中药单体治疗脓毒症急性肾损伤的研究进展
Research Progress in the Treatment of Acute Kidney Injury in Sepsis with Traditional Chinese Medicine Monomers
DOI: 10.12677/tcm.2025.146371, PDF,    科研立项经费支持
作者: 陈 湉：广西中医药大学研究生院，广西 南宁；林 化*：广西中医药大学第一附属医院，广西 南宁
关键词: 脓毒症；急性肾损伤；中药单体；中药提取物；Sepsis； Acute Kidney Injury； Traditional Chinese Medicine Monomer； Traditional Chinese Medicine Extract
摘要: 脓毒症相关急性肾损伤(sepsis-associated acute kidney injury, SA-AKI)是临床上常见的危重症，其发病机制复杂，常面临预后不良风险，严重威胁患者生命。现有临床治疗手段存在诸多局限性。近年来，中医药在脓毒症及其并发症的防治中展现出独特的优势，尤其是在改善肾功能、降低病死率方面具有巨大潜力。中药单体通过抗炎、抗氧化应激、保护肾脏组织、改善肾脏微循环等作用，从而减轻SA-AKI的病理损伤。本综述旨在阐述中药单体治疗SA-AKI的药理机制和临床疗效，为进一步深入研究和临床应用提供参考。
Abstract: Sepsis-associated acute kidney injury (SA-AKI) is a common critical illness in clinical practice, with complex pathogenesis, poor prognosis and serious threat to patients’ lives. There are many limitations to existing clinical treatments. In recent years, traditional Chinese medicine has shown unique advantages in the prevention and treatment of sepsis and its complications, especially in improving renal function and reducing mortality rate. TCM monomers alleviate the pathological damage of SA-AKI through anti-inflammatory, antioxidative stress, protection of kidney tissue, and improvement of renal microcirculation. The purpose of this review is to elucidate the pharmacological mechanism and clinical efficacy of traditional Chinese medicine monomers in the treatment of SA-AKI, and to provide a reference for further in-depth research and clinical application.
文章引用：陈湉, 林化. 中药单体治疗脓毒症急性肾损伤的研究进展[J]. 中医学, 2025, 14(6): 2516-2523. https://doi.org/10.12677/tcm.2025.146371

参考文献

[1] Evans, L., Rhodes, A., Alhazzani, W., et al. (2021) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Intensive Care Medicine, 47, 1181-1247.
[2] Hoste, E.A.J., Bagshaw, S.M., Bellomo, R., Cely, C.M., Colman, R., Cruz, D.N., et al. (2015) Epidemiology of Acute Kidney Injury in Critically Ill Patients: The Multinational AKI-EPI Study. Intensive Care Medicine, 41, 1411-1423. [Google Scholar] [CrossRef] [PubMed]
[3] Zarbock, A., Nadim, M.K., Pickkers, P., Gomez, H., Bell, S., Joannidis, M., et al. (2023) Sepsis-Associated Acute Kidney Injury: Consensus Report of the 28th Acute Disease Quality Initiative Workgroup. Nature Reviews Nephrology, 19, 401-417. [Google Scholar] [CrossRef] [PubMed]
[4] Chen, L., Ye, Z., Wang, D., Liu, J., Wang, Q., Wang, C., et al. (2022) Chuan Huang Fang Combining Reduced Glutathione in Treating Acute Kidney Injury (Grades 1-2) on Chronic Kidney Disease (Stages 2-4): A Multicenter Randomized Controlled Clinical Trial. Frontiers in Pharmacology, 13, Article 969107. [Google Scholar] [CrossRef] [PubMed]
[5] Herrera-Luna, Y., Lozano, M., Pasten, C., et al. (2022) The Ischemia and Reperfusion Injury Involves the Toll-Like RecePtor-4 Participation Mainly in the Kidney Cortex. Cellular Physiology & Biochemistry, 56, 613-628. [Google Scholar] [CrossRef] [PubMed]
[6] Zhai, B., Ma, L.S., Shen, R.Q., et al. (2023) CasPase-1/-11 Participates in LPS-Induced Sepsis-Associated Acute Kidney Injury by Cleaving GSDMD. Acta physiologica Sinica, 75, 10-16.
