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| 基于“糖毒损肾、积微致著”病机探讨糖尿病肾脏病相关“代谢记忆”形成的中西医机制 |
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李函舟1, 温伟波2, 孔祥英3, 邢利威2, 吕树泉4, 边育红1, 崔换天2
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1.天津中医药大学中西医结合学院, 天津 301671;2.云南中医药大学第一临床医学院, 昆明 650500;3.中国中医科学院中药研究所, 北京 100700;4.河北省沧州中西医结合医院内分泌科, 沧州 061001
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| 摘要: |
| 糖尿病肾脏病（DKD）是糖尿病微血管并发症之一，也是终末期肾病（ESRD）的主要原因。“代谢记忆”是指在糖尿病早期高血糖状态下，即使后期血糖得到控制，仍会持续影响并增加DKD等并发症风险的现象。文章综述了DKD相关“代谢记忆”的机制，包括细胞衰老、炎症反应、氧化应激等，并讨论了表观遗传修饰在其中的作用。此外，文章从中医的“糖毒”理论出发，提出“糖毒损肾、积微致著”的病机概念，探讨了中医药在改善DKD相关“代谢记忆”方面的潜在作用，并提出了中西医结合治疗DKD的新策略。最后，展望未来研究方向，包括深入理解“代谢记忆”机制，识别相关靶点，以及探索中医药干预疾病的动态变化规律，以期为后续研究提供参考方向。 |
| 关键词: 糖尿病肾脏病 代谢记忆 糖毒损肾、积微致著 |
| DOI：10.11656/j.issn.1673-9043.2025.03.12 |
| 分类号:R587.1 |
| 基金项目:国家自然科学基金青年项目（82405223）；云南省自然科学基金面上项目（202401AT070715）。 |
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| Based on the pathogenesis of “glucotoxicity damaging the kidney，and the accumulation of minor to significant”：exploring the mechanisms of “metabolic memory” formation in diabetic kidney disease from both traditional Chinese and Western medical perspectives |
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LI Hanzhou1, WEN Weibo2, KONG Xiangying3, XING Liwei2, LYU Shuquan4, BIAN Yuhong1, CUI Huantian2
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1.College of Integrated Traditional Chinese and Western Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;2.The First Clinical Medical College of Yunnan University of Chinese Medicine, Kunming 650500, China;3.Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China;4.Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province, Cangzhou 061001, China
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| Abstract: |
| Diabetic kidney disease(DKD) is one of the microvascular complications of diabetes and is also a major cause of end-stage renal disease(ESRD). "Metabolic memory" refers to the phenomenon where the high blood glucose state in the early stages of diabetes continues to influence and increase the risk of complications such as DKD,even after blood sugar is controlled later. This review summarizes the mechanisms related to "metabolic memory" in DKD,including cellular senescence,inflammatory responses,and oxidative stress,and discusses the role of epigenetic modifications in this process. In addition,starting from the theory of "Glucotoxicity" in traditional Chinese medicine(TCM),this paper proposes the pathogenic concept of "Glucotoxicity damaging the kidney,and the accumulation of minor to significant",and explores the potential role of TCM in improving the "metabolic memory" associated with DKD. It also proposes new strategies for the integration of Chinese and Western medicine in the treatment of DKD. Finally,this paper looks forward to future research directions,including a deeper understanding of the "metabolic memory" mechanism,identifying related targets,and exploring the dynamic laws of disease intervention by TCM,in order to provide a reference direction for subsequent research. |
| Key words: diabetic kidney disease metabolic memory glucotoxicity damaging the kidney, and the accumulation of minor to significant |
