DPP4抑制剂与中医药防治糖尿病视网膜病变研究进展

Research Progress of DPP4 and Chinese Medicine Treatment in Preventing and Treating Diabetic Retinopathy

近年来糖尿病的发病趋向呈上升态势,在全球迅速发展,成为危害人们身体健康的重大因素。糖尿病属代谢性疾病,在其发展过程中,可引发多种并发症,其中糖尿病视网膜病变(diabetic retinopathy,DR)为微血管病变中最常见的一类,成为糖尿病患者致盲的最重要病因。因此糖尿病视网膜病变的防预和治疗是医学研究者亟待解决的问题之一。DR的发病机制尚未明确,各种治疗方法疗效各异,目前DR的临床治疗手段主要有激光治疗、药物治疗、手术治疗。在药物治疗方面,二肽基肽酶4抑制剂作为一类新型降糖药,亦可用于糖尿病视网膜病变的治疗。二肽基肽酶4(DPP4)又称CD26,是一种跨膜糖蛋白,广泛分布于肝、肺、肾、小肠、淋巴细胞和内皮细胞等部位,可与多种底物结合,发挥多种生物学作用。其中肠促胰岛素是其发挥降血糖效应的主要作用因子。DPP4抑制剂在糖尿病的防治中效果甚佳,通过对胰高血糖素样肽-1分解过程的作用,进而使胰岛素的生成增加,发挥其对血糖的降低作用,同时DPP4抑制剂对DR亦具有不错疗效。同时,现代中医通过辨证论治,组方用药,取得了良好的疗效,提高了患者的生活质量。

In recent years,the incidence of diabetes has been on the rise,and it has developed rapidly around the globe,becoming a major factor endangering people’s lives.Diabetes is a metabolic disease.During its development,it can cause a variety of complications.Among them,diabetic retinopathy(DR),the most common type of microvascular disease,has become the most important cause of blindness in diabetic patients.Therefore,the prevention and treatment of diabetic retinopathy is one of the urgent problems for medical researchers.The pathogenesis of DR has not been clarified,and various treatments have different efficacy.At present,the clinical treatment methods of DR mainly include laser treatment,drug treatment,and surgical treatment.As for drug therapy,DPP4 inhibitors is one of new drug for decreasing blood glucose,it can also be used for DR.Dipeptidyl peptidase 4(DPP4),also called CD26,is a transmembrane glycoprotein that can be widely expressed.There are several main functions and substrates,among which incretin is the main factor of its hypoglycemic effect.DPP4 inhibitors have a very good effect in the prevention and treatment of diabetes.Through the effect on the decomposition process of glucagon-like peptide-1,the production of insulin is increased and its blood sugar lowering effect is exerted.At the same time,DPP4 inhibitors DR also has a good effect.At the meantime,traditional Chinese medicine has achieved good results and improved the quality of life of patients through syndrome differentiation and treatment.