中医药干预肠道菌群防治糖尿病的研究进展

Study Progress in Effect of Traditional Chinese Medicine in Preventing and Treating Diabetes by Interfering Intestinal Flora

随着城市化的发展和生活方式的改变,人们逐渐形成了高脂饮食、运动量减少等不良的生活习惯,糖尿病患者与日俱增,成为全球性不断升级的公共卫生问题,探究预防和治疗糖尿病的有效措施迫在眉睫。近年来的研究显示,肠道菌群与糖尿病发生发展密切相关,成为治疗糖尿病的潜在靶点。健康的肠道环境是人体生理代谢活动重要的内在环境,肠道菌群稳态失调伴随着机体的生理代谢紊乱,如诱发体内代谢性内毒素血症、胆汁酸代谢紊乱和短链脂肪酸(SCFA)生成减少,导致机体慢性低度炎症和胰岛素抵抗,是糖尿病发生的重要病理过程。中医药一直被运用于糖尿病的治疗,且疗效显著,目前关于中医药的活性成分及中医药复方调节肠道菌群结构,改善糖尿病症状的研究十分广泛。大量研究表明中医药和肠道菌群之间存在动态的双向作用的关系,肠道菌群可将中医药转化为多酚、生物碱、皂苷类化合物等具有药理作用的活性物质,同时这些活性成分可逆转肠道微生态的失调,且肠道菌群失调的恢复可以改善糖尿病的症状。可见肠道菌群是中医药治疗糖尿病的桥梁,这可能是中药治疗糖尿病的机制之一。该文就近年来中医药的活性成分及中医药复方干预肠道菌群治疗糖尿病的研究进展做一简要综述,以期为糖尿病的防治药物及治疗方法探究提供参考。

With the development of urbanization and the change of lifestyle,people have gradually developed unhealthy living habits,such as high-fat diet and reduced physical activity,which promotes the increasing number of diabetes patients and becomes an escalating public health problem worldwide. Therefore,it is urgent to explore effective measures to prevent and treat diabetes. Recent studies have shown that intestinal flora is closely related to the occurrence and development of diabetes,making it a potential target for the treatment of diabetes. A healthy intestinal environment is an important internal environment for physiological and metabolic activities of the human body. Intestinal flora homeostasis is accompanied by physiological metabolic disorders of the body,such as induced metabolic endotoxemia,bile acid metabolism disorders and reduced production of short chain fatty acid(SCFA),which leads to low-grade chronic inflammation and insulin resistance in the body that are important pathological processes of diabetes. Traditional Chinese medicine(TCM)has been used in the treatment of diabetes,with a remarkable curative effect. At present,there are extensive studies on the active ingredients of TCM and the compound of TCM for regulating structure of intestinal flora and improving symptoms of diabetes. A large number of studies have shown a dynamic two-way relationship between TCM and intestinal flora. Specifically,intestinal flora can transform TCM into polyphenols,alkaloids,saponins and other active substances with a pharmacological effect,in turn,these active ingredients can reverse the imbalance of intestinal microecology, and the recovery of intestinal flora imbalance can improve the symptoms of diabetes. It can be seen that intestinal flora is a bridge for TCM treatment of diabetes,which may be one of the mechanisms of TCM treatment of diabetes. This paper reviews the active ingredients of TCM and the compound of TCM in the treatment of diabetes, in order to provide reference for the exploration of prevention and treatment of diabetes.