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| 中药有效成分调控AMPK信号通路防治糖尿病肾病的研究进展 |
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贾慧雨1, 李琳1,2,3, 闫丰喆4, 冯文帅5, 尚磊强1, 邹菁1, 任明6, 李玉红1,2,3
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1.天津中医药大学, 天津 301617;2.组分中药国家重点实验室, 天津 301617;3.现代中药创制全国重点实验室, 天津 301617;4.中国人民解放军联勤保障部队第九八八医院, 郑州 450000;5.河南中医药大学第一附属医院, 郑州 450000;6.天津中医药大学附属保康医院, 天津 300193
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| 摘要: |
| 糖尿病肾病（DKD）是导致终末期肾病和肾脏替代治疗的主要因素，显著增加糖尿病患者不良心血管事件和过早死亡风险。钠-葡萄糖协同转运蛋白 2 抑制剂等新型药物的应用为 DKD 患者带来了明确的肾脏获益，但仍不能完全阻止疾病进展，且存在泌尿系感染及血容量不足等不良反应。中医药在防治 DKD 方面经验丰富，与西药联用具有协同增效、减毒的优势。腺苷酸活化蛋白激酶（AMPK）信号通路作为调节细胞能量代谢的核心枢纽，其激活后可调控下游的自噬、炎症、氧化应激及细胞程序性死亡等生物过程，深刻影响 DKD 进展中的肾脏细胞命运。近年来大量研究表明，中药有效成分（涉及生物碱、皂苷、黄酮、多糖、多酚、萜类、蒽醌、异硫氰酸酯、氰苷、香豆素及酚苷等类别）可靶向 AMPK 信号通路调节能量代谢、调控自噬水平、减轻氧化应激和炎症损伤并抑制肾脏细胞异常程序性死亡，从而保护肾脏结构和功能，改善 DKD。因此，文章立足于 AMPK 信号通路，介绍该通路参与 DKD 发病的主要机制，并系统梳理中药有效成分通过调控该通路防治 DKD 的研究现状，以期为基于靶向 AMPK 的 DKD 相关新型中药制剂的开发提供理论参考。 |
| 关键词: 糖尿病肾病 中药 有效成分 AMPK信号通路 研究进展 机制 |
| DOI：10.11656/j.issn.1672-1519.2026.10.15 |
| 分类号:R587.2 |
| 基金项目:*基金项目：现代中药新质生产力科技创新工程专项（24ZXZKSY00020）；国家重点研发计划（2018YFC1707403）。 |
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| Research progress on the regulation of the AMPK signaling pathway by active components of traditional Chinese medicine in the prevention and treatment of diabetic nephropathy |
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JIA Huiyu1, LI Lin1,2,3, YAN Fengzhe4, FENG Wenshuai5, SHANG Leiqiang1, ZOU Jing1, REN Ming6, LI Yuhong1,2,3
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1.Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China;2.State Key Laboratory of Component-Based Chinese Medicine, Tianjin 301617, China;3.State Key Laboratory of Modern Chinese Medicine Creation, Tianjin 301617, China;4.The 988th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Zhengzhou 450000, China;5.The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China;6.Baokang Hospital Affiliated to Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
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| Abstract: |
| Diabetic kidney disease（DKD）is a leading cause of end-stage renal disease and kidney replacement therapy，and is associated with a markedly increased risk of cardiovascular events and premature mortality in patients with diabetes. Although emerging therapies such as sodium-glucose cotransporter 2（SGLT2）inhibitors provide significant renal benefits，they cannot fully halt disease progression and are accompanied by adverse effects including urinary tract infections and hypovolemia. Traditional Chinese medicine（TCM）has accumulated extensive clinical experience in the prevention and treatment of DKD，and its integration with Western medicine offers advantages in synergistic efficacy and reduced toxicity. The adenosine monophosphate-activated protein kinase （AMPK）signaling pathway，a central regulator of cellular energy metabolism，modulates key downstream processes such as autophagy， inflammation，oxidative stress，and programmed cell death，thereby critically influencing renal cell fate during DKD progression. Growing evidence indicates that active components of TCM，including alkaloids，saponins，flavonoids，polysaccharides，polyphenols， terpenoids，anthraquinones，isothiocyanates，cyanogenic glycosides，coumarins，and phenolic glycosides exert DKD-related renoprotective effects by targeting the AMPK pathway to restore energy homeostasis，regulate autophagy，attenuate oxidative and inflammatory injury，and suppress aberrant programmed cell death in renal cells. Accordingly，this review delineates the involvement of the AMPK signaling pathway in the pathogenesis of DKD and systematically discusses current research on TCM active components that modulate this pathway for the prevention and treatment of DKD，aiming to provide a theoretical basis for the development of novel AMPK-targeted TCM-based therapeutic strategies. |
| Key words: diabetic kidney disease traditional Chinese medicine active components AMPK signaling pathway research progress mechanism |
