基于"肾微癥积"理论探讨活血化瘀法调节周细胞-肌成纤维细胞转分化防治肾间质纤维化的研究概况OA
Ideas and strategies of promoting blood circulation and removing blood stasis to regulate pericyte-myofibroblast transdifferentiation to prevent and treat renal interstitial fibrosis based on the theory of"nephrotic microscopic accumulation"
肾间质纤维化(renal interstitial fibrosis,RIF)是多种慢性肾病发展到终末期的共同病理变化过程,也是肾脏功能衰退的重要组织学表现,具有较高的死亡率和发病率,给社会和家庭带来沉重的经济负担.中医学认为,RIF多为疾病日久损伤肾络,导致脉络瘀阻,最终在肾脏中形成微型癥积,故归"肾微癥积"的范畴.因此,RIF病机关键为肾络瘀阻,可选用活血化瘀法治疗,为基于"肾微癥积"病机理论探讨中医药防治RIF提供新视角.现代医学认为,RIF发病的主要表现为肾间质血流减少、微血管稀疏,这与周细胞(Pericytes,PC)引起的微血管系统障碍以及PC从内皮细胞微血管中分离并转分化为肌成纤维细胞(myofibroblast,MyoF)密切相关,为RIF防治提供新靶点.在"肾微癥积"理论指导下,采用活血化瘀中药丹参、姜黄和红花等药物有效成分、复方下瘀血汤、益肾活血方和肾康注射液等均能调节α-SMA、Vimentin和PDGFR、TGF-β/Smad、Wnt/β-catenin、Hedgehog和Notch等PMT关键分子和通路,延缓RIF进展.这些为"肾微癥积"理论指导下探讨活血化瘀法调节周细胞-肌成纤维细胞转分化防治RIF提供新思路、新策略.
Renal interstitial fibrosis(RIF)is a common pathological change process in the development of a variety of chronic kidney diseases to end-stage,and is also an important histological manifestation of renal function decline.It has high mortality and morbidity and bring a heavy economic burden to the society and family.Traditional Chinese medicine be-lieves that RIF is mostly caused by diseases that damage the renal collaterals for a long time,resulting in stasis of the collat-erals and eventually forming a microscopic accumulation in the kidney,so it belongs to the category of"nephrotic microscop-ic accumulation".Therefore,the key to the pathogenesis of RIF is the obstruction of kidney collaterals,and we can use the method of promoting blood circulation and removing blood stasis,the curative effect is remarkable.It provides a new per-spective for exploring the prevention and treatment of RIF with traditional Chinese medicine based on the pathogenesis theo-ry of"nephrotic accumulation".Modern medicine believes that the pathogenesis of RIF is mainly manifested as decreased renal interstitial blood flow and sparse microvessels which is closely related to the microvascular barrier caused by pericytes(PC)and the separation and transdifferentiation of PC from endothelial cell microvessels into myofibroblast(MyoF)and is a new targets for RIF.Under the guidance of the theory of"nephrogenic syndrome",the active ingredients of traditional Chi-nese medicine for promoting blood circulation and removing blood stasis such as salvia,turmeric and safflower,and the tradi-tional Chinese medicine compound Xiayuxuetang,Yishenhuoxue prescription and compound preparation Shenkang injection can regulate key PMT molecules and pathways such as α-SMA,Vimentin,and PDGFR,TGF-β/Smad,Wnt/β-catenin,Hedgehog,and Notch which delays the progression of RIF.These provide new ideas and strategies for exploring the regula-tion of pericyte-myofibroblast transdifferentiation to prevent renal interstitial fibrosis by promoting blood circulation and re-moving blood stasis based on the theory of"nephrotic microscopic accumulation".
魏丹丹;王桂娟;郭昭昭;刘浩飞;方方;李闪闪;刘晓鹏;王行;马璐莹;柴爽爽;殷晶晶;王永杰
河南中医药大学第一附属医院针灸疼痛科,河南 郑州 450000河南中医药大学第一附属医院针灸疼痛科,河南 郑州 450000河南中医药大学第一附属医院针灸疼痛科,河南 郑州 450000河南中医药大学第一附属医院肾脏病诊疗中心,河南 郑州 450000河南中医药大学第一附属医院肾脏病诊疗中心,河南 郑州 450000河南中医药大学第一临床医学院,河南 郑州 450046河南中医药大学第一临床医学院,河南 郑州 450046河南中医药大学第一临床医学院,河南 郑州 450046河南中医药大学第一临床医学院,河南 郑州 450046河南中医药大学第一附属医院针灸疼痛科,河南 郑州 450000河南中医药大学第一附属医院针灸疼痛科,河南 郑州 450000河南省职业病防治医院中医科,河南 郑州 450000
医药卫生
肾间质纤维化肾微癥积活血化瘀法周细胞-肌成纤维细胞转分化
renal interstitial fibrosisnephrotic microscopic accumulationmethod of promoting blood circulation and removing blood stasispericyte-myofibroblast transdifferentiation
《现代中医药》 2026 (2)
49-56,8
国家自然科学基金青年科学基金项目(82204971)河南省科技攻关项目(242102311264)河南省中医药科学研究专项课题(2025ZY3019)
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