基于“脾胰-胃-肠”探讨葛根芩连汤治疗2型糖尿病

Mechanism of Gegen Qinlian Decoction in Treatment of T2DM Based on ‘Spleen and Pancreas-Stomach-Intestines’

中医学对2型糖尿病的认识多从“消渴”出发,以传统的上、中、下三消论治,继而“脾胰同源”理论的提出揭示了2型糖尿病的核心病机为脾虚胰病。现代研究发现,2型糖尿病的发生与胰腺、小肠内分泌细胞、肠道菌群等均有密切的联系。葛根芩连汤本为治疗协热下利之方,现代用于治疗糖尿病的研究也逐渐受到重视,其健脾升清、调和脾胃、燥湿厚肠之功与其恢复胰岛功能、改善胰岛素抵抗、促进胰高血糖素样肽-1(GLP-1)分泌、调节肠道菌群之功不谋而合,因此本文通过结合2型糖尿病的病机、葛根芩连汤的方义及现代研究,基于“脾胰-胃-肠”探讨葛根芩连汤治疗2型糖尿病的理论机制,以为临床应用提供理论依据。

In TCM,the understanding of type 2 diabetes mellitus(T2DM)is mostly based on‘Xiao Ke’,which are treated correspondingly according to‘upper Xiao,middle Xiao and lower Xiao’;based on this,the theory of‘Spleen and pancreas homology’is put forward,which reveals that the core pathogenesis of T2DM is pancreas disease due to Spleen deficiency.Modern studies have found that the occurrence of T2DM is closely related to the endocrine cells of pancreas and small intestines and intestinal flora.Gegen Qinlian Decoction was originally a prescription for the treatment of diarrhea due to external heat,which has been gradually used to treat diabetes.Its functions of strengthening Spleen and ascending clear-Qi,harmonizing Spleen and Stomach,drying dampness and thickening Intestine coincide with its functions of restoring islet function,improving IR,promoting secretion of glucagon like peptide-1(GLP-1)and regulating intestinal flora.Therefore,by combining the pathogenesis of T2DM,the meaning of Gegen Qinlian Decoction and modern research,this study explored the theoretical mechanism of Gegen Qinlian Decoction in treatment of T2DM based on‘Spleen and pancreas-Stomach-Intestine’,so as to provide theoretical basis for its clinical application.