五子衍宗汤方药解析及其在糖尿病肾病中的应用研究进展
Research Progress on the Analysis of Wuzi Yanzong Decoction Prescription Drugs and Their Application in Diabetic Kidney Disease
摘要: 五子衍宗汤是中医用于补肾益精的经典方剂,该方药性温和,其组方的化学成分具有抗氧化、抗炎、调节代谢等多靶点作用。糖尿病肾病(DKD)是糖尿病常见的微血管并发症,其病理改变可涉及全肾。近年来研究发现,五子衍宗汤在改善肾功能及调节代谢紊乱方面有较好疗效且安全性良好。本文系统梳理五子衍宗汤的方药解析、药理机制,并结合DKD的病理特征,探讨其在DKD治疗中的潜在价值,旨在为五子衍宗汤的现代化应用及DKD的中西医协同治疗提供理论依据与实践参考。
Abstract: Wuzi Yanzong Decoction is a classic formula in Traditional Chinese Medicine used for tonifying the kidneys and enriching essence. The formula has a mild nature, with its chemical components exhibiting multiple targets such as antioxidant, anti-inflammatory, and metabolic regulation effects. Diabetic Kidney Disease (DKD) is a common microvascular complication of diabetes, involving the entire kidney. Recent studies have found that Wuzi Yanzong Decoction has good therapeutic effects and safety in improving renal function and regulating metabolic disorders. This article systematically analyzes the pharmacological mechanisms of Wuzi Yanzong Decoction, combining its potential value in treating DKD with the pathological characteristics of DKD. It aims to provide theoretical basis and practical references for the modern application of Wuzi Yanzong Decoction and the integrated traditional Chinese and Western medicine treatment of DKD.
文章引用:陈明玉, 蔡萧君. 五子衍宗汤方药解析及其在糖尿病肾病中的应用研究进展[J]. 中医学, 2025, 14(8): 3310-3316. https://doi.org/10.12677/tcm.2025.148490

参考文献

[1] Ma, Z.F., Zhang, H., Teh, S.S., Wang, C.W., Zhang, Y., Hayford, F., et al. (2019) Goji Berries as a Potential Natural Antioxidant Medicine: An Insight into Their Molecular Mechanisms of Action. Oxidative Medicine and Cellular Longevity, 2019, Article ID: 2437397. [Google Scholar] [CrossRef] [PubMed]
[2] Zhou, W., Yang, T., Xu, W., Huang, Y., Ran, L., Yan, Y., et al. (2022) The Polysaccharides from the Fruits of Lycium barbarum L. Confer Anti-Diabetic Effect by Regulating Gut Microbiota and Intestinal Barrier. Carbohydrate Polymers, 291, Article 119626. [Google Scholar] [CrossRef] [PubMed]
[3] 王聪颖, 黄小强, 徐玥玥, 等. 枸杞子多糖的提取纯化、体外抗氧化及其抗衰老作用[J]. 食品工业科技, 2024, 45(19): 1-8.
[4] 苏保洲. 枸杞子活性成分药理作用研究进展[J]. 江苏中医药, 2022, 54(3): 78-81.
[5] 黄钰馨, 马玲, 李苗, 等. 枸杞子中甜菜碱含量测定方法的建立和提取方法的优化[J]. 中国药房, 2020, 31(14): 1700-1703.
[6] 黄明珠, 王景龙, 崔晓萍, 等. 菟丝子的药理作用研究进展[J]. 安徽中医药大学学报, 2023, 42(5): 101-104.
[7] 喻琴, 王东升, 张世栋, 等. 阳起石、菟丝子与淫羊藿对肾阳虚大鼠性激素及其受体表达的影响[J]. 中国兽医学报, 2019, 39(3): 535-540.
[8] 孟令裕, 王圣治. “山茱萸-菟丝子”治疗慢性肾小球肾炎作用机制探讨[J]. 中医药临床杂志, 2024, 36(2): 274-282.
[9] 王兴红, 常陆林, 王桂叶, 等. 槲皮素对2型糖尿病大鼠肾脏肥大的影响机制[J]. 中国中医基础医学杂志, 2015, 21(10): 1248-1250.
