Effects of Intestinal Flora and Local Renin-angiotensin System on Diabetic Nephropathy and Traditional Chinese Medicine Intervention： A Review
10.13422/j.cnki.syfjx.202202124
- VernacularTitle:肠道菌群与局部肾素-血管紧张素系统对糖尿病肾病的影响及中医药研究进展
- Author:
Chaomao YANG
1
;
Yuanyuan LI
1
;
Shunxiao ZHANG
1
;
Jiandong GAO
2
Author Information
1. Baoshan Branch， Shuguang Hospital， Shanghai University of Traditional Chinese Medicine（TCM）， Shanghai 201999， China
2. Shuguang Hospital， Shanghai University of TCM， Shanghai 201203， China
- Publication Type:Journal Article
- Keywords:
diabetic nephropathy（DN）;
intestinal flora;
renin-angiotensin system （RAS）;
traditional Chinse medicine;
Chinese medicinal materials
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2023;29(15):242-248
- CountryChina
- Language:Chinese
-
Abstract:
Diabetic nephropathy （DN） is a common clinical complication of diabetes， the main cause of end-stage renal disease （ESRD）， and a key determinant of survival in diabetic patients. The pathogenesis of DN is complex， and it is currently believed to be associated with hemodynamic abnormalities， intestinal flora disturbances， glucose and lipid metabolism disorders， oxidative stress， genetic susceptibility， and protein non-enzymatic glycosylation. The local renin-angiotensin system （RAS） has always been the core of the pathogenic and progressive changes of DN. Once activated， it will induce the massive release of oxygen free radicals in the blood vessels， damage the endothelial function， and affect the microcirculation of the body. The recent studies demonstrate that intestinal flora and its metabolites may affect the occurrence and development of DN by activating or antagonizing the local RAS. Compared with western medicine treatment， traditional Chinese medicine （TCM） has the advantages of multiple targets and little toxic and side effects. Many TCM scholars have found that single herbs， their active ingredient extracts， and TCM compound prescriptions can improve kidney function by regulating the local RAS or intestinal flora. Specifically， the Chinese medicinal materials tonifying spleen （Codonopsis Radix， Dioscoreae Rhizoma， Atractylodis Macrocephalae Rhizoma， and Poria）， replenishing kidney （Rehmanniae Radix Praeparata， Corni Fructus， and Pseudostellariae Radix）， and activating blood， resolving stasis， and dredging collaterals （Hirudo， Salviae Miltiorrhizae Radix et Rhizoma， and Angelicae Sinensis Radix） have the regulatory effect. This article summarizes the roles of intestinal flora and local RAS in the occurrence and development of DN， and analyzes the animal experiments or clinical trials of TCM intervention in DN in recent years， aiming to provide more therapies and a theoretical basis for the treatment of DN with integrated TCM and Western medicine.
