中药降糖机制研究进展  

Research on Hypoglycemic Mechanism of Traditional Chinese Medicine

作　　者：温志歌 张珊 倪青[1] WEN Zhige;ZHANG Shan;NI Qing(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《世界中医药》2024年第4期594-599,共6页World Chinese Medicine

基　　金：国家自然科学基金面上项目(82174354);中央高水平中医医院临床科研业务费资助项目(HLCMHPP2023084)。

摘　　要：糖尿病(DM)是由于胰岛素缺乏导致血液葡萄糖升高的代谢性疾病。胰岛素抵抗(IR)导致胰岛素分泌相对不足和利用障碍;胰岛B细胞功能下降,导致胰岛素分泌绝对不足,导致血糖蓄积。中药降糖临床疗效确切,作用机制有待阐明。中药可能通过多途径、多靶点改善IR、保护胰岛B细胞功能,从而改善糖脂代谢,治疗糖尿病。本文基于近10年中药(中药活性成分、单味药、复方)降糖的研究型文献,围绕中药从抗氧化应激、抗炎、调控葡萄糖转运通路、调节肠道菌群、抑制异位脂沉积、抑制脂肪组织巨噬细胞外泌体改善IR,刺激胰岛素分泌、调控胰岛B细胞分化、损伤、凋亡、再生以保护胰岛B细胞功能2大方面,系统梳理、归纳总结中药潜在降糖机制,并立足当前中药降糖研究领域,分析目前存在问题,探索未来发展趋势和方向,为进一步探索中药治疗DM基础研究提供参考。Diabetes mellitus(DM)is a metabolic disease characterized by blood glucose elevation due to insulin deficiency.Insulin resistance(IR)leads to relatively insufficient insulin secretion and impaired utilization;the decline in the function of pancreatic beta cells leads to absolute insufficient insulin secretion and blood sugar accumulation.The clinical curative effect of traditional Chinese medicine(TCM)on hypoglycemia is definite,but the mechanism remains to be elucidated.TCM may improve IR and protect the function of pancreatic beta cells through multiple channels and multiple targets,thereby improving glucose and lipid metabolism and treating diabetes.Based on the research literature on hypoglycemia of TCM(active ingredients of TCM,single herbal medicine,and compound prescription)in recent ten years,this article systematically sorted out and summarized the potential hypoglycemic mechanism of TCM by focusing on anti-oxidative stress,anti-inflammation,regulation of glucose transport pathways,regulation of intestinal flora,inhibition of ectopic lipid deposition,and inhibition of adipose tissue macrophage exosomes to improve IR,stimulate insulin secretion,and regulate pancreatic beta cell differentiation,injury,apoptosis,and regeneration,so as to protect pancreatic beta cell function.Based on the current research field of the hypoglycemic effect of TCM,this article analyzed the existing problems,explored the future development trend and direction,and provided a reference for further exploration of basic research on the treatment of DM with TCM.

关 键 词：中药 降糖 作用机制 胰岛素抵抗 胰岛B细胞 保护 分化 中医理论 

分 类 号：R255.4[医药卫生—中医内科学]