通讯作者: 蔡旭东, 3148004878@qq.com

DOI：10.12201/bmr.202407.00027

Macrophage Polarization Affects Chronic Kidney Disease:Based on Theory of “Harmful Hyperactivity and Responding Inhibition”

• 摘要：肾纤维化是慢性肾脏病(Chronic Kidney Disease, CKD)的主要病理学基础,炎症反应是肾纤维化发生发展的重要环节。巨噬细胞作为机体炎症反应的重要调节细胞,具有异质性和可塑性的特点,能够根据机体微环境改变极化成不同表型,参与CKD肾纤维化发展过程。“亢害承制”理论是用于认识疾病发生、发展和转归以及指导辨证施治的重要中医基础理论之一。CKD巨噬细胞极化发生机制高度契合“承者失制,亢者为害”的过程。笔者拟从理论内涵、西医发病机制、中医病机、中西医结合治疗等方面阐述巨噬细胞极化在肾纤维化发展中的作用,提出“承而制之,平亢除害”法治疗CKD,采用补益脾肾以固本,扶正治本以复承制；辅以化痰祛湿、活血化瘀、祛浊解毒等平亢除害,通过调控巨噬细胞极化改善肾脏炎症反应,以期为临床研究提供参考意见,同时为中西医结合防治CKD提供新思路。

  关键词： 亢害承制; 巨噬细胞极化; 炎症反应; 慢性肾脏病; 肾纤维化; 内环境稳态; 生克制化

   

  Abstract: Renal fibrosis serves as the primary pathological foundation of chronic kidney disease, with the inflammatory response playing a crucial role in its progression. Macrophages, key regulatory cells in the inflammatory response, exhibit heterogeneity and plasticity, allowing them to polarize into various phenotypes based on the organisms microenvironmental changes, thereby contributing to the development of renal fibrosis in chronic kidney disease. The theory of harmful hyperactivity and responding inhibition is a fundamental concept in traditional Chinese medicine that plays a crucial role in understanding the progression and regression of diseases, as well as guiding their diagnosis and treatment. The correlation between macrophage polarization in chronic kidney disease and the concept of uncontrolled hyperactivity causing harm aligns closely with this theory. The author seeks to elucidate the significance of macrophage polarization in the progression of renal fibrosis by examining theoretical connotations, pathogenesis in Western medicine, pathogenesis in traditional Chinese medicine, and the integration of traditional Chinese and Western medical approaches. Additionally, the author proposes the method of bearing and restraining, leveling hyperactivity, and eliminating harmful effects for the management of chronic kidney disease. The treatment was implemented to strengthen the spleen and kidney in order to enhance the essence, address the underlying issue, and promote overall health; complemented by actions such as resolving phlegm, eliminating dampness, improving blood circulation, removing blood stasis, dispelling turbidity, detoxifying toxins, and calming hyperactivity to mitigate harm. his study aims to enhance the inflammatory response of the kidney by modulating macrophage polarization, offering valuable insights for clinical research. Additionally, it proposes a novel approach for preventing and treating chronic kidney disease by integrating traditional Chinese and Western medicinal practices.

  Key words: harmful hyperactivity and responding inhibition; macrophage polarization; inflammatory response; chronic kidney disease; renal fibrosis; homeostasis of the internal environment; interaction of generation, restriction, control, and transformation

  提交时间：2024-07-14

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• 序号	提交日期	编号	操作
  1	2024-06-22	bmr.202407.00027V1	下载

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