Research progress in the treatment of lipid metabolism disorder in patients with diabetic kidney disease by the integrated traditional Chinese and Western medicine

Abstract

Diabetic kidney disease (DKD) is one of the most common and severe chronic microvascular complications of diabetes mellitus (DM). The pathogenesis of DKD is complex, and lipid metabolism disorders play an important role in the pathogenesis of DKD. DKD belongs to the category of "kidney deficiency", "edema", "guan ge" and other pathological factors secondary to "thirst quenching disease" in traditional Chinese medicine. The pathological factors mainly focus on blood stasis and toxicity, which is consistent with modern medical theory. At present, the efficacy and safety of integrated traditional Chinese and Western medicine in treating lipid metabolism disorders in patients with DKD have been extensively studied and confirmed. In this review, the application and possible mechanism of traditional Chinese patent medicines (Bailing Capsule, Shenyan Kangfu Tablets, Jinshuibao Capsule, Huangkui Capsule, Yi-Shen-Hua-Shi granule, Shenmai injection), Chinese medicine compound (Tangshen Formula, Danggui Buxue Decoction, Tangshenkang), single Chinese medicine (Astragalus membranaceus, Panax notoginseng, Salvia miltiorrhiza) combined with Western medicine in the treatment of DKD with lipid metabolism disorder were discussed, in order to provide ideas for clinical diagnosis and treatment of patients with DKD with lipid metabolism disorder.

Keywords: Chinese medicine compound; diabetic kidney disease; integrated traditional Chinese and Western medicine; lipid metabolism disorder; single Chinese medicine; traditional Chinese patent medicines.

Figure 1

The mechiasm of lipid accumulation. TGs from the diet are decomposed into free fatty acids (FFAs) and glycerol in the cytoplasm. After being stimulated by FFA, the expression of CD36 is upregulated in podocytes, speeding up the transport of CD36 from the cytoplasm to the cell membrane. Fatty acids (FAs) undergo beta oxidation in cells, also called FA oxidation (FAO), then form acetyl-CoA or are stored in the form of lipid droplets (LD), while glycerol directly enters the glycolytic pathway. If too much acetyl-CoA is produced, the tricarboxylic acid cycle (TCA cycle) will overload, provoking the conversion of acetyl-CoA to ketone bodies. if glucose levels are high, excess acetyl-CoA can be transformed into FAs, TG, cholesterol, steroids, and bile salts, a process known as adipogenesis.