[10] Luan, F., Zou, J., Zhang, X., Zeng, J., Peng, X., Li, R., et al. (2024) The Extraction, Purification, Structural Features, Bioactivities, and Applications of Schisandra Chinensis Polysaccharides: A Review. International Journal of Biological Macromolecules, 262, Article 130030. [Google Scholar] [CrossRef] [PubMed]
[11] 王曼姝. 中药活性成分五味子丙素减轻ABL1抑制剂致肾损伤的机制研究[D]: [硕士学位论文]. 天津: 天津中医药大学, 2024.
[12] 赵子平. 基于“肠-肾轴”理论对五味子醇甲改善肾损伤作用机制的研究[D]: [硕士学位论文]. 长春: 吉林农业大学, 2023.
[13] 程丹, 李洁, 周斌, 等. 覆盆子化学成分与药理作用研究进展[J]. 中药材, 2012, 35(11): 1873-1876.
[14] Hu, J., Pang, X., Liang, X., Shao, X., Xia, Q., Sun, J., et al. (2025) Raspberry Ameliorates Renal Fibrosis in Rats with Chronic Kidney Disease via the PI3K/Akt Pathway. Phytomedicine, 140, Article 156589. [Google Scholar] [CrossRef] [PubMed]
[15] Yau, M., Che, C., Liang, S., Kong, Y. and Fong, W. (2002) An Aqueous Extract of Rubus Chingii Fruits Protects Primary Rat Hepatocytes against Tert-Butyl Hydroperoxide Induced Oxidative Stress. Life Sciences, 72, 329-338. [Google Scholar] [CrossRef] [PubMed]
[16] Garcia, G., Pais, T.F., Pinto, P., Dobson, G., McDougall, G.J., Stewart, D., et al. (2020) Bioaccessible Raspberry Extracts Enriched in Ellagitannins and Ellagic Acid Derivatives Have Anti-Neuroinflammatory Properties. Antioxidants, 9, Article 970. [Google Scholar] [CrossRef] [PubMed]
[17] 赵丽君, 樊耀华, 徐文华. 覆盆子酮对高糖诱导的HK-2损伤的影响[J]. 中国老年学杂志, 2024, 44(1): 196-199.
[18] 曾小艳, 李永平, 赵钰, 等. 覆盆子原花青素对2型糖尿病大鼠糖脂代谢及抗氧化作用影响的研究[J]. 现代中药研究与实践, 2022, 36(1): 18-21.
[19] 徐静, 高宁, 匡海学, 等. 车前子及其有效成分的药理作用研究进展[J]. 广东药科大学学报, 2024, 40(4): 164-170.
[20] Miao, L., Liu, C., Cheong, M.S., Zhong, R., Tan, Y., Rengasamy, K.R.R., et al. (2022) Exploration of Natural Flavones’ Bioactivity and Bioavailability in Chronic Inflammation Induced-Type-2 Diabetes Mellitus. Critical Reviews in Food Science and Nutrition, 63, 11640-11667. [Google Scholar] [CrossRef] [PubMed]
[21] Wang, Q., Dai, X., Xiang, X., Xu, Z., Su, S., Wei, D., et al. (2021) A Natural Product of Acteoside Ameliorate Kidney Injury in Diabetes db/db Mice and HK‐2 Cells via Regulating NADPH/Oxidase‐TGF‐β/Smad Signaling Pathway. Phytotherapy Research, 35, 5227-5240. [Google Scholar] [CrossRef] [PubMed]
[22] Yang, Q., Qi, M., Tong, R., Wang, D., Ding, L., Li, Z., et al. (2017) Plantago asiatica L. Seed Extract Improves Lipid Accumulation and Hyperglycemia in High-Fat Diet-Induced Obese Mice. International Journal of Molecular Sciences, 18, Article 1393. [Google Scholar] [CrossRef] [PubMed]
[23] 沈鑫蕾, 朱清如, 余文凯, 等. 盐炙车前子调控肾小管上皮-间充质转化改善肾纤维化的机制研究[J]. 中国中药杂志, 2025, 50(5): 1195-1208.
