基于“阴火理论”探讨肠道内环境稳态对2型糖尿病影响机制

Based on the “Yin-Fire Theory” to Explore the Mechanism of the Intestinal Environment Homeostasis on Type 2 Diabetes

脾胃大家李东垣创立的"阴火理论",以"脾胃虚弱,阴火鸱张"为病机特点,与中医消渴病的基本病机相似,故现代医家另辟蹊径,从东垣"阴火理论"的角度论治2型糖尿病,临床治疗效果显著。西方医学发现2型糖尿病的发生与肠道内环境的稳态息息相关。通过大量临床试验证实,多数中药的有效成分可以调节人体的肠道内环境稳态,其中包括多酚类、生物碱,皂苷类化合物等。如存在于黄连中小檗碱又称黄连素,是生物碱中的一种,皂苷则广泛存在于人参、三七、甘草、柴胡、黄芪等中药内。纵观东垣创立的有关治疗消渴病的方剂中大多包含了以上药物。作者通过综述东垣阴火理论及肠道菌群稳态二者分别对2型糖尿病发生的影响,试述阴火理论降血糖的机制是否与其方剂中中药的有效成分参与调节了肠道菌群稳态有关。

The“Yin-fire theory”created by LI Dongyuan,a great master of the spleen and stomach,is characterized by“weakness in the spleen and stomach,and expansion of the Yin-fire”,which is similar to the basic pathogenesis of TCM diabetic disease. Therefore,modern doctors have taken a different approach from Dongyuan’s“Yin-fire theory”. From the perspective of treating type 2 diabetes,the clinical treatment effect is remarkable. Western medicine has found that the occurrence of type 2 diabetes is closely related to the homeostasis of the intestinal environment. A large number of clinical trials have confirmed that the effective ingredients of most Chinese medicines can regulate the homeostasis of the human intestinal environment,including polyphenols,alkaloids,and saponins. For example,berberine,also known as berberine,is one of alkaloids in Huanglian(Coptidis Rhizoma),while saponins are widely found in Renshen(Ginseng Radix Et Rhizoma),Sanqi(Notoginseng Radix Et Rhizoma),Gancao(Glycyrrhizae Radix Et Rhizoma),Chaihu(Bupleuri Radix),Huangqi(Astragali Radix)and other traditional Chinese medicines. Throughout the prescriptions created by Dongyuan for the treatment of diabetic disease,most of the above drugs are included. By reviewing the effects of Dongyuan“Yin-fire theory”and intestinal flora homeostasis on the occurrence of type 2 diabetes,the author tries to discuss whether the mechanism of“Yinfire theory”for lowering blood sugar and the effective ingredients of traditional Chinese medicine in its prescriptions participate in the regulation of intestinal flora steady state is related.