中医临床研究2025，Vol.17Issue(25)：104-109,6.DOI:10.3969/j.issn.1674-7860.2025.25.015
基于阴阳理论探讨线粒体自噬与铁死亡在中医药治疗糖尿病肾病中的作用机制
The action mechanism of mitochondrial autophagy and ferroptosis in the TCM treatment of diabetic nephropathy based on the theory of Yin-Yang
摘要
Abstract
Background:Diabetic nephropathy is a severe microvascular complication of diabetes with a high incidence rate and a lack of radical cure methods.Its pathogenesis is complex and involves multiple cell death pathways,among which the roles of mitochondrial autophagy and ferroptosis are increasingly prominent.Objective:Based on the Yin(阴)-Yang(阳)theory,the core theory of traditional Chinese Medicine(TCM),the key mechanisms of mitochondrial autophagy and ferroptosis in the prevention and treatment of diabetic nephropathy in TCM is explored in this study.Methods:Mitochondrial autophagy has a bidirectional regulatory effect in the process of diabetic nephropathy.Moderate mitochondrial autophagy(Yin-Yang balance)can remove damaged mitochondria,reduce oxidative stress,and protect the kidneys.Insufficient mitochondrial autophagy(excess of Yang and deficiency of Yin)and excessive mitochondrial autophagy(excess of Yin and deficiency of Yang)can both disrupt cellular homeostasis and accelerate the progression of diabetic nephropathy.Ferroptosis is driven by iron overload and lipid peroxidation,and can exacerbate renal injury.Its occurrence mechanism is similar to"excess of Yang and deficiency of Yin"(excessive Yang depleting Yin fluid),interacting with fibrosis,inflammation,and oxidative stress in diabetic nephropathy,and promoting disease deterioration.Studies have confirmed that many Chinese medicinal materials can bidirectionally regulate mitochondrial autophagy to an appropriate level by regulating key pathways,improve mitochondrial function,and reduce oxidative damage.At the same time,they can effectively inhibit ferroptosis,reduce iron overload,enhance antioxidant defense,and protect renal cells.This regulation essentially restores the intracellular balance of"Yin and Yang in harmony"by supporting Yang and restraining Yin or nourishing Yin and subduing Yang,thereby ameliorating the pathological process of diabetic nephropathy.Conclusion:This study innovatively combines the Yin-Yang theory in TCM with modern cell death mechanisms,clarifying its significant role in diabetic nephropathy and the intervention mechanisms of TCM.Future research should optimize TCM prescriptions based on the Yin-Yang theory,implement personalized treatment in different stages(supporting Yang in the early stage,balancing Yin and Yang in the middle stage,and nourishing Yin while supporting Yang in the late stage),and utilize modern technologies to further explore specific mechanisms.Providing a more solid theoretical basis and effective strategies for the prevention and treatment of diabetic nephropathy in TCM.关键词
糖尿病肾病/阴阳理论/线粒体自噬/铁死亡/中医药治疗Key words
Diabetic nephropathy/Yin-Yang theory/Mitochondrial autophagy/Ferroptosis/Traditional Chinese medicine treatment分类
医药卫生引用本文复制引用
李让,辛彩虹,赵涛..基于阴阳理论探讨线粒体自噬与铁死亡在中医药治疗糖尿病肾病中的作用机制[J].中医临床研究,2025,17(25):104-109,6.基金项目
辽宁省自然科学基金面上项目(2022-MS-431) （2022-MS-431）
沈阳市科技局基金项目(20-205-4-083). （20-205-4-083）
