肝硬化后肾损害的研究现状和临床科研思路探析.pdfVIP

第29卷第 11期 托南中运豫忐 Vo1．29 No．11 2013年 l1月 HUNANJOURNALOFTRADITIONALCHINESEMEDICINE Nov 2013 肝硬化后肾损害的 研究现状和临床科研思路探析 王耀光 (天津中医药大学第一附属医院，天津，300193) [摘要] 以中医学 “肝肾同源论”为基础，提出在发病学上肝 肾具有共 同的致病途径，在研究肝硬化相关肾纤维化时，要 注重脏器纤维化的关联性。在治疗学上倡导 “肝病治肾”、“肝 肾同活”。进而认识到多脏器纤维化之间的相互作用，并认为肝 肾在脏器纤维化发生机制上具有相关性，中药肾疏宁具有清热利湿解毒、活血化瘀、补益脾 肾作用，肾疏宁及 中药单体可能通 过干预Smad7蛋白表达、TGF—B 等细胞因子而发挥抗纤维化作用，为中药治疗肝硬化后肾损害的机制提供了研究思路。 [关键词] 肝硬化后。肾损害；机制研究；肝肾同源 ；肝肾同治 [中图分类号]R259．752 [文献标识码]A [文章编号]1003—7705(2013)ll一0001—02 Currentresearchonkidneyinjuryafterlivercirrhosisandideasofitsclinicalresearch WANG Yao—guang (TheFirstAffiliatedHospitalofTianjinUniversityofTraditionalChineseMedicine，Tianjin300193，China) Abstract：Basedonthe “theoryofhomogenyofliverandkidney”intraditionalChinesemedicine，thispaper suggeststhatthereisacommonpathogenicpathwayinthepathogenesisofliverandkidneydiseasesandthattheas— sociationbetweenorganfibrosesshouldbevaluedintheresearchoncirrhosis—relatedrenalfibrosis．“Treatmentof kidneyinliverdisease”and “treatmentofbothliverandkidney~’areproposedintherapeutics．Themutualeffectin multi—organfibrosisisrecognized，anditisthoughtthattheliverandkidneyareassociatedwitheachotherinthe pathogenesisoforganfibrosis．ThetraditionalChinesemedicineprescriptionofShenshuning，whichhasheat—clear— ing，diuresis—promoting，detoxicating，bloodcirculation—activating，bloodstasis—removing，andspleen— andkid- ney—invigoratingeffects，aswellasmonomersofChineseherbs，mayexertanti—fibroticeffectbyinterferingwith theSmad7expressionandcytokinessuchastransforminggrowthfactor—B1，providingideasfortheresearchonthe mechanismoftraditionalChinesemedicinetreatmentofkidneyinjuryafterlivercirrhosis． Keywords：kidneyinjuryafterlivercirrhosis；mechanismresearch；homogenyofliverandkidney；treatmentof bothliverandkidney