| 慢性肾脏病肌少症发病机制及中医药治疗研究进展 |
| Research progress on pathogenesis and traditional Chinese medicine treatment of sarcopenia in chronic kidney disease |
| DOI： |
| 中文关键词: 慢性肾脏病 肌少症 中医药 |
| 英文关键词: Chronic Kidney Disease Sarcopenia Traditional Chinese Medicine |
| 基金项目:中华中医药学会求实项目(2023-QNQS-04) |
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| 中文摘要: |
| 慢性肾脏病(CKD)合并肌少症显著影响患者生活质量和预后,本文系统综述了CKD肌少症的发病机制和中医药防治进展。现代医学研究表明,CKD肌少症主要由代谢紊乱、炎症持续激活及肠-肌轴失衡三大机制交织驱动。中医理论认为,肌少症属于“痿病”范畴,本质为脾肾亏虚、气血不足,治疗当以补脾益肾、益气活血为主,兼顾提升心阳和微循环。临床数据显示,补脾益肾类中药复方和针灸等外治法可改善患者肌肉功能及营养指标。基础研究揭示中药通过PI3K/Akt、AMPK/SIRT1等信号通路调控肌肉蛋白代谢与线粒体功能。然而,当前临床研究多为小样本非随机设计,尚缺乏高质量证据支持。未来应聚焦证候标准化、多组学机制研究及大规模随机对照试验,推动中医药精准干预CKD肌少症。 |
| 英文摘要: |
| Sarcopenia in patients with chronic kidney disease (CKD) significantly impairs quality of life and clinical outcomes. This review systematically summarizes the pathogenesis and advances in traditional Chinese medicine (TCM) treatment for CKD-related sarcopenia. Current evidence indicates that CKD-associated sarcopenia is driven by three interconnected mechanisms: metabolic dysregulation, persistent inflammatory activation, and gut-muscle axis disruption. According to TCM theory, sarcopenia falls within the category of "Wei syndrome" (flaccidity syndrome), with its pathological essence being spleen-kidney deficiency and qi-blood insufficiency. The therapeutic principle emphasizes tonifying the spleen and kidney, supplementing qi and activating blood circulation, while also enhancing cardiac yang and microcirculation. Clinical data demonstrate that TCM herbal formulas targeting spleen-kidney tonification and external therapies such as acupuncture can improve muscle function and nutritional parameters. Mechanistic studies reveal that Chinese herbal medicines regulate muscle protein metabolism and mitochondrial function through PI3K/Akt and AMPK/SIRT1 signaling pathways. However, most current clinical studies are limited by small sample sizes and non-randomized designs, lacking high-quality evidence. Future research should prioritize syndrome standardization, multi-omics mechanistic investigations, and large-scale randomized controlled trials to advance precision TCM interventions for CKD-related sarcopenia. |
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