Welcome to visit Zhongnan Medical Journal Press Series journal website!

Home Articles Vol 37,2024 No.5 Detail

Research progress of the relationship between intestinal flora imbalance and diabetic nephropathy and its prevention and treatment by traditional Chinese medicine

Published on May. 29, 2024Total Views: 383 times Total Downloads: 338 times Download Mobile

Author: WEI Jinfeng 1# WEI Xiaotao 2# ZHANG Xinli 3 WANG Weiwei 2

Affiliation: 1. Special Needs Ward, Jiu Gang Hospital, Jiayuguan 735100, Gansu Province, China 2. Clinical School of Chinese Medicine, Gansu University of Chinese Medicine, Lanzhou 730000, China 3. Department of Nephrology, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730000, China #Co-first author: WEI Jinfeng and WEI Xiaotao

Keywords: Diabetic nephropathy Intestinal flora Chronic kidney disease Traditional Chinese medicine

DOI: 10.12173/j.issn.1004-4337.202312024

Reference: Wei JF, Wei XT, Zhang XL, Wang WW. Research progress of the relationship between intestinal flora imbalance and diabetic nephropathy and its prevention and treatment by traditional Chinese medicine[J]. Journal of Mathematical Medicine, 2024, 37(5): 371-377. DOI: 10.12173/j.issn.1004-4337.202312024[Article in Chinese]

  • Abstract
  • Full-text
  • References
Abstract

As the largest microbial pool in human body, intestinal flora is rich in species, which is closely related to the development of health and disease. The imbalance of intestinal flora has been confirmed to be related to the pathogenesis of diabetic nephropathy (DN), and the more types and quantities of intestinal conditional pathogenic bacterium, the more serious renal damage in DN patients. Intervening the structure of intestinal flora and increasing the abundance of beneficial bacteria can effectively improve renal function and renal pathological damage, prevent DN and improve the poor prognosis of end-stage renal disease. Traditional Chinese medicine in the treatment of DN has the advantages of low price, good effect, small adverse reactions, more targets and wide channels. It occupies an important position in the prevention and treatment of DN, and can combine with western medicine to achieve the advantages of learning from each other and treating both symptoms and root causes. Traditional Chinese medicine has remarkable therapeutic effect on DN by interfering with intestinal flora, but the research on external treatment of traditional Chinese medicine is relatively limited. This paper reviewed the research progress of the relationship between intestinal flora and DN, and the active ingredients of traditional Chinese medicine, traditional Chinese medicine compound and enema intervention of traditional Chinese medicine on intestinal flora, in order to provide reference for the prevention and treatment of DN by traditional Chinese medicine.

Full-text
Please download the PDF version to read the full text: download
References

1.Verma A, Patel AB, Upadhyay A, et al. CREDENCE: significant victory for diabetic kidney disease[J]. Trends Endocrinol Metab, 2020, 31(6): 391-393. DOI: 10.1016/j.tem.2020.04.002.

2.Fernandez-Prado R, Esteras R, Perez-Gomez MV, et al. Nutrients turned into toxins: microbiota modulation of nutrient properties in chronic kidney disease[J]. Nutrients, 2017, 9(5): 489. DOI: 10.3390/nu9050489.

3.Chen WH, Chen QW, Chen Q, et al. Biomedical polymers: synthesis, properties, and applications[J]. Sci China Chem, 2022, 65(6): 1010-1075. DOI: 10.1007/s11426-022-1243-5.

4.Song S, Lee JE. Dietary patterns related to triglyceride and high-density lipoprotein cholesterol and the incidence of type 2 diabetes in Korean men and women[J]. Nutrients, 2018, 11(1): 8. DOI: 10.3390/nu11010008.

5.Jeon J, Jang J, Park K. Effects of consuming calcium-rich foods on the incidence of type 2 diabetes mellitus[J]. Nutrients, 2018, 11(1): 31. DOI: 10.3390/nu11010031.

