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Outline
Diabetic kidney disease (DKD) is a progressive renal complication for which effective reversal strategies remain elusive. Traditional Chinese medicine (TCM), based on the principle of "strengthening the body's defenses and expelling pathogens" demonstrates advantages in multi-targeted, holistic regulation for controlling blood glucose and improving renal function. Astragalus membranaceus, a key Qi-tonifying herb, excels at replenishing Qi, elevating Yang, promoting diuresis, and reducing edema. Its properties align closely with the core pathogenesis of DKD—Qi deficiency with retention of turbidity—making it a frequently used clinical agent for preventing and treating DKD. This systematic review of relevant literature reveals that Astragalus membranaceus, through its active components (e.g., astragaloside Ⅳ, astragalus polysaccharide, and calycosin), synergistic combinations (e.g., Astragalus membranaceus-Dioscorea opposita, Astragalus membranaceus-Cornus officinalis, Astragalus membranaceus-Caragana sinica), and formulae (e.g., Shenqi Dihuang Decoction, Yuye Decoction, Huangqi Gegen Decoction, Huangqi Liuyi Decoction, Huangqi Decoction), and related proprietary Chinese medicines like Keluxin Capsule, Shenqi Jiangtang Capsule, and Niaoduqing Granule demonstrate promising potential in DKD prevention and treatment. Its mechanisms involve regulating glucose and lipid metabolism, inhibiting oxidative stress and inflammatory responses, improving insulin resistance, and modulating multiple pathways of programmed cell death (pyroptosis/apoptosis/ferroptosis/autophagy), counteracting renal fibrosis, and alleviating endoplasmic reticulum stress. This review systematically summarizes research progress on Astragalus membranaceus and its formula combinations in intervening DKD, aiming to preliminarily elucidate the modern scientific implications of Astragalus membranaceus's "Qi-tonifying and water-draining" efficacy, providing reference for its clinical application and further investigation.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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