Volume 10,Issue 4
Integrative Management of CKD-Related Sarcopenia: Mechanisms and Clinical Efficacy of She Ethnic Medicine (Jianpi Yishen Tea) Combined with Resistance Training
Objective: This study systematically elucidates the clinical efficacy, molecular mechanisms, and translational value of Jianpi Yishen Tea—a characteristic formula of She ethnic medicine—combined with resistance exercise in the management of sarcopenia associated with chronic kidney disease (CKD). Methods: Guided by the 2024 Expert Consensus on the Diagnosis, Treatment, and Prevention of Sarcopenia in Chronic Kidney Disease, we conducted a comprehensive review of domestic and international literature from the past five years. Moving beyond a reductionist perspective, this study performs a panoramic analysis of the pathological network underpinning CKD-related sarcopenia, covering pharmacokinetics of uremic toxins, micro-inflammatory cascades, mitochondrial quality control (MQC) homeostasis, and the "Gut-Kidney-Muscle" axis. Subsequently, an evidence-based evaluation of the combined intervention was performed. Results: Current evidence identifies the pathological core of CKD-related sarcopenia as systemic metabolic and immune dysregulation, clinically manifesting as "Spleen-Kidney deficiency combined with damp-turbidity and stasis." Modern pharmacological research confirms a synergistic "drug-exercise coupling" effect between Jianpi Yishen Tea (containing Chimonanthus nitens, Astragalus membranaceus, etc.) and resistance training. This combined protocol specifically inhibits the NF-κB signaling pathway—thereby blocking inflammatory storm-mediated muscle protein degradation—and significantly upregulates PGC-1α expression. Consequently, this restores mitochondrial function across three dimensions: biogenesis, fusion-fission dynamics, and mitophagy. Furthermore, the therapy remodels the gut microbiota, reducing the accumulation of gut-derived toxins such as indoxyl sulfate. Clinical data demonstrate that compared to monotherapy, this integrated regimen yields superior outcomes in reversing skeletal muscle atrophy, ameliorating the decline in estimated glomerular filtration rate (eGFR), and reducing all-cause mortality. Conclusion: The integration of She medicine (Jianpi Yishen Tea) with resistance exercise establishes a precision-based, multi-targeted intervention model. This strategy leverages the unique wisdom of ethnic medicine to disrupt the vicious cycle of sarcopenia in CKD, offering a novel, evidence-based therapeutic paradigm.
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