2型糖尿病合并肌少症发病机制及中医药治疗进展  

Pathogenesis of Type 2 Diabetes Mellitus Complicated with Sarcopenia and Progress of Treatment in Traditional Chinese Medicine

作　　者：王琪 雷涛[2] 徐媛颖 张翠平[2] 沙雯君 陈琳[2] WANG Qi;LEI Tao;XU Yuanying;ZHANG Cuiping;SHA Wenjun;CHEN Lin(Shanghai University of Chinese Medicine,Shanghai 201203,China;Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学,上海201203 [2]上海中医药大学附属普陀医院,上海200062

出　　处：《山东中医药大学学报》2022年第1期129-136,共8页Journal of Shandong University of Traditional Chinese Medicine

基　　金：上海市卫计委临床研究专项(面上)(编号:201840345);上海市医学重点专科项目(编号:ZK2019B16)。

摘　　要：2型糖尿病与肌少症关系密切,2型糖尿病可通过多种途径影响肌少症的发生、发展,概述了胰岛素抵抗、炎症反应、脂质沉积、线粒体损伤等与2型糖尿病合并肌少症的相关性。中医认为2型糖尿病归属消渴范畴,病机与五脏衰弱、脾肾不足相关。肌少症在中医理论中可归类于痿证、虚劳的范畴,病机与脾肾不足、五脏衰败有关。两者病本在脾胃亏虚、肾气乏力,治以调理脾肾法,兼以解郁化瘀,临床常用八珍汤、补中益气汤、济生肾气丸、血府逐瘀汤等方剂。并综述了单味中药如黄芪、人参、当归、五味子、枸杞子等能通过抑制炎症因子、改善胰岛素抵抗等途径治疗2型糖尿病合并肌少症。参考文献84篇。Type 2 diabetes mellitus(T2DM)is closely related to sarcopenia.T2DM can affect the occurrence and development of sarcopenia through many ways.Insulin resistance,inflammatory reaction,lipid deposition,mitochondrial damage,and other factors are linked to the occurrence of T2DM combined with sarcopenia.In traditional Chinese medicine(TCM),T2DM belongs to the category of consumptive thirst.The Pathogenesis is linked to weakness of five zang-organs,and deficiency of spleen and kidney.Sarcopenia belongs to the category of atrophy disease or consumptive disease.Its pathogenesis in related to deficiency of spleen and kidney,and decline of five zang-organs.Deficiency of spleen and stomach,weakness of kidney qi are the pathogenesis root in both diseases.Therefore the treatment should be stressed on regulating spleen and kidney,resolving depression and promoting blood circulation.Bazhen Decoction(八珍汤),Buzhong Yiqi Decoction(补中益气汤),Jisheng Shenqi Pills(济生肾气丸),and Xuefu Zhuyu Decoction(血府逐瘀汤),etc.are commonly used in clinical practice.This paper also reviews the treatment of T2DM combined with sarcopenia by using single Chinese herbal medicine,such as Huangqi(Astragali Radix),Renshen(Ginseng Radix et Rhizoma),Danggui(Angelicae sinensis Radix),Wuweizi(Schisandrae Chinensis Fructus),Gouqizi(Lych Fructus),etc.through inhibiting inflammatory factors and improving insulin resistance.There are 84 references in total.

关 键 词：2型糖尿病 消渴 肌少症 胰岛素抵抗 炎症反应 脂质沉积 脾肾不足 五脏衰败 八珍汤 补中益气汤 

分 类 号：R259.871[医药卫生—中西医结合] R259.92[医药卫生—中医内科学]