慢性肾脏病(chronic kidney disease，CKD)逐渐成为人们所关注的健康问题，预计将成为全球主要的死亡原因。蛋白质能量消耗(protein energy wasting，PEW)是CKD患者常见的并发症，使患者的生存质量严重下降，在CKD和终末期肾脏疾病(end stage renal disease，ESRD)的患者中出现肌肉痿废不用、肌肉减少和恶病质均会加重PEW的发病率，PEW与CKD患者的病情进展和病死率密切相关。在中医五脏学说中指出，脾在体合肉，主运化水谷精微以滋养四肢肌肉，健脾益肾可以改善PEW患者的肌肉萎软无力、食欲下降的状态。炎症和尿毒症毒素是造成PEW最主要的两个因素，因而基于脾主肌肉理论通过改善微炎症状态和调节肠道菌群，为延缓CKD的进展提供了一种治疗思路。
Research Progress of Protein Energy Wasting in Chronic Kidney Disease
Chronic kidney disease(CKD)has gradually become a health problem that people pay attention to.The incidence rate also increases,and is expected to become the main cause of death worldwide.Protein Energy Wasting(PEW)is a common complication of CKD patients,which severely reduces the quality of life of patients.Muscle impotence and disuse,muscle reduc-tion and cachexia in patients with CKD and End Stage Renal Disease(ESRD)will increase the incidence rate of PEW.PEW is closely related to the disease progress and mortality of CKD patients.In the theory of the five zang organs in traditional Chinese medicine,it is pointed out that the spleen integrates the body with the flesh,mainly transports and transforms water and grain es-sence to nourish the muscles of the limbs.Strengthening the spleen and tonifying the kidney can improve the muscle weakness and decreased appetite of PEW patients.Inflammation and Uremia toxin are the two main factors that cause PEW.Therefore,based on the theory of spleen governing muscle,it provides a therapeutic idea to delay the progress of CKD by improving the mi-cro inflammatory state and regulating Gut microbiota.
chronic kidney diseaseprotein energy wastingspleen governing musclepathogenesiswestern medicine preven-tion and treatmenttraditional Chinese medicine prevention and treatment
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