[24] 高红雪. 车前子治疗痛风的药效物质基础及作用机制研究[D]: [博士学位论文]. 合肥: 中国科学技术大学, 2024.
[25] Rabbani, N. and Thornalley, P.J. (2018) Advanced Glycation End Products in the Pathogenesis of Chronic Kidney Disease. Kidney International, 93, 803-813. [Google Scholar] [CrossRef] [PubMed]
[26] 张志, 陈文, 吕薇, 等. 糖尿病肾病中西医研究概况[J]. 中外医学研究, 2025, 23(4): 163-166.
[27] Steenbeke, M., Speeckaert, R., Desmedt, S., Glorieux, G., Delanghe, J.R. and Speeckaert, M.M. (2022) The Role of Advanced Glycation End Products and Its Soluble Receptor in Kidney Diseases. International Journal of Molecular Sciences, 23, Article 3439. [Google Scholar] [CrossRef] [PubMed]
[28] Wang, Y., Feng, X., Li, Y., Niu, S., Li, J., Shi, H., et al. (2025) Targeting Inflammation and Necroptosis in Diabetic Kidney Disease: A Novel Approach via PPARα Modulation. International Immunopharmacology, 154, Article 114562. [Google Scholar] [CrossRef] [PubMed]
[29] Lai, W., Shi, M., Huang, R., Fu, P. and Ma, L. (2022) Fatty Acid-Binding Protein 4 in Kidney Diseases: From Mechanisms to Clinics. European Journal of Pharmacology, 931, Article 175224. [Google Scholar] [CrossRef] [PubMed]
[30] Wu, Y., Chen, J., Lin, L., Huang, J., Chang, C. and Chang, T. (2025) FABP4 Inhibition Protects Renal Tubular Cells and Ameliorates Renal Inflammation in Diabetic Kidney Disease. Biochemical Pharmacology, 236, Article 116899. [Google Scholar] [CrossRef] [PubMed]
[31] Chang, T., Li, S., Lin, L., Chen, C. and Chen, J. (2023) Macrophage Inflammatory Protein-1β as a Novel Therapeutic Target for Renal Protection in Diabetic Kidney Disease. Biomedicine & Pharmacotherapy, 161, Article 114450. [Google Scholar] [CrossRef] [PubMed]
[32] Han, Y., Xu, X., Tang, C., Gao, P., Chen, X., Xiong, X., et al. (2019) Corrigendum to ‘Reactive Oxygen Species Promote Tubular Injury in Diabetic Nephropathy: The Role of the Mitochondrial Ros-Txnip-Nlrp3 Biological Axis’ [Redox Biology 16 (2018) 32-46]. Redox Biology, 24, Article 101216. [Google Scholar] [CrossRef] [PubMed]
[33] 高丹妮, 杨悦, 金亮. 线粒体内质网相关膜在糖尿病肾病中作用机制的研究进展[J]. 中国药科大学学报, 2025, 56(3): 382-389.
[34] 尹大鹏, 郭志新. Nrf2调节氧化应激在糖尿病肾病中的作用机制[J]. 中国临床研究, 2023, 36(5): 646-650.
[35] 彭会巧, 郝晓晓, 吴亚靓, 等. 表观遗传学机制在糖尿病肾病发生发展中的作用[J]. 中国实用医药, 2023, 18(1): 158-162.
[36] Guan, H., Xia, M., Wang, M., Guan, Y. and Lyu, X. (2020) Methylenetetrahydrofolate Reductase Genetic Polymorphism and the Risk of Diabetic Nephropathy in Type 2 Diabetic Patients. Medicine, 99, e21558. [Google Scholar] [CrossRef] [PubMed]
[37] Harjutsalo, V., Katoh, S., Sarti, C., Tajima, N. and Tuomilehto, J. (2004) Population-Based Assessment of Familial Clustering of Diabetic Nephropathy in Type 1 Diabetes. Diabetes, 53, 2449-2454. [Google Scholar] [CrossRef] [PubMed]
[38] Yamazaki, T., Mimura, I., Tanaka, T. and Nangaku, M. (2021) Treatment of Diabetic Kidney Disease: Current and Future. Diabetes & Metabolism Journal, 45, 11-26. [Google Scholar] [CrossRef] [PubMed]
[39] 于天宇, 姜世敏, 方锦颖, 等. 肾素-血管紧张素系统抑制剂治疗慢性肾脏病3期糖尿病肾病疗效分析[J]. 中国临床医生杂志, 2020, 48(12): 1441-1445.
