3种雷公藤制剂治疗糖尿病肾病的新研究进展
New Research Progress of Three Tripterygium wilfordii Preparations for the Treatment of Diabetic Nephropathy
DOI: 10.12677/jcpm.2024.34355, PDF,    科研立项经费支持
作者: 陈星海, 邓云婷, 苏炳华, 王德重：黑龙江省中医药科学院，黑龙江 哈尔滨；王 涛*：黑龙江省中医医院，黑龙江 哈尔滨
关键词: 雷公藤多苷片；昆仙胶囊；火把花根片；糖尿病肾病；Tripterygium wilfordii Polyglycoside Tablets； Kunxian Capsules； Torch Flower Root Tablets； Diabetic Nephropathy
摘要: 糖尿病肾病作为糖尿病最严重的并发症之一，是导致终末期肾病的最主要原因，给人们的生命健康造成了极大威胁，然而现代医学对此疾病没有特效的治疗手段。雷公藤多苷片、火把花根片、昆仙胶囊为3种常见的雷公藤制剂，研究发现其对糖尿病肾病有一定的治疗作用，但大多为单方面、单机制的研究，缺乏对整体临床疗效及作用机制的总结与归纳。因此，本文通过检索中国知网(CNKI)、PubMed两大中文与英文数据库近10年来收录的关于此3种雷公藤制剂治疗糖尿病肾病的研究文献，并进行分析与总结归纳，从临床疗效以及作用机制两方面阐述雷公藤制剂治疗糖尿病肾病的研究进展，为临床用药提供依据。
Abstract: As one of the most serious complications of diabetes, diabetic nephropathy is the main cause of end-stage renal disease, which poses a great threat to people’s lives and health, but modern medicine has no specific treatment for this disease. Tripterygium wilfordii polyglycoside tablets, torch flower root tablets, and Kunxian capsules are three common preparations, which have been found to have a certain therapeutic effect on diabetic nephropathy, but most of them are unilateral and single-mechanism studies, and there is a lack of summary and induction of the overall clinical efficacy and mechanism of action. Therefore, this paper retrieved the research literature on the treatment of diabetic nephropathy with these three Tripterygium wilfordii preparations collected in the past 10 years from the two Chinese and English databases of China National Knowledge Infrastructure (CNKI) and PubMed, and analyzed and summarized the research progress of Tripterygium wilfordii preparations in the treatment of diabetic nephropathy from the aspects of clinical efficacy and mechanism of action, so as to provide a basis for clinical use.
文章引用：陈星海, 邓云婷, 苏炳华, 王德重, 王涛. 3种雷公藤制剂治疗糖尿病肾病的新研究进展[J]. 临床个性化医学, 2024, 3(4): 2491-2497. https://doi.org/10.12677/jcpm.2024.34355

参考文献

[1] 中华医学会糖尿病学分会微血管并发症学组. 中国糖尿病肾脏疾病防治临床指南[J]. 中华糖尿病杂志, 2019, 11(1): 15-28.
[2] 李敏州, 高彦彬, 马鸣飞, 等. 糖尿病肾病发病机制研究进展[J]. 中国实验方剂学杂志, 2012, 18(22): 344-349.
[3] Yoon, J., Park, J., Lee, Y., Kim, H., Han, B., Jin, H., et al. (2021) Protective Effects of Ethanolic Extract from Rhizome of Polygoni Avicularis against Renal Fibrosis and Inflammation in a Diabetic Nephropathy Model. International Journal of Molecular Sciences, 22, Article 7230. [Google Scholar] [CrossRef] [PubMed]
[4] Espinel, E., Agraz, I., Ibernon, M., Ramos, N., Fort, J. and Serón, D. (2015) Renal Biopsy in Type 2 Diabetic Patients. Journal of Clinical Medicine, 4, 998-1009. [Google Scholar] [CrossRef] [PubMed]
[5] 陈玉强, 汪年松. 糖尿病肾病的诊治现状[J]. 中国临床医生杂志, 2020, 48(5): 508-511.
[6] 童国玉, 朱大龙. 糖尿病肾病国内外临床指南和专家共识解读[J]. 中国实用内科杂志, 2017, 37(3): 211-216.
[7] 黄红. 探讨肾内科糖尿病肾病患者的临床就诊分析[J]. 临床心身疾病杂志, 2015, 21(Z1): 77-78.
