肠道菌群在糖尿病肾病中的作用机制及中西药干预新进展
The Mechanism of Intestinal Flora in Diabetic Nephropathy and New Progress in the Intervention with Traditional Chinese and Western Medicines
DOI: 10.12677/acm.2025.15103036, PDF,   
作者: 侯佳岐：广西中医药大学研究生院，广西 南宁
关键词: 肠道菌群；糖尿病肾病；综述；Intestinal Flora； Diabetic Nephropathy； Review
摘要: 糖尿病肾病(DN)患者因肾功能受损导致尿毒素蓄积，引发肠道菌群紊乱，进而通过“肠–肾轴”加剧肾脏损伤。具体机制包括短链脂肪酸(如丁酸)生成减少、肠源性尿毒素(如TMAO、PCS、IS)增多以及参与炎症反应、氧化应激，这些变化共同促进炎症反应、氧化应激和肾纤维化。西药治疗主要依赖粪便微生物群移植、特定药物或益生菌等手段。中医药则通过单体(如山药多糖、黄芪多糖)、复方(如大黄蛰虫丸、玉液汤)等干预方式，调节菌群结构，增强有益菌、抑制有害菌，改善肠道屏障和肾功能。
Abstract: Diabetic nephropathy (DN) patients suffer from impaired renal function, which leads to the accumulation of urinary toxins and disrupts the intestinal flora. This, in turn, exacerbates kidney damage through the “intestinal-kidney axis”. The specific mechanisms include reduced production of short-chain fatty acids (such as butyric acid), increased intestinal-origin urinary toxins (such as TMAO, PCS, IS), and involvement in inflammatory responses and oxidative stress. These changes collectively promote inflammatory responses, oxidative stress, and renal fibrosis. Western medicine treatment mainly relies on methods such as fecal microbiota transplantation, specific drugs, or probiotics. Traditional Chinese medicine intervenes through single agents (such as astragalus polysaccharides, atractylodes polysaccharides) and compound preparations (such as rhubarb and termita pill, Yuye decoction), regulating the flora structure, enhancing beneficial bacteria, inhibiting harmful bacteria, and improving intestinal barrier and renal function.
文章引用：侯佳岐. 肠道菌群在糖尿病肾病中的作用机制及中西药干预新进展[J]. 临床医学进展, 2025, 15(10): 2496-2503. https://doi.org/10.12677/acm.2025.15103036

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