糖尿病络病相关发病机制研究进展

A review on the pathogenesis of diabetes collateral disease

糖尿病络病是指在糖尿病基础上由于长期持续性高血糖引起络脉损伤而导致的一类疾患,其以络脉瘀阻为核心病机,本质为糖尿病微血管并发症,为糖尿病发展到后期的特异性损害,严重时可致残或致死,通常预后较差。临床上,现代医学多使用降糖类西药调控血糖以治疗糖尿病,但其用于糖尿病后期各种慢性并发症时治疗效果不佳。中医药善于调治各种慢性疾病,临床上医者们在精准辨证论治的前提下遣方用药治疗糖尿病时疗效颇佳,但糖尿病发展到后期通常病机复杂交错,不易准确辨别。糖尿病络病对应现代医学上的糖尿病微血管并发症,治疗宜以保护微血管为主。中医上糖尿病络病的共同病机为糖尿病日久,久病入络,络脉瘀阻损伤,其治疗以养络护络为核心。如何更有效地保护络脉,延缓和减轻糖尿病络病对人体微血管的损伤,成为糖尿病络病临床治疗的难点。故从中西医角度综合认识糖尿病络病发病机制或更有利于其临床防治。文章通过整理和分析糖尿病络病理论及其相关文献,从糖尿病微血管并发症病变对应的糖尿病肾脏、视网膜、心脏、脑血管、神经及足部病变方面,对糖尿病络病中西医发病机制进行归纳与总结,以期为糖尿病络病的临床防治提供理论参考。

Diabetic collateral disease refers to a kind of disease caused by collateral damage due to long-term persistent hyperglycemia on the basis of diabetes mellitus.Its core pathogenesis is collateral stasis,and its essence is diabetic microvascular complication,which is the specific damage in the later stage of diabetes.In severe cases,it can cause disability or death to patients,and it is usually with poor prognosis.Clinically,modern medicine mostly uses hypoglycemic Western medicine to regulate blood glucose to treat diabetes mellitus,but its therapeutic effect is not good when it is used for various chronic complications in the later stage of diabetes mellitus.Traditional Chinese medicine is good at regulating and treating various chronic diabetes mellitus.Clinically,on the premise of accurate syndrome differentiation and treatment,doctors give prescriptions to treat diabetes with good curative effects.However,when diabetes mellitus develops to the later stage,the pathogenesis is usually complicated and intertwined,and it is difficult to accurately identify it.Diabetic collateral disease corresponds to diabetic microvascular complications in modern medicine,and the treatment should focus on protecting microvascular.The common pathogenesis of diabetic collaterals in traditional Chinese medicine is that diabetes mellitus lasts for a long time,and the collaterals are blocked by blood stasis.Its treatment is centered on nourishing and protecting collaterals.How to protect collaterals more effectively,delay and reduce the damage of diabetic collaterals to human microvessels has become a difficult point in clinical treatment of diabetic collaterals.Therefore,a comprehensive understanding of the pathogenesis of diabetic collateral disease from the perspective of traditional Chinese medicine and Western medicine is more conducive to its clinical prevention and treatment.By sorting out and analyzing the theory of diabetic collateral disease and related literature,the paper summarizes the pathogenesis of diabetic collateral disease in traditional Chinese medicine and Western medicine from the aspects of diabetic kidney,retina,heart,cerebrovascular,nerve and foot diseases corresponding to diabetes mellitus microvascular complications,so as to provide a theoretical reference for clinical prevention and treatment of diabetic collateral disease.