[8] Fox, C.S., Matsushita, K., Woodward, M., Bilo, H.J., Chalmers, J., Heerspink, H.J.L., et al. (2012) Associations of Kidney Disease Measures with Mortality and End-Stage Renal Disease in Individuals with and without Diabetes: A Meta-Analysis. The Lancet, 380, 1662-1673. [Google Scholar] [CrossRef] [PubMed]
[9] 余翠, 熊钱颖, 王李卓, 等. 糖尿病肾病的发病机制及治疗进展[J]. 医学综述, 2015, 21(21): 3944-3947.
[10] 杨敏, 李瑾. 中医药治疗糖尿病肾病研究进展[J]. 中国中医药现代远程教育, 2023, 21(23): 86-89.
[11] 常成成, 魏聪, 吴以岭. 脉络学说“孙络-微血管”概念及其临床指导意义[J]. 中医杂志, 2016, 57(1): 7-11.
[12] 刘梦宇. 基于络病理论探析糖尿病肾病发病机制[J]. 中医学报, 2021, 36(7): 1421-1425.
[13] 范增慧, 李小会, 马锋锋. 从脉络学说“孙络-微血管”理论阐释糖尿病肾病[J]. 辽宁中医杂志, 2019, 46(12): 2551-2554.
[14] Shan, Y., Zhao, J., Wei, K., Jiang, P., Xu, L., Chang, C., et al. (2023) A Comprehensive Review of Tripterygium Wilfordii Hook. F. in the Treatment of Rheumatic and Autoimmune Diseases: Bioactive Compounds, Mechanisms of Action, and Future Directions. Frontiers in Pharmacology, 14, Article 1282610. [Google Scholar] [CrossRef] [PubMed]
[15] Li, Y., Miao, R., Liu, Y., Zhang, J., Dou, Z., Zhao, L., et al. (2021) Efficacy and Safety of Tripterygium Glycoside in the Treatment of Diabetic Nephropathy: A Systematic Review and Meta-Analysis Based on the Duration of Medication. Frontiers in Endocrinology, 12, Article 656621. [Google Scholar] [CrossRef] [PubMed]
[16] 朱国双, 王岚, 龙清华, 等. 雷公藤多苷对比RAAS阻滞剂治疗糖尿病肾脏病有效性和安全性的Meta分析[J]. 临床肾脏病杂志, 2019, 19(10): 727-733.
[17] Wu, X., Huang, Y., Zhang, Y., He, C., Zhao, Y., Wang, L., et al. (2020) Efficacy of Tripterygium Glycosides Combined with ARB on Diabetic Nephropathy: A Meta-Analysis. Bioscience Reports, 40, BSR20202391. [Google Scholar] [CrossRef] [PubMed]
[18] Guo, H., Peng, J., Xuan Wang,, Zhang, K., Zhong, G., Chen, W., et al. (2021) Efficacy of Tripterygium Glycosides for Diabetic Nephropathy: A Meta-Analysis of Randomized Controlled Trials. BMC Nephrology, 22, Article No. 304. [Google Scholar] [CrossRef] [PubMed]
[19] Wang, W. (2018) Different Doses of Tripterygium Glycosides in the Treatment of Diabetic Nephropathy: Effects on Blood Lipids. Kidney and Blood Pressure Research, 43, 931-937. [Google Scholar] [CrossRef] [PubMed]
[20] 谭莹, 李楠, 严倩华, 等. 含雷公藤甲素的3种中成药治疗糖尿病肾病的机制及临床应用进展[J]. 中成药, 2023, 45(12): 4049-4056.
[21] Dong, X., An, Z., Guo, Y., Zhou, J. and Qin, T. (2017) Effect of Triptolide on Expression of Oxidative Carbonyl Protein in Renal Cortex of Rats with Diabetic Nephropathy. Journal of Huazhong University of Science and Technology [Medical Sciences], 37, 25-29. [Google Scholar] [CrossRef] [PubMed]
[22] 郝丽, 潘梦舒, 郑云, 等. 冬虫夏草及雷公藤多甙对糖尿病肾病大鼠足细胞影响的实验研究[J]. 中国中西医结合杂志, 2012, 32(2): 261-265.
