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参芪地黄汤治疗糖尿病肾病的作用机制及临床应用研究进展
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| 篇名： | 参芪地黄汤治疗糖尿病肾病的作用机制及临床应用研究进展 |
| TITLE： | Research progress on the mechanism of action and clinical application of Shenqi dihuang decoction in the treatment of diabetic nephropathy |
| 摘要： | 糖尿病肾病（DN）是糖尿病常见的严重微血管并发症。近年来，经典名方参芪地黄汤在DN的临床治疗中显示出独特优势。本文通过系统综述参芪地黄汤治疗DN的作用机制及临床应用研究进展，发现该方治疗DN的机制涉及多靶点协同调控，例如其可通过调控磷脂酰肌醇3-激酶/蛋白激酶B、腺苷一磷酸活化蛋白激酶/沉默信息调节因子1/叉头框转录因子O1、核因子E2相关因子2/血红素氧合酶-1等途径，发挥调节糖脂代谢、抑制氧化应激、抗炎、改善胰岛素抵抗、调控细胞死亡（凋亡/自噬/铁死亡/焦亡）以及抗肾脏纤维化等多重药理作用。现有的临床研究表明，参芪地黄汤及其加减方单用或联合其他治法，能显著改善DN患者的糖脂代谢、降低尿蛋白水平、延缓肾功能下降，效果优于厄贝沙坦、缬沙坦、恩格列净等西药，且安全性良好。建议未来学者可借助系统生物学与人工智能技术进一步解析参芪地黄汤治疗DN的作用机制，推动其临床应用的精准化与规范化。 |
| ABSTRACT： | Diabetic nephropathy（DN） is a common and severe microvascular complication of diabetes. In recent years， the classical herbal formula Shenqi dihuang decoction has demonstrated unique advantages in the clinical treatment of DN. This article conducts a systematic review of the mechanisms of action and clinical applications of Shenqi dihuang decoction in the treatment of DN. It reveals that the mechanism by which this formula improves DN involves multi-target synergistic regulation. For instance, Shenqi dihuang decoction exerts multiple pharmacological effects by regulating signaling pathways including phosphatidy linostiol 3-kinase/protein kinase B， AMP-activated protein kinase/silent information regulator 1/forkhead box O1， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 pathways.These effects include regulating glucose and lipid metabolism， inhibiting oxidative stress， reducing inflammation， improving insulin resistance， modulating cell death （apoptosis/autophagy/ferroptosis/pyroptosis）， and preventing renal fibrosis. Existing clinical studies indicate that Shenqi dihuang decoction and its modified formulas， alone or in combination with other therapeutic methods， can significantly improve glucose and lipid metabolism， reduce proteinuria， and delay renal function decline in patients with DN. These effects are superior to those of Western medicines such as irbesartan， valsartan， and empagliflozin， and the treatment demonstrates good safety. Future research should leverage systems biology and artificial intelligence technologies to further elucidate the integrated mechanisms in the treatment of DN by Shenqi dihuang decoction， thereby advancing the precision and standardization of its clinical application. |
| 期刊： | 2026年第37卷第08期 |
| 作者： | 李家劼；王家琦；赵杰；李泽株；王亚平；张桂荣；晏和国；廖加抱；温伟波 |
| AUTHORS： | LI Jiajie， WANG Jiaqi，ZHAO Jie，LI Zezhu，WANG Yaping，ZHANG Guirong，YAN Heguo，LIAO Jiabao，WEN Weibo |
| 关键字： | 参芪地黄汤；糖尿病肾病；作用机制；临床应用 |
| KEYWORDS： | Shenqi dihuang decoction； diabetic nephro- |
| 阅读数： | 9 次 |
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