生脉散治疗糖尿病心肌病探析

Analysis of Shengmai Powder in the Treatment of Diabetic Cardiomyopathy

糖尿病心肌病由糖尿病发展而来,是糖尿病的重要并发症,现代临床发现其发病机制与糖脂代谢异常、胰岛素抵抗、氧化应激、钙调节受损、AGEs积累增加、心肌纤维化、线粒体损伤、微血管功能障碍等因素有关。中医认为,糖尿病心肌病证属本虚标实,气阴两虚为其基本病机,气滞、血瘀、痰浊、水饮为其病理产物,临床治疗应标本兼治,但以治本为主。生脉散为益气养阴之经典方剂,目前多用于心律不齐、心肌炎、冠心病、慢性心力衰竭等心脏类疾病的治疗,现代研究证实其可有效干预DCM的多种发病机制和病理环节,以上均为生脉散临床治疗DCM提供依据。

Diabetic cardiomyopathy develops from diabetes mellitus and is an important complication of diabetes. Its pathogenesis is related to abnormal glucose and lipid metabolism, insulin resistance, oxidative stress, impaired calcium regulation, AGEs accumulation, myocardial fibrosis, mitochondrial injury, microvascular dysfunction and other factors.According to traditional Chinese medicine, root deficiency and branch excess is the main syndrome of DCM. Deficiency of both qi and yin is basic pathogenesis of DCM. Qi stagnation, blood stasis, phlegm turbidity and fluid retention is its pathological product. The clinical treatment should treat both symptoms and root causes, but mainly to treat the root cause. Shengmai Powder is a classic prescription for supplementing qi and nourishing yin, and is presently used for the treatment of arrhythmia, myocarditis, coronary heart disease, chronic heart failure and other heart diseases. Modern studies have proved that it can effectively intervene in various pathogenesis and pathological links of DCM. All of the above provide the basis for clinical treatment of DCM with Shengmai Powder.