糖尿病肾脏疾病（diabetic kidney disease，DKD）是糖尿病常见的微血管并发症，其发病机制复杂，涉及多种病理过程。近年来，非编码RNA（non-coding RNA，ncRNA）在DKD发生发展中的调控作用备受关注，包括微小RNA、长链非编码RNA和环状RNA等，它们通过影响基因表达、信号通路及细胞功能参与DKD的进展。研究发现，黄芪多糖可通过靶向长链非编码RNA（long non-coding RNA，lncRNA）Gm41268/催乳素受体促进自噬并缓解DKD，黄连可通过lncRNA CLYBL-AS2-miR-204-5p-SNAI1轴抑制DKD的上皮-间质转化和纤维化发生，中药具有多靶点、多途径的作用特点，通过调控ncRNA在DKD防治中展现出独特优势。综述了中药通过干预ncRNA网络调控DKD的潜在分子机制，旨在为DKD的靶向治疗提供新思路，并凸显中医药在表观遗传调控领域的应用前景。未来研究需进一步结合高通量测序和生物信息学技术，深入探索中药-ncRNA-靶基因的相互作用网络，以推动中药现代化及精准治疗的发展。

Diabetic kidney disease (DKD) is a common microvascular complication of diabetes mellitus, and its pathogenesis is complex and involves multiple pathological processes. In recent years, much attention has been paid to the regulatory role of non-coding RNAs (ncRNAs) in the development of DKD, including microRNAs (miRNAs), long non-coding RNAs (lncRNAs) and circular RNAs, which are involved in the progression of DKD by affecting gene expression, signaling pathways and cellular functions. It was found that astragalus polysaccharide could promote autophagy and alleviate DKD by targeting lncRNA Gm41268/prolactin receptor, and Coptidis Rhizoma could inhibit the epithelial-mesenchymal transition and fibrogenesis of DKD through lncRNA CLYBL-AS2-miR-204-5p-SNAI1 axis. Traditional Chinese medicines (TCMs), with their multi-targeted, multi-pathway action characteristics, by regulating ncRNAs in the DKD prevention and treatment showed unique advantages. This review summarized the potential molecular mechanisms of TCMs in regulating DKD through interfering with the ncRNA network, aiming to provide new ideas for the targeted treatment of DKD and highlighting the application prospects of TCM in the field of epigenetic regulation. Future studies need to further combine high-throughput sequencing and bioinformatics technologies to explore the TCM-ncRNA-target gene interaction network in depth, in order to promote the modernization of Chinese medicines and the development of precision therapy.

R284.1

国家自然科学基金面上项目(82174362); 中国中医科学院科技创新工程重大攻关项目(CI2021A01208);中国中医科学院西苑医院能力提升项目(XYZX0201-20)