中医药治疗慢性肾脏病合并肌少症的研究进展

Research Progress on Traditional Chinese Medicine in the Treatment of Chronic Kidney Disease Complicated with Sarcopenia

摘要: 慢性肾脏病(chronic kidney disease, CKD)合并肌少症(sarcopenia)是CKD常见且严重的并发症，显著增加患者跌倒、残疾和死亡风险。现代医学认为其发病与蛋白质能量消耗、慢性炎症、代谢性酸中毒、激素异常、氧化应激及“肠–肌轴”失调等多因素相关。中医药通过健脾补肾、活血化瘀、化浊解毒等治法，在改善肌肉质量、增强肌力、调节代谢及炎症状态等方面显示出多靶点、整体调节的优势。本文结合近年国内外研究进展与临床共识，从中医病机、辨证分型、中药复方及单体机制、综合干预策略等方面进行综述，以期为中西医结合防治CKD肌少症提供理论依据与临床参考。

Abstract: Chronic kidney disease (CKD) complicated with sarcopenia is a common and serious complication of CKD, significantly increasing the risk of falls, disability, and mortality. Modern medicine suggests that its pathogenesis is associated with multiple factors, including protein-energy wasting, chronic inflammation, metabolic acidosis, hormonal abnormalities, oxidative stress, and gut-muscle axis dysfunction. Traditional Chinese Medicine (TCM) demonstrates multi-target and holistic regulatory advantages in improving muscle mass, enhancing muscle strength, and regulating metabolic and inflammatory states through therapeutic approaches such as strengthening the spleen and kidneys, promoting blood circulation and resolving stasis, and eliminating turbidity and toxins. This article reviews recent domestic and international research progress and clinical consensus, covering TCM pathogenesis, syndrome differentiation, mechanisms of Chinese herbal compounds and monomers, and comprehensive intervention strategies, aiming to provide a theoretical basis and clinical reference for the integrated prevention and treatment of sarcopenia in CKD.