6.余江毅, 倪青, 刘苏. 糖尿病肾病病证结合诊疗指南[J]. 中医杂志, 2022, 63(2): 190-197. [Yu JY, Ni Q, Liu S, Diagnosis and treatment guidelines for diabetic nephropathy[J]. Journal of Traditional Chinese Medicine, 2022, 63(2): 190-197.] DOI: 10.13288/j.11-2166/r.2022.02.018.

7.《中国老年型糖尿病防治临床指南》编写组. 中国老年2型糖尿病防治临床指南(2022年版)[J]. 中国糖尿病杂志, 2022, 30(1): 2-51. [The Writing Committee of Chinese Clinical Guidelines for the Prevention and Treatment of Diabetes in the Elderly. Chinese clinical guidelines for the prevention and treatment of type 2 diabetes in the elderly (2022 edition) [J]. Chinese Journal of Diabetes, 2022, 30(1): 2-51.] DOI: 10.3969/j.issn.1006-6187.2022.01.002.

8.Chlebicz-Wójcik A, Śliżewska K. Probiotics, prebiotics, and synbiotics in the irritable bowel syndrome treatment: a review[J]. Biomolecules, 2021, 11(8): 1154. DOI: 10.3390/biom11081154.

9.Matos J, Matos I, Calha M, et al. Insights from bacteroides species in children with type 1 diabetes[J]. Microorganisms, 2021, 9(7): 1436. DOI: 10.3390/microorganisms9071436.

10.Mertowska P, Mertowski S, Wojnicka J, et al. A link between chronic kidney disease and gut microbiota in immunological and nutritional aspects[J]. Nutrients, 2021, 13(10): 3637. DOI: 10.3390/nu13103637.

11.Said I, Ahad H, Said A. Gut microbiome in non-alcoholic fatty liver disease associated hepatocellular carcinoma: current knowledge and potential for therapeutics[J]. World J Gastrointest Oncol, 2022, 14(5): 947-958. DOI: 10.4251/wjgo.v14.i5.947.

12.冯春念, 曾琳智, 王仕均, 等. 2型糖尿病与糖尿病肾病患者微炎症及肠道微生物多样性分析[J]. 中国微生态学杂志, 2020, 32(11): 1273-1278. [Feng CN, Zeng LZ, Wang SJ, et al. Analysis of microinflammation and intestinal microbial diversity in patients with type 2 diabetes mellitus and diabetes kidney disease[J]. Chinese Journal of Microecology, 2020, 32(11): 1273-1278.] DOI: 10.13381/j.cnki.cjm.202011006.

13.Tang G, Li S, Zhang C, et al. Clinical efficacies, underlying mechanisms and molecular targets of Chinese medicines for diabetic nephropathy treatment and management[J]. Acta Pharm Sin B, 2021, 11(9): 2749-2767. DOI: 10.1016/j.apsb.2020.12.020.

14.de A Boleti AP, de O Cardoso PH, F Frihling BE, et al. Adipose tissue, systematic inflammation, and neurodegenerative diseases[J]. Neural Regen Res, 2023, 18(1): 38-46. DOI: 10.4103/1673-5374.343891.

15.Yu ZY, Hao LY, Li ZY, et al. Correlation between slow transit constipation and spleen Qi deficiency, and gut microbiota: a pilot study[J]. J Tradit Chin Med, 2022, 42(3): 353-363. DOI: 10.19852/j.cnki.jtcm.20220408.002.

16.Wu JS, Zhang FQ, Li ZZ, et al. Integration strategy of network pharmacology in Traditional Chinese Medicine: a narrative review[J]. J Tradit Chin Med, 2022, 42(3): 479-486. DOI: 10.19852/j.cnki.jtcm.20220408.003.

17.Zhang L, Zhang Z, Xu L, et al. Maintaining the balance of intestinal flora through the diet: effective prevention of illness[J]. Foods, 2021, 10(10): 2312. DOI: 10.3390/foods10102312.

