基于“玄府—精浊”理论探讨清热通玄逐浊法辨治2型糖尿病胰岛β细胞损伤的思路

Based on the Theory of“Xuanfu-Jingzhuo”to Explore the Idea of Clearing Heat,Opening Mysterious Mansion and Expelling Turbidity Method in the Treatment of IsletβCell Damage in Type 2 Diabetes Mellitus

当前糖尿病(Diabetes Mellitus,DM)已成为全球增长最快的突发卫生事件之一,而我国DM形势尤为严峻,2型糖尿病(Type 2Diabetes Mellitus,T2DM)患病人数呈逐年激增态势。鉴于胰岛β细胞损伤是T2DM发生的先决条件,故以β细胞为中心的T2DM管理策略越来越受到重视。中医学认为,胰乃脾之副脏,胃肠积热所致玄府郁闭、精易为浊而伤脾与消渴病(T2DM)的发生、发展关系密切。胰岛β细胞作为含有高度发达内质网结构的细胞,内质网应激是导致T2DMβ细胞损伤的重要原因,这与中医学热郁玄府致“精易浊、浊生害”的病理改变具有一定相似性。因此,本文拟基于中医“玄府—精浊”理论,参以现代医学内质网应激,探讨清热通玄逐浊法在T2DM胰岛β细胞损伤辨治中的应用,以期为我国T2DM的中医药防治提供新的思路和借鉴。

At present,diabetes mellitus(DM)has become one of the fastest growing health emergencies in the world,and the DM situation in China is particularly severe,with the number of type 2 diabetes mellitus(T2DM)increasing year by year.Since isletβcell damage is a prerequisite for T2DM,βcell-centered T2DM management strategies have received increasing attention.According to Traditional Chinese medicine,the pancreas is the accessory organ of spleen,The occurrence and development of diabetes mellitus(T2DM)is closely related to the stagnation of Xuanfu caused by damp-heat in intestine and stomach,and the injury of spleen caused by turbid essence which is closely related to the occurrence and development of Xiao Ke(T2DM).Islet beta cells are cells with highly developed endoplasmic reticulum structure,endoplasmic reticulum stress is an important cause ofβcell injury in T2DM,which is similar to the pathological changes of“essence turns turbidity,turbidity produces harm”in Chinese medicine due to heat depletion in Xuanfu.Therefore,this paper based on the theory of“Xuanfu-Xin turbidity”in Chinese medicine,and with reference to endoplasmic reticulum stress in modern medicine,this paper discusses the application of the method of clearing heat and removing turbidity in the differentiation and treatment of islet beta cell injury in T2DM,with a view to providing new ideas and reference for the prevention and treatment of type 2 diabetes mellitus in Chinese medicine.