Research Progress on Traditional Chinese Medicine Regulating Nrf2/HO-1 Signaling Pathway in the Intervention of Diabetic Kidney Disease

Author：ZHANG Sitian1, SUN Xinyu1,2

Unit：1.The Second Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou Henan 450003, China; 2.Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou Henan 450002, China

Quote：引用：张思甜，孙新宇.中医药调控Nrf2/HO-1通路干预糖尿病肾脏病研究进展[J].中医药导报,2026,32(3):159-165,215.

DOI：10.13862/j.cn43-1446/r.2026.03.025

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Abstract：

The nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) signaling pathway plays a key role in the occurrence and development of diabetic kidney disease (DKD). Traditional Chinese medicine can intervene in factors upstream and downstream of the Nrf2/HO-1 pathway, including glutathione peroxidase 4 (GPX4), superoxide dismutase (SOD), Kelch-like ECH-associated protein 1 (Keap1), nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3), and transferrin receptor 1 (TFR-1), thereby regulating core pathological processes such as oxidative stress, inflammatory response, ferroptosis, apoptosis, and renal fibrosis, and exerting therapeutic effects on DKD. However, current studies mostly focus on cell and animal experiments with small sample sizes in clinical studies and a lack of multi-center randomized controlled trials. The composition of Chinese medicines is complex, and the specific molecular mechanisms and key targets by which they regulate the Nrf2/HO-1 pathway have not been fully clarified. In addition, studies on the correlation between syndrome differentiation and treatment and pathway regulation are insufficient and require further in-depth investigation.

Key words：diabetic kidney disease; Nrf2/HO-1; pathogenesis; traditional Chinese medicine; review

摘要：核转录因子红系2相关因子2（Nrf2）/血红素加氧酶1（HO-1）信号通路在糖尿病肾脏病（DKD）的发生发展中具有关键作用。中医药可通过干预Nrf2/HO-1上下游谷胱甘肽过氧化物酶4（GPX4）、超氧化物歧化酶（SOD）、Kelch样ECH关联蛋白1（Keap1）、核苷酸结合结构域富含亮氨酸重复序列和含热蛋白结构域受体3（NLRP3）、转铁蛋白受体1（TFR-1）等因子，调节氧化应激、炎症反应、铁死亡、细胞凋亡及肾纤维化等核心病理过程，发挥治疗DKD的作用。然而，当前研究多聚焦于细胞与动物实验，临床研究样本量小且缺乏多中心随机对照试验；中药成分复杂，其调控Nrf2/HO-1通路的具体分子机制与关键靶点尚未完全明确；辨证论治与通路调控的关联研究不足，需要进一步深入研究。

关键词：糖尿病肾脏病；Nrf2/HO-1；发病机制；中医药；综述

Release time：2026-04-22

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