18.Wang Y, Liu H, Zheng M, et al. Berberine slows the progression of prediabetes to diabetes in zucker diabetic fatty rats by enhancing intestinal secretion of glucagon-like peptide-2 and improving the gut microbiota[J]. Front Endocrinol (Lausanne), 2021, 12: 609134. DOI: 10.3389/fendo.2021.609134.

19.Tanase DM, Gosav EM, Neculae E, et al. Role of gut microbiota on onset and progression of microvascular complications of type 2 diabetes (T2DM)[J]. Nutrients, 2020, 12(12): 3719. DOI: 10.3390/nu12123719.

20.Xiao L, Liu Q, Luo M, et al. Gut microbiota-derived metabolites in irritable bowel syndrome [J]. Front Cell Infect Microbiol, 2021, 11: 729346. DOI: 10.3389/fcimb.2021.729346.

21.Suriano F, Van Hul M, Cani PD. Gut microbiota and regulation of myokine-adipokine function[J]. Curr Opin Pharmacol, 2020, 52: 9-17. DOI: 10.1016/j.coph.2020.03.006.

22.Li J, Zhang H, Wang G. Correlations between inflammatory response, oxidative stress, intestinal pathological damage and intestinal flora variation in rats with type 2 diabetes mellitus[J]. Eur Rev Med Pharmacol Sci, 2020, 24(19): 10162-10168. DOI: 10.26355/eurrev_202010_23236.

23.Ma Q, Li Y, Li P, et al. Research progress in the relationship between type 2 diabetes mellitus and intestinal flora[J]. Biomed Pharmacother, 2019, 117: 109138. DOI: 10.1016/j.biopha.2019.109138.

24.吴国琳, 余国友, 卢雯雯. 肠道微生态的中医本质探讨[J]. 中华中医药学刊, 2015, 33(11): 2586-2588. [Wu GL, Yu GY, Lu WW. Discussion on TCM essence of intestinal microecology[J]. Chinese Archives of Traditional Chinese Medicine, 2015, 33(11): 2586-2588.] DOI: 10.13193/j.issn.1673-7717.2015.11.007.

25.Meijers BK, Evenepoel P. The gut-kidney axis: indoxyl sulfate, p-cresyl sulfate and CKD progression[J]. Nephrol Dial Transplant, 2011, 26(3): 759-761. DOI: 10.1093/ndt/gfq818.

26.Lu CC, Hu ZB, Wang R, et al. Gut microbiota dysbiosis-induced activation of the intrarenal renin-angiotensin system is involved in kidney injuries in rat diabetic nephropathy[J]. Acta Pharmacol Sin, 2020, 41(8): 1111-1118. DOI: 10.1038/s41401-019-0326-5.

27.Kumar R, Priyadarshi RN, Anand U. Chronic renal dysfunction in cirrhosis: a new frontier in hepatology[J]. World J Gastroenterol, 2021, 27(11): 990-1005. DOI: 10.3748/wjg.v27.i11.990.

28.Ochoa-Sanchez R, Oliveira MM, Tremblay M, et al. Genetically engineered E. coli Nissle attenuates hyperammonemia and prevents memory impairment in bile‐duct ligated rats[J]. Liver Int, 2021, 41(5): 1020-1032. DOI: 10.1111/liv.14815.

29.Li S, Heng X, Guo L, et al. SCFAs improve disease resistance via modulate gut microbiota, enhance immune response and increase antioxidative capacity in the host[J]. Fish Shellfish Immunol, 2022, 120: 560-568. DOI: 10.1016/j.fsi.2021.12.035.

30.Lau WL, Chang Y, Vaziri ND. The consequences of altered microbiota in immune-related chronic kidney disease[J]. Nephrol Dial Transplant, 2021, 36(10): 1791-1798. DOI: 10.1093/ndt/gfaa087.