[23] Ma, Z., Zhang, X., Li, L., Yang, W., Wang, S., Guo, X., et al. (2015) Tripterygium Glycosides Tablet Ameliorates Renal Tubulointerstitial Fibrosis via the Toll-Like Receptor 4/Nuclear Factor Kappa B Signaling Pathway in High-Fat Diet Fed and Streptozotocin-Induced Diabetic Rats. Journal of Diabetes Research, 2015, 1-10. [Google Scholar] [CrossRef] [PubMed]
[24] 王慧敏, 吴毅伟, 陈祉娴. 昆仙胶囊联合缬沙坦治疗糖尿病肾病Ⅳ期蛋白尿的临床效果[J]. 中国医药导报, 2020, 17(16): 156-159.
[25] 孙婷婷. 昆仙胶囊联合缬沙坦治疗糖尿病肾病Ⅳ期临床观察[J]. 中国中医药现代远程教育, 2021, 19(23): 32-34.
[26] 赵倩, 马骁龙, 张吉艳. 对比雷公藤片与昆仙胶囊对糖尿病肾病患者的临床疗效及对肾功能、肾间质纤维化指标的影响[J]. 医学食疗与健康, 2021, 19(18): 77-78.
[27] 荆自伟, 马真真, 张丁丁, 等. 昆仙胶囊治疗蛋白尿的“成分-靶点-通路”研究[J]. 中国医院药学杂志, 2020, 40(23): 2396-2405.
[28] 刘毓东, 马兆臣, 李聪翀, 等. 昆仙胶囊通过矫正“免疫-炎症”失衡网络有效干预糖尿病肾病的潜能及其分子机制研究[J]. 药学学报, 2022, 57(2): 375-384.
[29] 熊阔海, 高天舒. 火把花根片治疗糖尿病肾病的系统评价与Meta分析[J]. 中医临床研究, 2022, 14(1): 136-140.
[30] 杨小红, 林凯, 陈香, 等. 火把花根片治疗糖尿病肾病30例临床研究[J]. 新中医, 2007(11): 75-77+78.
[31] 周静波, 王丽娟, 孙心怡, 等. 火把花根片与厄贝沙坦片治疗糖尿病肾病的效果比较[J]. 西南国防医药, 2016, 26(9): 961-963.
[32] 王丽娟, 范丽萍, 殷美琦, 等. 火把花根片治疗2型糖尿病肾病的疗效及对血清HGF、尿TGF-β_1水平的影响[J]. 现代中西医结合杂志, 2015, 24(19): 2057-2059+2082.
[33] Guo, L., Duan, L., Liu, K., Liu, E. and Li, P. (2014) Chemical Comparison of Tripterygium Wilfordii and Tripterygium Hypoglaucum Based on Quantitative Analysis and Chemometrics Methods. Journal of Pharmaceutical and Biomedical Analysis, 95, 220-228. [Google Scholar] [CrossRef] [PubMed]
[34] Qu, Z., Liu, A., Li, P., Liu, C., Xiao, W., Huang, J., et al. (2020) Advances in Physiological Functions and Mechanisms of Epicatechin. Critical Reviews in Food Science and Nutrition, 61, 211-233. [Google Scholar] [CrossRef] [PubMed]
[35] Samra, Y.A., Said, H.S., Elsherbiny, N.M., Liou, G.I., El-Shishtawy, M.M. and Eissa, L.A. (2016) Cepharanthine and Piperine Ameliorate Diabetic Nephropathy in Rats: Role of NF-κB and NLRP3 Inflammasome. Life Sciences, 157, 187-199. [Google Scholar] [CrossRef] [PubMed]
[36] Wada, J. and Makino, H. (2012) Inflammation and the Pathogenesis of Diabetic Nephropathy. Clinical Science, 124, 139-152. [Google Scholar] [CrossRef] [PubMed]
[37] 方玲娜, 卢冰, 张莉, 等. 火把花根对糖尿病肾病大鼠肾脏Angptl2和NF-κB表达的影响[J]. 现代中西医结合杂志, 2018, 27(25): 2749-2753.
[38] Pugliese, G. (2014) Updating the Natural History of Diabetic Nephropathy. Acta Diabetologica, 51, 905-915. [Google Scholar] [CrossRef] [PubMed]
[39] 陈文娟, 吴晶金. 雷公藤毒性及中药配伍减毒研究进展[J]. 中成药, 2023, 45(2): 499-503.