肠道菌群诱发2型糖尿病合并轻度认知功能障碍  

Intestinal flora induced type 2 diabetes and mild cognitive impairment

作　　者：赵丽[1] 阎小燕[2] Zhao Li;Yan Xiaoyan

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院,山东济南250000

出　　处：《中医临床研究》2021年第21期50-52,97,共4页Clinical Journal Of Chinese Medicine

基　　金：山东省医药卫生科技发展计划项目(2015BJYB12),项目名称:益智合剂对老年2型糖尿病认知功能障碍的干预及对相关标志物影响的研究

摘　　要：胰岛素受体广泛分布于脑组织中,胰岛素/胰岛素受体可调节学习、记忆等高级脑功能活动。肠道菌群死亡裂解后释放脂多糖,释放大量炎症因子(白细胞介素-1、白细胞介素-6、肿瘤坏死因子),从而诱发宿主产生重要的炎症级联反应,引发胰岛素抵抗。胰岛素抵抗引发高血糖,大量释放白介素-6,使得更多的炎性因子攻击脑细胞并破坏神经递质乙酰胆碱的合成,从而触发神经功能障碍。肠道菌群失调引起胰岛素抵抗的机制可能是影响能量代谢、介导慢性炎症反应及免疫反应等。消渴病机为阴津亏损,燥热偏盛,其病位尤以肾为关键,“消渴”并“呆病”皆根于肾。消渴病阴精亏损日久以致脑海失充,髓减脑消,进而发展为“呆病”;另一方面,病久入络,血脉瘀滞,痹阻脑络,神机失用,亦可逐渐发展为“呆病”。因此,2型糖尿病合并轻度认知功能障碍的中医主要病机为脾虚络瘀,肾虚髓减,胃衰痰生,弥漫心窍,使神明受累,髓减脑消而为病。中药、中药有效成分及中药复方具有多种生物活性,可调节菌群比例来代谢中药,调节药效,具有安全性高、效果好的优势。益智合剂重视阴阳双补,气血同调,可以发挥调节身体内环境的稳定并促进各功能的良性循环,同时不具有西药所带来的负面影响,具有明显的优势。Insulin receptors are widely distributed in brain tissues,and insulin/insulin receptors can regulate higher brain functions such as learning and memory.Lipopolysaccharides are released after the death and lysis of intestinal flora releases a large number of inflammatory factors(interleukin-1,interleukin-6,and tumor necrosis factor),thus inducing the host to produce an important inflammatory cascade and triggering insulin resistance.High blood sugar,triggered by insulin resistance,releases interleukin-6 in large quantities,causing more inflammatory factors to attack brain cells and disrupt the production of the neurotransmitter acetylcholine,triggering neurological dysfunction.The mechanism of insulin resistance caused by intestinal flora imbalance may be influencing energy metabolism,mediating chronic inflammatory response and immune response,etc.The pathogenesis of quenching thirst is yin and jin deficit and excessive heat,especially the kidney is the key."Quenching thirst"and"idle disease"are all rooted in the kidney.For a long time,the deficiency of yin and essence leads to the loss of brain filling,which leads to the decrease of marrow and brain elimination,and then develops into"idle disease".On the other hand,the disease will enter into collaterals for a long time,blood stasis,blockage of cerebral collaterals,and loss of the magic machine can also gradually develop into"idle disease".Therefore,the main pathogenesis of type 2 diabetes combined with mild cognitive impairment in TCM is spleen deficiency and collateral stasis,deficiency of kidney marrow,phlegm growth due to stomach failure,diffuse the mind and body,involving the deities,and decrease of marrow and brain,thus becoming a disease.Traditional Chinese medicine,active ingredients of traditional Chinese medicine and traditional Chinese medicine compound have a variety of biological activities,which can adjust the proportion of bacteria to metabolize traditional Chinese medicine,regulate the efficacy with high safety and good effect advantages.Yizhi mix

关 键 词：肠道菌群 胰岛素抵抗 2型糖尿病 轻度认知功能障碍 益智合剂 

分 类 号：R255.4[医药卫生—中医内科学]