31.Tao S, Li L, Li L, et al. Understanding the gut-kidney axis among biopsy-proven diabetic nephropathy, type 2 diabetes mellitus and healthy controls: an analysis of the gut microbiota composition[J]. Acta Diabetol, 2019, 56(5): 581-592. DOI: 10.1007/s00592-019-01316-7.

32.Gao Y, Yang R, Guo L, et al. Qing-Re-Xiao-Zheng Formula modulates gut microbiota and inhibits inflammation in mice with diabetic kidney disease[J]. Front Med (Lausanne), 2021, 8: 719950. DOI: 10.3389/fmed.2021.719950.

33.Wang R, Deng Y, Deng Q, et al. Vibrio parahaemolyticus infection in mice reduces protective gut microbiota, augmenting disease pathways[J]. Front Microbiol, 2020, 11: 73. DOI: 10.3389/fmicb.2020.00073.

34.张桥, 乐世俊, 陈艳琰, 等. 中药调节肠道菌群治疗慢性腹泻的研究进展[J]. 中草药, 2022, 53(8): 2539-2549. [Zhang Q, Le SJ, Chen YT, et al. Research progress on traditional Chinese medicine regulating gut microbiota in treatment of chronic diarrhea[J]. Chinese Traditional and Herbal Drugs, 2022, 53(8): 2539-2549.] DOI: 10.7501/j.issn.0253-2670.2022.08.031.

35.毛梦琳, 林萍, 熊林林, 等. 参苓白术散和理中汤对AAD动物模型肠道产丁酸菌群多样性变化的影响[J]. 中国实验方剂学杂志, 2021, 27(22): 23-30. [Mao ML, Lin P, Xiong LL, et al. Changes in diversity of intestinal butyrate-producing bacteria during treatment with shenling baizhusan and lizhongtang in animal model of AAD[J]. Chinese Journal of Experimental Traditional Medical Formulae, 2021, 27(22): 23-30.] DOI: 10.13422/j.cnki.syfjx.20212106.

36.张文杰, 赖星海, 陈佳薇. 山药多糖治疗肥胖糖尿病肾病大鼠的效果观察及对其肾功能和肠道微生态的影响[J]. 中国微生态学杂志, 2021, 33(1): 37-42. [Zhang WJ, Lai XH, Chen JW. Effect of yam polysaccharides in the treatment of obese diabetic nephropathy rats and its effect on renal function and intestinal microecology[J]. Chinese Journal of Microecology, 2021, 33(1): 37-42.] DOI: 10.13381/j.cnki.cjm.202101006.

37.蔡红蝶, 宿树兰, 郭建明, 等. 丹参对糖尿病肾损伤大鼠肠道菌群多样性的影响[J]. 中国中药杂志, 2021, 46(2): 426-435. [Cai HD, Su SL, Guo JM, et al. Effect of salviae miltiorrhizae radix et rhizoma on diversity of intestinal flora in diabetic nephropathy rats[J]. China Journal of Chinese Materia Medica, 2021, 46(2): 426-435.] DOI: 10.19540/j.cnki.cjcmm.20200723.402.

38.Yang J, Dong H, Wang Y, et al. Cordyceps cicadae polysaccharides ameliorated renal interstitial fibrosis in diabetic nephropathy rats by repressing inflammation and modulating gut microbiota dysbiosis[J]. Int J Biol Macromol, 2020, 163: 442-456. DOI: 10.1016/j.ijbiomac.2020.06.153.

39.Cai TT, Ye XL, Li RR, et al. Resveratrol modulates the gut microbiota and inflammation to protect against diabetic nephropathy in mice[J]. Front Pharmacol, 2020, 11: 1249. DOI: 10.3389/fphar.2020.01249.