[7] Oliveira, F.R.M.B., Assreuy, J. and Sordi, R. (2022) The Role of Nitric Oxide in Sepsis-Associated Kidney Injury. Bioscience Reports, 42, BSR20220093. [Google Scholar] [CrossRef] [PubMed]
[8] Dou, Q., Tong, H., Yang, Y., Zhang, H. and Gan, H. (2021) PICK1 Deficiency Exacerbates Sepsis-Associated Acute Kidney Injury. BioMed Research International, 2021, Article ID: 9884297. [Google Scholar] [CrossRef] [PubMed]
[9] Kounatidis, D., Vallianou, N.G., Psallida, S., Panagopoulos, F., Margellou, E., Tsilingiris, D., et al. (2024) Sepsis-Associated Acute Kidney Injury: Where Are We Now? Medicina, 60, Article 434. [Google Scholar] [CrossRef] [PubMed]
[10] 倪清颖, 何振洋, 方雅萱, 等. 中医药治疗急性肾损伤研究概述[J]. 中医药学报, 2022, 50(10): 93-96.
[11] 袁瑞瑛, 桂明安, 杨贵斌, 等. 白藜芦醇药理学作用及其衍生物改善光性皮肤病的研究进展[J]. 药学前沿, 2024, 28(12): 719-728.
[12] 黄丹, 周斌, 彭盛亮, 等. PI3K-Akt信号通路在大鼠肾缺血再灌注损伤的作用及白黎芦醇的干预研究[J]. 吉林医学, 2024, 45(12): 2897-2900.
[13] 朱冬菊, 吴祥, 祝司霞. 白藜芦醇对缺氧复氧致肾小管上皮细胞内质网应激和炎性损伤的影响[J]. 中华中医药学刊, 2023, 41(5): 42-44, 264.
[14] 蔡涵晖, 刘景全, 邵自强, 等. 白藜芦醇对脓毒症小鼠急性肾损伤的保护作用和机制研究[J]. 浙江医学, 2022, 44(7): 684-689, 1.
[15] Wang, B., Wang, Y., Xu, K., Zeng, Z., Xu, Z., Yue, D., et al. (2021) Resveratrol Alleviates Sepsis-Induced Acute Kidney Injury by Deactivating the LncRNA MALAT1/MiR-205 Axis. Central European Journal of Immunology, 46, 295-304. [Google Scholar] [CrossRef] [PubMed]
[16] Bao, Y., Ge, Y., Wang, Z., Wang, H., Wang, Q. and Yuan, J. (2025) Safranal Ameliorates Renal Damage, Inflammation, and Podocyte Injury in Membranous Nephropathy via SIRT/NF-κB Signalling. Current Medical Science, 45, 288-300. [Google Scholar] [CrossRef] [PubMed]
[17] Mahmoudzadeh, L., Najafi, H., Ashtiyani, S.C. and Yarijani, Z.M. (2017) Anti‐Inflammatory and Protective Effects of Saffron Extract in Ischaemia/Reperfusion‐Induced Acute Kidney Injury. Nephrology, 22, 748-754. [Google Scholar] [CrossRef] [PubMed]
[18] 吴小清, 南倩倩, 苏燚. 藏红花素对脓毒症大鼠PINK1/Parkin1信号通路及肾损伤的影响[J]. 中国中西医结合肾病杂志, 2021, 22(11): 1000-1002, 1038.
[19] Gao, J., Zhao, F., Yi, S., Li, S., Zhu, A., Tang, Y., et al. (2022) Protective Role of Crocin against Sepsis-Induced Injury in the Liver, Kidney and Lungs via Inhibition of p38 MAPK/NF-κB and Bax/Bcl-2 Signalling Pathways. Pharmaceutical Biology, 60, 543-552. [Google Scholar] [CrossRef] [PubMed]
[20] Song, Z., Hei, T.K. and Gong, X. (2025) Tetramethylpyrazine Attenuates Sodium Arsenite-Induced Acute Kidney Injury by Improving the Autophagic Flux Blockade via a YAP1-Nrf2-p62-dependent Mechanism. International Journal of Biological Sciences, 21, 1158-1173. [Google Scholar] [CrossRef] [PubMed]
[21] Zhu, Z., Li, J., Song, Z., Li, T., Li, Z. and Gong, X. (2024) Tetramethylpyrazine Attenuates Renal Tubular Epithelial Cell Ferroptosis in Contrast-Induced Nephropathy by Inhibiting Transferrin Receptor and Intracellular Reactive Oxygen Species. Clinical Science, 138, 235-249. [Google Scholar] [CrossRef] [PubMed]
[22] 应静, 吴晋, 姚利峰. 川芎嗪对脓毒症急性肾损伤小鼠血管内皮细胞的保护作用[J]. 浙江医学, 2021, 43(2): 138-142, 233.
