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中医药防治糖尿病肾病的机制研究进展
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Abstract:
糖尿病肾病(Diabetic Nephropathy, DN)是糖尿病最严重的微血管并发症之一，也是终末期肾脏疾病的主要病因。中医认为糖尿病肾病的病机为本虚标实，以脾肾虚衰为本，水湿、痰饮、瘀血为标，邪滞总由正虚产生。近现代医家多从脏腑角度辨证治疗糖尿病肾病，补肾为主，兼顾他脏。现代医学则认为与免疫、基因、代谢、炎症等因素有关，其机制研究也紧紧围绕着免疫失调、基因遗传、代谢紊乱、炎症感染等方向。目前临床上治疗方法多样，主要有中药内服、针刺、艾灸、中药灌肠等，作用以拮抗氧化应激、干预基因靶点、抑制炎症因子分泌等为主，安全性较高，不良反应少。该文基于近年来针对该领域的相关研究，对中医药防治糖尿病肾病的机制进行综述，以期为中医药的临床推广、新药研发与应用提供治疗方案和依据。
Diabetic nephropathy (DN) is one of the most serious microvascular complications of diabetes and the main cause of end-stage renal disease. Traditional Chinese medicine believes that the pathogenesis of diabetic nephropathy is based on deficiency and marked by excess, based on deficiency and failure of spleen and kidney, and marked by water dampness, phlegm and blood stasis. Evil stagnation is always produced by positive deficiency. Modern physicians treat diabetic nephropathy based on syndrome differentiation from the perspective of viscera, giving priority to tonifying the kidney and giving consideration to other organs. Modern medicine believes that it is related to immune, gene, metabolism, inflammation and other factors, and its mechanism research also closely revolves around immune dysregulation, gene inheritance, metabolic disorders, inflammatory infection and other directions. At present, there are various therapeutic methods in clinic, mainly including oral administration of traditional Chinese medicine, acupuncture, moxibustion, enema of traditional Chinese medicine, etc., which mainly antagonize antioxidant stress, intervene gene targets, inhibit the secretion of inflammatory factors, etc., with high safety and few adverse reactions. Based on the relevant research in this field in recent years, this paper reviews the mechanism of traditional Chinese medicine in the prevention and treatment of diabetic nephropathy, in order to provide a treatment plan and basis for the clinical promotion of traditional Chinese medicine, the development and application of new drugs.
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