中药复方治疗IgA肾病作用机制研究进展OA

IgA nephropathy(IgA)nephropathy is the most common type of primary glomerulonephritis worldwide.Numerous studies have explored its pathogenesis,with the"quadruple strike"theory,gut microbiota dysbiosis,genetic susceptibility,and immunological mechanisms being the most prevalent.Compared to conventional Western medicine's immunotherapy and symptomatic treatment alone,integrated traditional Chinese and Western medicine offers distinct advantages in managing IgAN.Traditional Chinese medicine compound,as one approach in TCM for treating IgAN,has been widely applied clinically.Commonly used formulations include Liuwei Dihuang Pill(六味地黄丸),Huangqi Guizhi Wuwu Decoction(黄芪桂枝五物汤),Huangqi Chifeng Decoction(黄芪赤风汤),and Dabuyin Pill(大补阴丸)for tonifying the spleen and kidneys;and Dahuang Zhechong Pill(大黄䗪虫丸),Wuwei Xiaodu Decoction(五味消毒饮),Sanren Decoction(三仁汤),and Mahuang Lianqiao Chixiaodou Decoction(麻黄连翘赤小豆汤)for dispelling dampness and resolving blood stasis.Through basic and clinical research,numerous scholars have discovered that TCM compound can treat IgAN by repairing podocyte damage,influencing the gut microbiota and intestinal mucosal immunity,inhibiting inflammatory responses,alleviating oxidative stress,delaying renal fibrosis,and inhibiting the activation of the complement system,etc.The involved signaling pathways primarily include the Nrf2/Keap1/HO-1 signaling pathway,NF-κB signaling pathway,PI3K/Akt/mTOR signaling pathway,TGF-β1/Smad3 signaling pathway,and others.TCM compound exerts synergistic regulatory effects through multiple targets,pathways,and mechanisms in IgAN treatment,demonstrating promising clinical application prospects.This paper reviews relevant literature from the past five years focusing on the use of TCM compound to intervene in IgAN.The aim is to enrich research on TCM prevention and treatment of IgAN,providing insights and evidence for its clinical application and mechanism studies.