[23] Ying, J., Wu, J., Zhang, Y., Han, Y., Qian, X., Yang, Q., et al. (2019) Ligustrazine Suppresses Renal NMDAR1 and Caspase-3 Expressions in a Mouse Model of Sepsis-Associated Acute Kidney Injury. Molecular and Cellular Biochemistry, 464, 73-81. [Google Scholar] [CrossRef] [PubMed]
[24] 高鑫, 尹柏坤, 左军. 黄芩提取物及其有效成分的药理作用研究进展[J]. 中医药学报, 2025, 53(3): 112-117.
[25] 王锦妮, 汪靓婧, 王美茜, 等. 汉黄芩素对脂多糖诱导的急性肾损伤小鼠的保护作用[J]. 安徽医科大学学报, 2024, 59(8): 1411-1416.
[26] 胡洋, 吕传意, 代鑫, 等. 黄芩素通过Nrf-2/HO-1信号通路改善脓毒血症小鼠肾损伤[J]. 中国兽医学报, 2025, 45(1): 121-128.
[27] Shahmohammadi, A., Golchoobian, R., Mirahmadi, S., Rousta, A., Ansari, F., Sharayeli, M., et al. (2022) Scutellarin Alleviates Lipopolysaccharide-Provoked Septic Nephrotoxicity via Attenuation of Inflammatory and Oxidative Events and Mitochondrial Dysfunction. Immunopharmacology and Immunotoxicology, 45, 295-303. [Google Scholar] [CrossRef] [PubMed]
[28] Le, J., Fan, H., Sun, M., et al. (2021) Protective Effect and Mechanism of Baicalin on Acute Kidney Injury in Septic Mice. Chinese Critical Care Medicine, 33, 866-870.
[29] 王旭东, 赵玉良, 史为涛, 等. 黄芪多糖对脓毒症急性肾损伤大鼠AMPK/SIRT1信号通路介导的肾上皮细胞能量代谢的影响[J]. 中国医院药学杂志, 2021, 41(21): 2181-2185.
[30] Feng, M., Lv, J., Zhang, C., Chen, D., Guo, H., Tu, Y., et al. (2022) Astragaloside IV Protects Sepsis-Induced Acute Kidney Injury by Attenuating Mitochondrial Dysfunction and Apoptosis in Renal Tubular Epithelial Cells. Current Pharmaceutical Design, 28, 2825-2834. [Google Scholar] [CrossRef] [PubMed]
[31] Xu, J., Zhang, Z., Ren, D., Liu, L., Xing, H., Wang, D., et al. (2024) Astragaloside Ⅳ Negatively Regulates Gpr97-TPL2 Signaling to Protect against Hyperhomocysteine-Exacerbated Sepsis Associated Acute Kidney Injury. Phytomedicine, 125, Article ID: 155346. [Google Scholar] [CrossRef] [PubMed]
[32] 刘伟, 顾秀竹, 吴筱霓, 等. 姜黄素药理作用的研究进展[J]. 华西药学杂志, 2021, 36(3): 336-340.
[33] Zhu, H., Wang, X., Wang, X., Liu, B., Yuan, Y. and Zuo, X. (2020) Curcumin Attenuates Inflammation and Cell Apoptosis through Regulating NF-κB and JAK2/STAT3 Signaling Pathway against Acute Kidney Injury. Cell Cycle, 19, 1941-1951. [Google Scholar] [CrossRef] [PubMed]
[34] Li, L., Liu, X., Li, S., Wang, Q., Wang, H., Xu, M., et al. (2021) Tetrahydrocurcumin Protects against Sepsis-Induced Acute Kidney Injury via the SIRT1 Pathway. Renal Failure, 43, 1028-1040. [Google Scholar] [CrossRef] [PubMed]
[35] Li, H., Sun, H., Xu, Y., Xing, G. and Wang, X. (2021) Curcumin Plays a Protective Role against Septic Acute Kidney Injury by Regulating the TLR9 Signaling Pathway. Translational Andrology and Urology, 10, 2103-2112. [Google Scholar] [CrossRef] [PubMed]