清热益气法治疗2型糖尿病评述

Comment on Treatment of Type-2 Diabetes with Method of Clearing Heat and Replenishing Qi

清热益气法作为中医治疗2型糖尿病的独特疗法,可缓解临床症状,控制血糖血脂,减轻胰岛素抵抗,延缓并发症进展。清热益气法主要通过降低C-反应蛋白(C-reactive protein,CRP)及炎症相关细胞因子改善慢性炎症、抗氧化应激、抗自由基、胰岛素增敏、胰岛保护、调节肠道菌群等发挥作用。但是由于清热益气中药方配伍较为灵活,研究人员干预方式多样,结局指标缺乏规范标准,或由于样本量不足,可重复性差,故较难指导多中心、大样本、系统化的临床研究。同时,在清热益气法的作用机制方面,中药发挥作用的具体分子机制和通络环节尚不明确。目前的研究偏重于炎性因素和胰岛病理因素研究,今后需进一步加强对肠道菌群、细菌分子生物因素的实验数据支持及基础研究。

As a unique treatment for type-2 diabetes in Chinese medicine,the method of clearing heat and replenishing qi can relieve clinical symptoms,control blood sugar and blood lipids,reduce insulin resistance,and delay the progression of complications.The method of clearing away heat and replenishing qi mainly works by reducing C-reactive protein(CRP)and inflammation-related cytokines,anti-oxidative stress,anti-free radicals,insulin sensitization,islet protection,and regulating intestinal flora.However,it is difficult to guide multi-center,large-sample,and systematic clinical research due to the flexible compatibility of the heat-clearing and qi-replenishing method,the diverse intervention methods of researchers,the lack of standardized outcome indicators,or the insufficient sample size and poor reproducibility.In addition,in terms of the mechanism of action of the method of clearing heat and replenishing qi,the specific molecular mechanism and pathway links of the role of traditional Chinese medicine are still unclear.Current research focuses on inflammatory factors and pancreatic islet pathological factors.In the future,it is necessary to further strengthen experimental data support and basic research on intestinal flora and bacterial molecular biological factors.