40.姚宇剑, 倪雅丽, 李想, 等. 缩泉益肾方对糖尿病肾病小鼠肠道菌群多样性的影响[J]. 时珍国医国药, 2020, 31(8): 1846-1848. [Yao YJ, Ni YL, Li X, et al. Effect of Suoquan Yishen Decoction on intestinal flora diversity in mice with diabetic nephropathy[J]. Lishizhen Medicine and Materia Medica Research, 2020, 31(8): 1846-1848.] DOI: 10.3969/j.issn.1008-0805.2020.08.017.

41.Chen Q, Ren D, Wu J, et al. Shenyan Kangfu tablet alleviates diabetic kidney disease through attenuating inflammation and modulating the gut microbiota[J]. J Nat Med, 2021, 75(1): 84-98. DOI: 10.1007/s11418-020-01452-3.

42.Wei H, Wang L, An Z, et al. QiDiTangShen granules modulated the gut microbiome composition and improved bile acid profiles in a mouse model of diabetic nephropathy[J]. Biomed Pharmacother, 2021, 133: 111061. DOI: 10.1016/j.biopha.2020.111061.

43.Zhao T, Zhang H, Yin X, et al. Tangshen formula modulates gut Microbiota and reduces gut-derived toxins in diabetic nephropathy rats[J]. Biomed Pharmacother, 2020, 129: 110325. DOI: 10.1016/j.biopha.2020.110325.

44.Su X, Yu W, Liu A, et al. San-Huang-Yi-Shen capsule ameliorates diabetic nephropathy in rats through modulating the gut microbiota and overall metabolism[J]. Front Pharmacol, 2021, 12: 808867. DOI: 10.3389/fphar.2021.808867.

45.王毅强, 越东杰, 王俪娟, 等. 金匮肾气丸对阴阳两虚型糖尿病肾病患者的临床疗效[J]. 中成药, 2023, 45(12): 4179-4184. [Wang YQ, Yue DJ, Wang LJ, et al. The clinical effect of Jinkui Shenqi Pill on patients with diabetic nephropathy of yin and yang deficiency type[J]. Chinese Traditional Patent Medicine, 2023, 45(12): 4179-4184.] DOI: 10.3969/j.issn.1001-1528.2023.12.057.

46.孙雅娴. 早期肾功改变的2型糖尿病患者肠道菌群分析研究[D]. 大连:大连医科大学, 2017. [Sun YX. Analysis of intestinal flora of type 2 diabetic suffered from earlier change of renal function[D]. Dalian: Dalian Medical University, 2017.] https://d.wanfangdata.com.cn/thesis/ChJUaGVzaXNOZXdTMjAyNDAxMDkSCFkzMDkwNzQ2GghpanY2dnhtdg%3D%3D.

47.Ji C, Deng Y, Yang A, et al. Rhubarb enema improved colon mucosal barrier injury in 5/6 nephrectomy rats may associate with gut microbiota modification[J]. Front Pharmacol, 2020, 11: 1092. DOI: 10.3389/fphar.2020.01092.

48.徐艳文, 张莉, 李敏. 糖肾涤肠方保留灌肠治疗2型糖尿病肾病40例[J]. 浙江中医杂志, 2021, 56(9): 642. [Xu YW, Zhang L, Li M. Tangshen Dichang Decoction retention enema in the treatment of 40 cases of type 2 diabetic nephropathy[J]. Zhejiang Journal of Traditional Chinese Medicine, 2021, 56(9): 642.] DOI: 10.3969/j.issn.0411-8421.2021.09.010.

49.冯程程, 藏登, 陈茜, 等. 糖肾灌肠方经肠道干预糖尿病肾病小鼠模型的肠道菌群研究[J]. 实用中医内科杂志, 2022, 36(4): 75-79, 148-151. [Feng CC, Zang D, Chen Q, et al. Study on Tangshen Guanchang prescription intervening intestinal flora via intestine of diabetic kidney disease mice[J]. Journal of Practical Traditional Chinese Internal Medicine, 2022, 36(4): 75-79, 148-151.] DOI: 10.13729/j.issn.1671-7813.Z20210100.

Popular papers
Last 6 months