022, 23(23): 15330.
OU Y, ZHANG W, CHEN S, et al. Baicalin improves podocyte injury in rats with diabetic nephropathy by inhibiting PI3K/Akt/mTOR signaling pathway[J]. Open Med(Wars), 2021, 16(1): 1286-1298.
ZHANG X T, WANG G, YE L F, et al. Baicalin reversal of DNA hypermethylation-associated Klotho suppression ameliorates renal injury in type 1 diabetic mouse model[J]. Cell Cycle, 2020, 19(23): 3329-3347.
NAM J E, JO S Y, AHN C W, et al. Baicalin attenuates fibrogenic process in human renal proximal tubular cells (HK-2) exposed to diabetic milieu[J]. Life Sci, 2020, 254: 117742.
ZHAO L. The gut microbiota and obesity: from correlation to causality[J]. Nat Rev Microbiol, 2013, 11(9): 639-647.
DELZENNE N M, CANI P D. Interaction between obesity and the gut microbiota: relevance in nutrition[J]. Annu Rev Nutr, 2011, 31: 15-31.
YANG J, Li Q, HENNING S M, et al. Effects of prebiotic fiber xylooligosaccharide in adenine-induced nephropathy in mice[J]. Mol Nutr Food Res, 2018, 62(15): e1800014.
CAI K, MA Y, CAI F, et al. Changes of gut microbiota in diabetic nephropathy and its effect on the progression of kidney injury[J]. Endocrine, 2022, 76(2): 294-303.
CANI P D, AMAR J, IGLESIAS M A, et al. Metabolic endotoxemia initiates obesity and insulin resistance[J]. Diabetes, 2007, 56(7): 1761-1772.
徐君. 黄芩-黄连药对与肠道菌群的相互作用研究[D]. 南京:南京中医药大学, 2014.
刘彤,王惠,赵然,等. 黄连解毒汤加减治疗老年T2DM疗效及对患者糖脂代谢、肠道菌群的影响[J].中国老年学杂志, 2023, 43(18): 4375-4378.
张博荀. 基于“肠道菌群-黏膜屏障”研究“黄芩-黄连”药对治疗T2DM的疗效机制及配伍效应[D]. 成都:成都中医药大学, 2020.
XIAO S, LIU C, CHEN M, et al. Scutellariae radix and coptidis rhizoma ameliorate glycolipid metabolism of type 2 diabetic rats by modulating gut microbiota and its metabolites[J]. Appl Microbiol Biot, 2020, 104(1): 303-317.
何文娇,胡甜,石晶晶,等. 基于16S rDNA技术研究黄连解毒汤对db/db糖尿病小鼠肠道菌群的影响[J]. 中华中医药杂志, 2021, 36(8): 5024-5028.
PAN L, YU H, FU J, et al. Berberine ameliorates chronic kidney disease through inhibiting the production of gut-derived uremic toxins in the gut microbiota[J]. Acta Pharm Sin B, 2023, 13(4): 1537-1553.
WATANABE H, MIYAMOTO Y, HONDA D, et al. p-Cresyl sulfate causes renal tubular cell damage by inducing oxidative stress by activation of NADPH oxidase[J]. Kidney Int, 2013, 83(4): 582-592.
ZHANG W, MIIKEDA A, ZUCKERMAN J, et al. Inhibition of microbiota-dependent TMAO production attenuates chronic kidney disease in mice[J]. Sci Rep, 2021, 11(1): 518.
JEONG K H, KIM J S, WOO J T, et al. Genome-wide association study identifies new susceptibility loci for diabetic nephropathy in Korean patients with type 2 diabetes mellitus[J]. Clin Genet, 2019, 96(1): 35-42.
SIMPSON K, WONNACOTT A, FRASER D J, et al. MicroRNAs in diabetic nephropathy: from biomarkers to therapy[J]. Curr Diab Rep, 2016, 16(3): 35.
XU J, LIU L, GAN L, et al. Berberine acts on C/EBPβ/lncRNA Gas5/miR-18a-5p loop to decrease the mitochondrial ROS generation in HK-2 cells[J]. Front Endocrinol, 2021, 12: 675834.
ZHANG S, XU L, LIANG R, et al. Baicalin suppresses renal fibrosis through microRNA-124/TLR4/NF-κB axis in streptozotocin-induced diabetic nephropathy mice and high glucose-treated human proximal tubule epithelial cells[J]. J Physiol Biochem, 2020, 76(3): 407-416.
0
Views
0
下载量
0
CSCD
0
CNKI被引量
Publicity Resources
Related Articles
Related Author
Related Institution