关键词： ACEI, angiotensin-converting enzyme inhibitor ADE, adverse event AGEs, advanced glycation end-products AM, mesangial area AMPKα, adenosine monophosphate-activated protein kinase α ARB, angiotensin receptor blocker AREs, antioxidant response elements ATK, protein kinase B BAX, BCL-2-associated X protein BCL-2, B-cell lymphoma 2 BCL-XL, B-cell lymphoma-extra large BMP-7, bone morphogenetic protein-7 BUN, blood urea nitrogen BW, body weight C, control group CCR, creatinine clearance rate CD2AP, CD2-associated protein CHOP, C/EBP homologous protein CI, confidence interval COL-I/IV, collagen I/IV CRP, C-reactive protein CTGF, connective tissue growth factor Chinese medicine D, duration DAG, diacylglycerol DG, glomerular diameter DKD, diabetic kidney disease DM, diabetes mellitus DN, diabetic nephropathy Diabetic kidney disease Diabetic nephropathy EMT, epithelial-to-mesenchymal transition EP, E-prostanoid receptor ER, endoplasmic reticulum ESRD, end-stage renal disease ET-1, endothelin-1 ETAR, endothelium A receptor FBG, fasting blood glucose FN, fibronectin GCK, glucokinase GCLC, glutamate-cysteine ligase catalytic subunit GFR, glomerular filtration rate GLUT4, glucose transporter type 4 GPX, glutathione peroxidase GRB 10, growth factor receptor-bound protein 10 GRP78, glucose-regulated protein 78 GSK-3, glycogen synthase kinase 3 Gαq, Gq protein alpha subunit HDL-C, high density lipoprotein-cholesterol HO-1, heme oxygenase-1 HbA1c, glycosylated hemoglobin Herbal medicine ICAM-1, intercellular adhesion molecule-1 IGF-1, insulin-like growth factor 1 IGF-1R, insulin-like growth factor 1 receptor IKK-β, IκB kinase β IL-1β/6, interleukin 1β/6 IR, insulin receptor IRE-1α, inositol-requiring enzyme-1α IRS, insulin receptor substrate IκB-α, inhibitory protein α JAK, Janus kinase JNK, c-Jun N-terminal kinase LC3, microtubule-associated protein light chain 3 LDL, low-density lipoprotein LDL-C, low density lipoprotein-cholesterol LOX1, lectin-like oxidized LDL receptor 1 MAPK, mitogen-activated protein kinase MCP-1, monocyte chemotactic protein-1 MD, mean difference MDA, malondialdehyde MMP-2, matrix metallopeptidase 2 MYD88, myeloid differentiation primary response 88 Molecular target N/A, not applicable N/O, not observed N/R, not reported NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells NOX-4, nicotinamide adenine dinucleotide phosphate-oxidase-4 NQO1, NAD(P)H:quinone oxidoreductase 1 NRF2, nuclear factor erythroid 2-related factor 2 OCP, oxidative carbonyl protein ORP150, 150-kDa oxygen-regulated protein P70S6K, 70-kDa ribosomal protein S6 kinase PAI-1, plasminogen activator inhibitor-1 PARP, poly(ADP-Ribose) polymerase PBG, postprandial blood glucose PERK, protein kinase RNA-like eukaryotic initiation factor 2A kinase PGC-1α, peroxisome proliferator-activated receptor gamma coactivator 1α PGE2, prostaglandin E2 PI3K, phosphatidylinositol 3 kinases PINK1, PTEN-induced putative kinase 1 PKC, protein kinase C PTEN, phosphatase and tensin homolog RAGE, receptors of AGE RASI, renin-angiotensin system inhibitor RCT, randomized clinical trial ROS, reactive oxygen species SCr, serum creatinine SD, standard deviation SD-rat, Sprague–Dawley rat SIRT1, sirtuin 1 SMAD, small mothers against decapentaplegic SMD, standard mean difference SMURF-2, SMAD ubiquitination regulatory factor 2 SOCS, suppressor of cytokine signaling proteins SOD, superoxide dismutase STAT, signal transducers and activators of transcription STZ, streptozotocin Signaling pathway T, treatment group TBARS, thiobarbituric acid-reactive substance TC, total cholesterol TCM, traditional Chinese medicine TFEB, transcription factor EB TG, triglyceride TGBM, thickness of glomerular basement membrane TGF-β, tumor growth factor β TGFβR-I/II, TGF-β receptor I/II TII, tubulointerstitial injury index TLR-2/4, toll-like receptor 2/4 TNF-α, tumor necrosis factor α TRAF5, tumor-necrosis factor receptor-associated factor 5 UACR, urinary albumin to creatinine ratio UAER, urinary albumin excretion rate UMA, urinary microalbumin UP, urinary protein VCAM-1, vascular cell adhesion molecule-1 VEGF, vascular endothelial growth factor WMD, weight mean difference XBP-1, spliced X box-binding protein 1 cAMP, cyclic adenosine monophosphate eGFR, estimated GFR eIF2α, eukaryotic initiation factor 2α mTOR, mammalian target of rapamycin p-IRS1, phospho-IRS1 p62, sequestosome 1 protein α-SMA, α smooth muscle actin

来  源：   DOI：10.1016/j.apsb.2020.12.020   PDF(Sci-hub)   PDF(Pubmed)

Abstract：
Diabetic nephropathy (DN) has been recognized as a severe complication of diabetes mellitus and a dominant pathogeny of end-stage kidney disease, which causes serious health problems and great financial burden to human society worldwide. Conventional strategies, such as renin-angiotensin-aldosterone system blockade, blood glucose level control, and bodyweight reduction, may not achieve satisfactory outcomes in many clinical practices for DN management. Notably, due to the multi-target function, Chinese medicine possesses promising clinical benefits as primary or alternative therapies for DN treatment. Increasing studies have emphasized identifying bioactive compounds and molecular mechanisms of reno-protective effects of Chinese medicines. Signaling pathways involved in glucose/lipid metabolism regulation, antioxidation, anti-inflammation, anti-fibrosis, and podocyte protection have been identified as crucial mechanisms of action. Herein, we summarize the clinical efficacies of Chinese medicines and their bioactive components in treating and managing DN after reviewing the results demonstrated in clinical trials, systematic reviews, and meta-analyses, with a thorough discussion on the relative underlying mechanisms and molecular targets reported in animal and cellular experiments. We aim to provide comprehensive insights into the protective effects of Chinese medicines against DN.
摘要：
糖尿病肾病(DN)是糖尿病的严重并发症,是终末期肾病的主要病因,这给全世界的人类社会造成了严重的健康问题和巨大的经济负担。常规战略,如肾素-血管紧张素-醛固酮系统阻断，血糖水平控制，和减轻体重,在许多DN管理的临床实践中，可能无法获得令人满意的结果。值得注意的是,由于多目标函数，中药作为DN治疗的主要或替代疗法具有很好的临床益处。越来越多的研究强调确定中药的生物活性化合物和肾脏保护作用的分子机制。参与糖/脂代谢调节的信号通路，抗氧化，抗炎，抗纤维化，足细胞保护已被确定为重要的作用机制。在这里，在回顾临床试验结果后，我们总结了中药及其生物活性成分在治疗和管理DN中的临床疗效，系统评价,和荟萃分析，对动物和细胞实验中报道的相关潜在机制和分子靶标进行了彻底讨论。我们旨在全面了解中药对DN的保护作用。
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