| 引用本文: |
刘辰霈, 杜雨芃, 张家芮, 许颖迈, 乔佳, 林燕.从“虚气留滞”理论探讨糖尿病肾病铁死亡病机[J].湖南中医药大学学报,2025,45(10):1910-1916[点击复制] |
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| 从“虚气留滞”理论探讨糖尿病肾病铁死亡病机 |
| 刘辰霈,杜雨芃,张家芮,许颖迈,乔佳,林燕 |
| (天津中医药大学第一附属医院, 天津 300382;国家中医针灸临床医学研究中心, 天津 300382;天津医科大学研究生院, 天津 300070) |
| 摘要: |
| 糖尿病肾病（DKD）是糖尿病最严重的微血管并发症，也是导致终末期肾脏病的主要原因，对人类健康构成极大威胁。铁死亡，作为一种新型、独特的细胞死亡方式，以亚铁离子驱动脂质过氧化物堆积，破坏细胞结构，诱导细胞死亡为特点，现已成为中医药干预DKD领域的潜在靶点。“虚气留滞”理论是指由于元气亏虚，气血津液运行失常，出现气滞、血瘀、痰凝、水停等邪气留滞的病理过程，与DKD“本虚标实、虚实夹杂”的核心病机高度契合。DKD以“虚气”（脾肾气虚、气阴两虚）为本，以“邪实”（血瘀、痰浊）留滞为标，虚实夹杂，互为因果，导致恶性循环。DKD“虚气留滞”的病机特点与微观下肾脏固有细胞铁死亡的过程有相通之处。因此，本文试从“虚气留滞”角度立论，探讨DKD铁死亡病机的中医学内涵，为中医药干预DKD提供新的思路与方法。 |
| 关键词: 虚气留滞 铁死亡 糖尿病肾病 线粒体代谢 氧化应激 |
| DOI：10.3969/j.issn.1674-070X.2025.10.014 |
| 投稿时间：2025-06-13 |
| 基金项目:国家自然科学基金面上项目（81373609）； 天津市名中医林燕传承工作室建设项目（tjmzy2404）。 |
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| Exploring the pathogenesis of ferroptosis in diabetic kidney disease based on the theory of "qi deficiency leading to pathogenic accumulation" |
| LIU Chenpei, DU Yupeng, ZHANG Jiarui, XU Yingmai, QIAO Jia, LIN Yan |
| (First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300382, China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300382, China;Graduate School of Tianjin Medical University, Tianjin 300070, China) |
| Abstract: |
| Diabetic kidney disease (DKD) represents the most severe micro-vascular complication of diabetes and stands as the primary cause of end-stage renal disease, posing a great threat to human health. Ferroptosis, a novel and distinctive form of cell death, is characterized by the accumulation of lipid peroxides driven by ferrous ions, which disrupts cellular structures and induces cell death. It has now emerged as a potential target for TCM intervention in DKD. The theory of "qi deficiency leading to pathogenic accumulation" refers to a pathological process in which Yuan-primordial qi deficiency leads to dysfunction in the movement of qi, blood, and body fluids, resulting in the accumulation of pathogenic factors such as qi stagnation, blood stasis, phlegm formation, and water retention. It is highly consistent with the core pathogenesis of DKD, which is characterized by a combination of deficiency (the root) and excess (the manifestations). DKD is fundamentally characterized by qi deficiency (i.e., qi deficiency of the spleen and kidney, and dual deficiency of qi and yin) as its root cause, with "pathogenic excess" (i.e., blood stasis and phlegm turbidity) as its manifestation. This interplay between deficiency and excess is mutually causative, leading to a vicious cycle. The pathological characteristics of "qi deficiency leading to pathogenic accumulation" in DKD share similarities with the microscopic process of ferroptosis in renal intrinsic cells. Therefore, this paper aims to explore the TCM connotations of the pathogenesis of ferroptosis in DKD from the perspective of "qi deficiency leading to pathogenic accumulation," providing novel insights and approaches for TCM intervention in DKD. |
| Key words: qi deficiency leading to pathogenic accumulation ferroptosis diabetic kidney disease mitochondrial metabolism oxidative stress |
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