基于肠道菌群探讨葛根芩连汤改善胰岛素抵抗的作用机制  

The mechanism of Gegen Qinlian Decoction improving insulin resistance based on intestinal flora

作　　者：程瑞 李力 冯志海[1] 董贤慧 牧亚峰 贾慧雨 CHENG Rui;LI Li;FENG Zhihai;DONG Xianhui;MU Yafeng;JIA Huiyu(He'nan University of Chinese Medicine,Zhengzhou,He'nan 450000,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450000 [2]杭州师范大学附属医院

出　　处：《中国微生态学杂志》2024年第7期847-854,共8页Chinese Journal of Microecology

基　　金：浙江省“尖兵”“领雁”研发攻关计划项目(2022C03138);杭州师范大学科研启动项目(2018QDL038)。

摘　　要：葛根芩连汤由葛根、黄芩、黄连和甘草四味药物组成,具有解表清里的功效,是治疗肠道湿热型下痢的经典名方,目前临床上根据“异病同治”的原则用于治疗2型糖尿病和肥胖等与胰岛素抵抗(insulin resistance,IR)相关的代谢性疾病,但作用机制尚不明确。现代研究证明,葛根芩连汤能够增加肠道内短链脂肪酸产生菌等益生菌,减少致病菌,调节肠道菌群的结构、丰度和代谢产物,修复受损的肠黏膜,保护肠道屏障功能,从而减少脂多糖进入血液循环,抑制其引发的炎症级联反应,起到提高胰岛素敏感性,改善IR,调节糖脂代谢的作用。本文就肠道菌群与IR的关系、葛根芩连汤通过调节肠道菌群治疗IR的基础和临床研究进行综述。Gegen Qinlian Decoction(GQD)is a classic traditional Chinese medicine(TCM)prescription treating intestinal dampness-heat syndrome in dysentery,which has the effect of relieving superficies and clearing interior.The GQD is composed of Radix puerariae,Radix scutellariae,Rhizoma coptidis and Radix glycyrrhizae.According to the principle of"homotherapy for heteropathy to different diseases",GQD is used clinically to treat type 2 diabetes,obesity and other metabolic diseases related to insulin resistance(IR),while the mechanism remains unclear.Modern studies have proved that GQD can increase probiotics such as short chain fatty acids producing bacteria and reduce pathogenic bacteria to regulate the structure,abundance and metabolites of intestinal flora,repair damaged intestinal mucosa,protect intestinal barrier function,and then reduce the lipopolysaccharide entering the blood circulation,thus inhibiting the inflammatory cascade reaction caused by it,playing a role in increasing insulin sensitivity,improving IR and regulating the homeostasis of glucose and lipid metabolism.Therefore,this article reviews the relationship between intestinal flora and IR,as well as the basic and clinical research on GQD regulating intestinal flora to treat IR.

关 键 词：葛根芩连汤 肠道菌群 胰岛素抵抗 代谢性疾病 

分 类 号：R285[医药卫生—中药学]