糖尿病肾病（diabetic nephropathy，DN）是糖尿病最常见的并发症之一，最终可能导致终末期肾病。黄芪多糖是黄芪的主要有效成分，近年来被证实具有抗氧化应激、抗炎和免疫调节等功效。基于黄芪多糖可清除活性氧、调节腺苷酸活化蛋白激酶信号通路、抑制炎症因子释放、调节免疫应答等多维度药理作用，其可降低DN患者因氧化应激导致的肾损伤，减轻肾脏的炎症反应，并改善免疫微循环，最终保护患者的肾功能，延缓DN的进程。但黄芪多糖为酸性杂多糖及葡聚糖大分子混合物，其膜渗透性差，口服生物利用度低，所以临床应用受到了限制。通过基于黄芪多糖的多维度药理作用，综述黄芪多糖治疗DN的作用机制，并对黄芪多糖的剂型研究进行总结，为黄芪多糖用于DN提供参考和指导。

Diabetic nephropathy (DN) is one of the most common complications of diabetes, which may eventually lead to end-stage renal disease. Astragalus polysaccharides (APS) are the main active components of Huangqi (Astragali Radix) and have been proven to possess multiple functions such as antioxidative stress, anti-inflammation and immunomodulation in recent years. Based on the multi-dimensional pharmacological effects of scavenging reactive oxygen species and regulating adenosine monophosphate activated protein kinase signaling pathway, inhibiting the release of inflammatory factors, and regulating immune responses, APS can reduce the renal injury caused by oxidative stress in patients with DN, reduce the inflammatory response of the kidneys, improve the immune microcirculation, exhibit renal protective effects, and ultimately delay the progression of DN. However, APS are macromolecular mixtures by acidic heteropolysaccharides and dextran, with poor membrane permeability and low oral bioavailability, which limit their clinical application. This article reviews the mechanism of action of APS in treatment of DN based on their multi-dimensional pharmacological effects and summarizes the research on the formulations of APS, which provide reference and guidance for the application of APS in DN.

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国家自然科学基金青年基金项目（82003665）;广东省学位与研究生教育改革研究项目（2023JGXM_087）