黄芪甲苷调控PI3K/Akt分子通路在防治糖尿病并发症中的作用机制研究进展  

Mechanism of AstragalosideⅣin Regulating PI3K/Akt Molecular Pathway in Prevention and Treatment of Diabetes Complications:A Review

作　　者：胡可心 朱晋如 吴晴 王胜茂 王梦凡 钱爱 方朝晖[2,3] HU Kexin;ZHU Jinru;WU Qing;WANG Shengmao;WANG Mengfan;QIAN Ai;FANG Zhaohui(Anhui University of Chinese Medicine,Hefei 230012,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Key Laboratory of Xin'an Medical Education Department,Anhui University of Chinese Medicine,Hefei 230038,China)

机构地区：[1]安徽中医药大学,合肥230012 [2]安徽中医药大学第一附属医院,合肥230031 [3]安徽中医药大学新安医学教育部重点实验室,合肥230038

出　　处：《中国实验方剂学杂志》2025年第9期307-314,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82474431);2型糖尿病中医药循证能力提升项目(2023-24);安徽省中医药领军人才及培养对象项目(20190027);安徽省高校协同创新项目(GXXT-2020-025)。

摘　　要：糖尿病(DM)是由于胰岛素绝对或相对分泌不足及外周细胞对胰岛素敏感度降低导致的一种代谢性疾病,已经严重影响全人类的健康。其后期引起的慢性并发症可导致眼、心、肝、肾、神经及足等多个器官功能衰退甚至丧失,是DM患者死亡最重要的原因。现代医学在并发症的治疗上取得一些进展,但仍然存在价钱昂贵、药物不良反应大等原因,寻找价格低廉而又高效的药物是目前的重中之重。黄芪是我国中药宝库中一颗璀璨的明珠,诸多研究表明,其主要成分黄芪甲苷具有抗炎、抗氧化、抗病毒、改善心脑功能、改善神经传导及保护心肌等生物活性。同时磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路是调控机体氧化应激、炎症反应、细胞凋亡和自噬等多种机制的重要信号通路,多项实验发现其对多种糖尿病并发症具有重大意义,人们对二者结合开展了广泛研究。该文梳理了有关黄芪甲苷通过调控PI3K/Akt通路减少DM患者的胰腺细胞毒性,保护心脏的基本功能、抑制视网膜的细胞损害、改善大脑神经的功能障碍、降低肾脏、肝脏的慢性危害及减轻下肢神经及血管的毒性损伤,为黄芪及其中药单体黄芪甲苷在DM及其并发症的临床应用提供参考。Diabetes mellitus(DM)is a metabolic disease caused by absolute or relative insulin deficiency and reduced insulin sensitivity in peripheral cells,posing a serious threat to global health.Chronic complications arising in the later stages of DM can lead to the decline or even loss of function in multiple organs,including the eyes,heart,liver,kidneys,nerves,and feet,making them the primary cause of mortality in DM patients.Although modern medicine has made some progress in the treatment of these complications,challenges such as high costs and adverse drug reactions remain.Thus,identifying highly effective drugs with minimal adverse effects has become a top priority.Astragalus membranaceus is a shining gem in the treasure trove of Chinese medicine.Numerous studies have shown that its primary active component,astragalosideⅣ,possesses various biological activities,including anti-inflammatory,antioxidant,and antiviral effects,as well as benefits for cardiac and cerebral function,nerve conduction,and myocardial protection.Meanwhile,the phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway plays a crucial role in regulating oxidative stress,inflammatory responses,apoptosis,and autophagy.Extensive research has highlighted the significant role of this pathway in various DM complications,leading to widespread studies on its interaction with astragalosideⅣ.This review summarizes research findings on how astragalosideⅣalleviates pancreatic cytotoxicity in DM patients by modulating the PI3K/Akt pathway.Additionally,it highlights its protective effects on basic cardiac function,inhibition of retinal cell damage,improvement of cerebral nerve dysfunction,reduction of chronic kidney and liver damage,and mitigation of neurovascular toxicity in the lower limbs.These insights provide a valuable reference for the clinical application of A.membranaceus and its active monomer,astragalosideⅣ,in the treatment of DM and its complications.

关 键 词：黄芪甲苷 磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)信号通路 糖尿病并发症 药理研究进展 

分 类 号：R259[医药卫生—中西医结合] R587.2[医药卫生—中医内科学] R781.64[医药卫生—中医学]