收稿日期: 2026-01-23
网络出版日期: 2026-06-15
基金资助
国家重点研发计划项目(2020YFE0201800);河南省科技攻关项目(202102311137)
Research progress on the treatment of diabetic kidney disease with traditional chinese medicine based on gut microbiota
Received date: 2026-01-23
Online published: 2026-06-15
糖尿病肾病（diabetic kidney disease， DKD）是糖尿病（diabetes mellitus， DM）最常见且最严重的微血管并发症之一，是慢性肾脏病（chronic kidney disease，CKD）和终末期肾病（end-stage renal disease，ESRD）的主要原因，给患者和社会带来沉重的健康与经济负担。肠道菌群是寄居在人体肠道内的所有微生物的总和，是一个极其复杂且庞大的生态系统。肠道菌群和肾脏间的有机相互作用已被证明直接或间接地影响人体健康，其中肠道菌群失调、肠道屏障受损、肠道菌群代谢产物失衡会引发氧化应激、免疫炎症反应，加速DKD的进展。中医药以其多靶点、整体调节、副作用小的特点在防治DKD方面展现出独特的优势。研究发现，中药单体苷类、黄酮类、多酚类、萜类、生物碱类、多糖类等多种化合物及祛瘀泄浊、益气养阴、清热解毒等类别的中药复方通过调节肠道菌群，靶向相关信号通路，减轻肾损伤，延缓DKD进展。该文系统梳理了肠道菌群参与DKD的关键机制，分析了近年来中药单体及复方在DKD治疗中调节肠道菌群方面所取得的研究成果，以期为中医药防治DKD提供新的思路和方向。
周秋雨 , 孙新宇 . 基于肠道菌群探讨中医药治疗糖尿病肾病的研究进展[J]. 实用医学杂志, 2026 , 42(11) : 1996 -2006 . DOI: 10.3969/j.issn.1006-5725.2026.11.014
Diabetic kidney disease （DKD） stands as one of the most prevalent and severe microvascular complications of diabetes mellitus （DM）， serving as the primary cause of chronic kidney disease （CKD） and end-stage renal disease （ESRD）. This imposes a substantial burden on both patients and society from health and economic perspectives. The gut microbiota represents the aggregate of all microorganisms inhabiting the human intestine， forming an extremely intricate and extensive ecosystem. The organic interplay between the gut microbiota and the kidneys has been verified to directly or indirectly influence human health. Specifically， dysbiosis of the gut microbiota， impairment of the intestinal barrier， and imbalance of gut microbiota metabolites can initiate oxidative stress and immune-inflammatory responses， thereby accelerating the progression of DKD. In recent years， traditional Chinese medicine has manifested unique advantages in the prevention and treatment of DKD， attributed to its multi-target approach， holistic regulation， and minimal side effects. Studies have revealed that various compounds， including monosaccharide glycosides， flavonoids， polyphenols， terpenoids， alkaloids， polysaccharides， as well as traditional Chinese medicine formulas categorized as removing blood stasis and clearing turbidity， tonifying qi and nourishing yin， and clearing heat and detoxifying， can regulate the gut microbiota， target relevant signaling pathways， alleviate renal damage， and delay the progression of DKD. This article systematically reviews the key mechanisms through which the gut microbiota is involved in DKD， analyzes the research achievements in regulating the gut microbiota for the treatment of DKD in recent years， and aims to offer new insights and directions for the prevention and treatment of DKD with traditional Chinese medicine.
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