基于“少火生气,壮火食气”理论探析2型糖尿病进程中胰岛巨噬细胞对β细胞功能变化的影响  

Effect of islet macrophages on β-cell function changes during type 2 diabetes mellitus progression based on the"moderate fire generating qi,hyperactive fire consuming qi"theory

作　　者：张钰莹 黄薇宇 袁颢瑜 王保华[2] 李赛美[2] ZHANG Yuying;HUANG Weiyu;YUAN Haoyu;WANG Baohua;LI Saimei(The First Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;The First Affiliated Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一临床医学院,广州510006 [2]广州中医药大学第一附属医院

出　　处：《北京中医药大学学报》2025年第1期14-20,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金项目(No.82104791);广东省基础与应用基础研究基金面上项目(No.21202104030001057)。

摘　　要：本文基于“少火生气,壮火食气”理论探讨2型糖尿病(T2DM)进程中胰岛巨噬细胞对β细胞功能变化的影响。T2DM与慢性低度炎症密切相关,胰岛巨噬细胞在这一过程中发挥关键作用。生理状态下,胰岛巨噬细胞通过分泌抗炎因子和生长因子,适度调节免疫反应,促进细胞增殖,维持胰岛β细胞的存活和功能,发挥类似于“少火生气”的作用。在T2DM的病理过程中,胰岛巨噬细胞过度活化,功能失调,分泌大量促炎因子,引发严重的炎症反应和氧化应激,直接损伤胰岛β细胞,并破坏胰岛微环境和血供,加剧局部炎症和结构损伤,恶化β细胞的生存环境,最终导致胰岛β细胞的数量减少和功能丧失,与“壮火食气”理论中亢盛之火导致机体气血耗伤的过程相吻合。本文探讨中医学理论在西医学中的理解与应用,并为T2DM的防治提供了新的视角,调控胰岛巨噬细胞功能、减弱其促炎反应,可能成为保护β细胞功能、延缓T2DM进程的关键策略。This study examined the effect of islet macrophages onβ-cell function changes during type 2 diabetes mellitus(T2DM)progression based on the traditional Chinese medicine theory that"moderate fire generating qi,hyperactive fire consuming qi".T2DM is closely associated with chronic low-grade inflammation,with islet macrophages playing a central role in this process.Under physiological conditions,islet macrophages secrete anti-inflammatory and growth factors to regulate the immune response,promote cell proliferation,and support islet β-cell survival and function,reflecting the concept of"moderate fire generating qi".However,during the pathological process of T2DM,islet macrophages become over-activated and dysfunctional,secreting large amounts of pro-inflammatory factors that trigger severe inflammatory responses and oxidative stress.This process damages islet β-cells,disrupts the islet microenvironment and blood supply,exacerbates local inflammation and structural damage,and worsens the survival environment of β-cells.Ultimately,this leads to fewer β-cells and function loss,aligning with the"hyperactive fire consuming qi"theory,where excessive fire depletes qi and blood.This study enhances the understanding and application of traditional Chinese medicine theories in modern medicine,offering a new perspective on T2DM prevention and treatment.Regulating islet macrophage function and reducing their pro-inflammatory responses may become key strategies for preserving β-cell function and slowing T2DM progression.

关 键 词：2型糖尿病 胰岛巨噬细胞 胰岛Β细胞 少火生气 壮火食气 

分 类 号：R259.871[医药卫生—中西医结合]