基于肠道菌群的中医药防治2型糖尿病研究进展

Research Progress of TCM Prevention and Treatment Type II Diabetes Based on Intestinal Flora

糖尿病患者与健康人相比,其肠道菌群结构发生了明显改变。肠道菌群紊乱,通过影响短链脂肪酸生成、激活炎症信号通路、胆汁酸代谢受阻等途径,使机体发生胰岛素抵抗。研究均证实中药单体或提取物、中药复方、针灸推拿等对肠道菌群均有调节作用,干预机制多从减少有害菌增殖、提高有益菌水平等方面考虑。但由于中药药物有效成分较多,其特异性有效成分及作用靶点尚未明晰,现有针灸推拿的相关研究均未阐明其调节肠道菌群可能的作用机制。今后相关的研究中,需要侧重考虑如中药的哪些成分发挥了调节菌群作用、是否有特异性菌群、动物实验结果是否适用于临床、不同证型患者肠道菌群分布有何特点等问题。肠道菌群紊乱可导致血糖异常,血糖异常患者常伴有肠道菌群失调,二者互相影响,糖尿病常规治疗的同时理应重视调节肠道菌群。目前国内糖尿病临床治疗指南中,尚未纳入肠道菌群的相关治疗手段,中药、针灸等可作为防治糖尿病、稳定患者肠道菌群平衡的重要治疗方法。

The main prevention and treatment methods of TCM for type II diabetes based on intestinal flora include monomer or extract of Chinese medicinals,compound formula of Chinese medicinals,acupuncture and massage,etc.TCM therapy has a regulatory effect on intestinal flora,and its intervention mechanism for diabetes is mostly considered from the aspects of reducing the proliferation of harmful bacteria and improving the level of beneficial bacteria.However,due to the large number of effective ingredients in Chinese medicinals and formulas,their specific effective ingredients and action targets have not yet been clarified.The existing researches on acupuncture and massage have not clarified their possible mechanism of action in regulating intestinal flora.At present,the domestic clinical treatment guidelines for diabetes have not included the relevant treatment methods of intestinal flora.In the future related research,it is necessary to focus on such issues as which components of Chinese medicinals and formulas play a role in regulating the flora,whether there is a specific flora,whether the results of animal experiments are suitable for clinical use,and what are the characteristics of the distribution of intestinal flora in patients with different syndrome types.When the technology of fecal bacteria transplantation is not mature and widely used,the therapies with TCM characteristics can become an important auxiliary method for clinical prevention and treatment of diabetes.