MingJie Wu of Fengyang TCM - The mechanism and clinical application of Danggui Shaoyao decoction in treating kidney disease and reducing creatinine
Danggui Shaoyao Decoction (当归芍药汤), originating from the ancient Chinese medical text Jin Gui Yao Lue (《金匮要略》), comprises six herbs: Angelica sinensis (Danggui), Ligusticum chuanxiong (Chuanxiong), Paeonia lactiflora (Baishao), Atractylodes macrocephala (Baizhu), Poria cocos (Fuling), and Alisma orientale (Zexie). Traditionally, it is used to harmonize the nutritive and defensive Qi, nourish blood, and strengthen the spleen to promote urination. Modern research indicates that this formula may have therapeutic effects in reducing serum creatinine levels and improving kidney function in patients with chronic kidney disease (CKD).
Mechanisms of Action:
1. Improvement of Renal Hemodynamics: Herbs like Danggui, Chuanxiong, and Baishao possess blood-activating properties that can enhance microcirculation in the glomeruli, reduce hyperperfusion and hyperfiltration, protect the glomerular basement membrane, and slow the progression of glomerulosclerosis.
2. Diuretic Effect and Promotion of Metabolite Excretion: Baizhu, Fuling, and Zexie have spleen-strengthening and diuretic effects, which help alleviate fluid retention, increase urine output, and facilitate the excretion of metabolic waste products such as creatinine, thereby lowering serum creatinine levels.
3. Anti-inflammatory and Immunomodulatory Effects: Components like Danggui and Baishao can modulate immune responses and inhibit the expression of inflammatory cytokines such as TNF-α, IL-6, and IL-1β, reducing inflammation-induced renal damage.
4. Antioxidant and Antifibrotic Properties: Herbs including Baishao, Danggui, and Fuling exhibit antioxidant activities and can inhibit the TGF-β1 signaling pathway, thereby reducing renal interstitial fibrosis and slowing the deterioration of kidney function.
Clinical Application:
Danggui Shaoyao Decoction is commonly employed in the management of CKD, particularly in patients presenting with proteinuria, edema, and elevated serum creatinine levels. Clinical studies have demonstrated that this formula can effectively reduce 24-hour urinary protein excretion, urinary albumin excretion rate, serum creatinine, and blood urea nitrogen levels, thereby improving renal function with a favorable safety profile.
Precautions:
When administering Danggui Shaoyao Decoction, it is essential to tailor the treatment to the individual patient’s condition, adjusting the herbal composition as necessary. Regular monitoring of blood pressure, blood glucose, lipid profiles, and other relevant parameters is recommended to comprehensively assess the treatment’s efficacy and safety.
In summary, Danggui Shaoyao Decoction, through its multifaceted mechanisms of action, shows promising clinical efficacy in lowering serum creatinine and enhancing kidney function. It holds significant potential for broader application in the integrative management of chronic kidney disease.
