糖尿病血糖波动的中医理论和方剂研究进展  

TCM Research of Theories and Prescriptions on Blood Glucose Fluctuation in Diabetes Mellitus:A Review

作　　者：朱泳江 富晓旭[1,2,3] 谢红艳 谢春光[2,3] ZHU Yongjiang;FU Xiaoxu;XIE Hongyan;XIE Chunguang(Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610072,China;Hospital of Chengdu University of TCM,Chengdu 610072,China;TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province,Chengdu 610072,China)

机构地区：[1]成都中医药大学,成都610072 [2]成都中医药大学附属医院,成都610072 [3]代谢性疾病中医药调控四川省重点实验室,成都610072

出　　处：《中国实验方剂学杂志》2025年第8期303-310,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(82374404);国家中医药管理局人才支持项目-岐黄学者(国中医药人教函[2022]6号);国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202209)。

摘　　要：查阅并综述近10年糖尿病血糖波动的中医药文献,梳理并总结血糖波动的中医理论和方剂研究进展,为后续的中医药理论探索、基础研究和临床防治提供参考。血糖波动是糖尿病慢性并发症的独立危险因素,其相关的中医理论和方剂研究已取得长足发展。中医理论包括“脾胰同源”“肝主疏泄”“小肠气化与泌别清浊”和“一气周流”“玄府气液”“阴火理论”等,均以“气”为关键;方剂研究主要为临床试验,平均血糖波动幅度等各类血糖波动指标及经方、自拟方广泛使用,汤剂、颗粒剂、胶囊等剂型运用丰富,“气阴两虚”是血糖波动的主要证型;基础研究则着眼于改善血糖波动和减少慢性并发症的机制探索,如可以通过肾素-血管紧张素系统去调控胰岛β细胞功能、通过转化生长因子-β1以减少脏器纤维化等。然而,中医理论的证据支撑和证候研究,方剂临床研究的高级别循证评价、多种剂型的疗效比较及如何与更多中医理论结合,方剂基础研究的开展数量、多层次验证、血糖波动模型建立和干预的标准及方-证对应,临床和基础研究的结合互补等尚有不足。中医药理论丰富、手段多样、疗效确切,是改善血糖波动、减少糖尿病慢性并发症的新突破口。A systematic review of the traditional Chinese medicine(TCM)literatures published over the past decade on blood glucose fluctuations in diabetes mellitus was conducted to summarize related TCM research progress of theories and prescriptions,so as to provide references for future TCM theoretical exploration,basic research,and clinical prevention and treatment.Blood glucose fluctuation is an independent risk factor for chronic complications of diabetes mellitus,with significant progress made in TCM theories and prescription studies targeting this condition.The TCM theories include"spleen-pancreas homology","liver controlling dispersion","small intestine transforming qi and separating purity from turbidity","Yi Qi Zhou Liu theory","Xuan Fu Qi Ye theory","Yin-fire theory"and so on,all of which emphasize"Qi".Prescription studies primarily utilize clinical trials,which evaluate plentiful indexes of blood glucose fluctuation such as the mean amplitude of glycemic excursion.Classical and self-formulated prescriptions are widely used,with various dosage forms such as decoctions,granules and capsules."Qi-Yin deficiency"is the main syndrome of blood glucose fluctuation.Basic research focuses on mechanisms that improve blood glucose fluctuation and reduce chronic complications,such as the renin-angiotensin system regulating isletβcell's function,and the transforming growth factor-β1 inhibiting organ fibrosis.However,there are still some deficiencies in the evidential support and syndrome study of TCM theories,in the high-level evidence-based evaluation,efficacy comparison among multiple dosage forms,and the integration of TCM theories with prescription's clinical research,in the quantities,multi-level verifications,blood glucose fluctuation model establishment and intervention criteria as well as prescription-syndrome correspondence of prescription's basic research,and in the collaboration between clinical and basic research.Despite these challenges,TCM offers a promising approach to improving blood glucose fluctuation and

关 键 词：血糖波动 病机 方剂 研究进展 综述 

分 类 号：R2-031[医药卫生—中西医结合] R287[医药卫生—中医学] R825.8