从肝脾肾角度论述胰岛素抵抗

Discuss on of Insulin Resistance from the Perspective of Liver,Spleen and Kidney

胰岛素抵抗(insulin resistance,IR)是引起多种代谢综合征相关性疾病的共同生理病理基础,而IR是2型糖尿病的特征机制,同时也是众多2型糖尿病患者病发与病情发展的始动因素,因此改善IR对于治疗与延缓2型糖尿病至关重要。传统中医学对糖尿病有多方面的认识与理解,而IR的机制多与遗传、肥胖、饮食等因素密切相关,肝脾肾三脏与这些因素关系密切。肝主疏泄,喜调达而恶抑郁,肝气郁滞会影响下丘脑-垂体-肾上腺轴功能紊乱,最终导致IR的发生。通过应用疏肝解郁治法能够提升胰岛素的敏感性,改善IR。脾胃作为后天之本,脾虚失健会影响水谷精微物质的转运。同时脾与胰腺、胃-肠-胰岛轴的关系密切,通过健运脾气治法,能够调整二者功能,改善IR。肾作为先天之本,五脏阴阳之根,与糖尿病的多尿、尿甘有着密切联系。通过补固肾气,调理阴阳,能够提升胰岛素敏感性,降低机体的炎症反应,改善IR。三脏联系密切,改善肝脾肾的功能,对临床治疗糖尿病胰岛素抵抗具有一定的价值。

Insulin resistance(IR)is a common physiophysiological basis for multiple metabolic syndrome-related diseases,and IR is the characteristic mechanism of type 2 diabetes,and also the initiation factor and development of many patients with type 2 diabetes. Therefore,improving IR is crucial for the treatment and delaying type 2 diabetes. Traditional Chinese medicine has multiple understanding and understanding of diabetes,and the mechanism of IR is mostly closely related to genetic,obesity,diet and other factors,and the liver,spleen and kidney viscera are closely related to these factors. Liver master drainage,pleasant tune and evil depression,liver Qi stagnation will affect the hypothalamicpituitary-adrenal axis dysfunction,eventually leading to the development of IR. The application of liver and destreatment can improve insulin sensitivity and improve IR. The spleen and stomach as the nurture,spleen deficiency will affect the transport of microsubstances. At the same time,the spleen is closely related to the pancreas,stomach-intestine-islet axis. Through the exercise and temper treatment,the two function can be adjusted to improve IR. Kidney,the root of the five viscera of Yin and Yang,is closely related to the polyuria and uregan of diabetes. By strengthening kidney Qi and regulating Yin and Yang,it can improve insulin sensitivity,reduce the inflammatory response of the body,and improve IR. The three viscera are closely related,improve the function of liver,spleen and kidney,and have certain value to the clinical treatment of diabetic insulin resistance.