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。
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.