[40] 唐琼珍, 陈红丽, 陈发秀. 强化降脂治疗对早期糖尿病肾病的影响[J]. 实用临床医学, 2022, 23(2): 6-8.
[41] 张忠银, 胡廷婷, 胡晨吉, 等. 非甾体类盐皮质激素受体拮抗剂治疗糖尿病肾病新进展[J]. 世界临床药物, 2024, 45(12): 1309-1313.
[42] Agarwal, R., Filippatos, G., Pitt, B., Anker, S.D., Rossing, P., Joseph, A., et al. (2021) Cardiovascular and Kidney Outcomes with Finerenone in Patients with Type 2 Diabetes and Chronic Kidney Disease: The FIDELITY Pooled Analysis. European Heart Journal, 43, 474-484. [Google Scholar] [CrossRef] [PubMed]
[43] Shahzad, K., Bock, F., Al-Dabet, M.M., Gadi, I., Nazir, S., Wang, H., et al. (2016) Stabilization of Endogenous Nrf2 by Minocycline Protects against Nlrp3-Inflammasome Induced Diabetic Nephropathy. Scientific Reports, 6, Article No. 34228. [Google Scholar] [CrossRef] [PubMed]
[44] 李莎莎. 糖尿病肾病: 了解、预防与治疗[J]. 健康必读, 2025(8): 18.
[45] 寇战利, 陈社论, 刘冰林. 地黄多糖通过Wnt通路对2型糖尿病大鼠骨代谢的调节作用及机制研究[J]. 中医药导报, 2021, 27(9): 20-24+30.
[46] 何立芳, 李青科, 薛艳芸, 等. 黄葵胶囊辅助治疗对早期糖尿病肾病患者尿蛋白排泄率和氧化应激的影响[J]. 中国医药导报, 2023, 20(12): 90-93.
[47] 施书涵, 高汉源, 林志民. 探讨海昆肾喜胶囊联合缬沙坦对老年早期糖尿病肾病患者细胞因子、转化生长因子、基质金属蛋白酶和肾功能的影响[J]. 糖尿病新世界, 2023, 26(6): 166-169.
[48] 马秀琴, 郭宁, 王永超, 等. 补阳还五汤合升降散治疗糖尿病肾病临床观察[J]. 中国中医药现代远程教育, 2024, 22(1): 60-62.
[49] 郑树然, 张勉之, 董少宁, 等. 糖肾方联合针灸治疗糖尿病肾病3期的临床疗效观察[J]. 中国处方药, 2024, 22(12): 162-164.
[50] 姚栀芳, 邢磊, 邢海辉. 龙杞方加减联合穴位贴敷治疗早中期糖尿病肾病的效果研究[J]. 中国社区医师, 2023, 39(5): 85-87.
[51] 左莹莹, 陈号, 李方怡, 等. 三子固本汤联合艾灸治疗肝肾阴虚型糖尿病肾病的临床观察[J]. 河北中医, 2025, 47(2): 205-208+212.
[52] 王艺洁, 王莉明, 胡剑卓. 消渴安肾汤联用中药灌肠治疗非透析糖尿病肾病临床观察[J]. 山西中医, 2024, 40(9): 45-46.
[53] 雷国奇, 沈金峰, 张家珍. 五子衍宗汤联合桃红四物汤辅治2型糖尿病肾病肝肾阴虚兼血瘀证临床研究[J]. 实用中医药杂志, 2024, 40(9): 1755-1758.
[54] 徐恬. 五子衍宗汤对肾虚型早期糖尿病肾病患者的疗效研究及IL-6的影响[D]: [硕士学位论文]. 南京: 南京中医药大学, 2019.
[55] 杜端华, 梁苹茂. 梁苹茂运用五子衍宗丸验案举隅[J]. 湖南中医杂志, 2016, 32(11): 97-98.