黄芪-葛根药对治疗糖尿病心肌病的理论探讨

Theoretical discussion on treatment of diabetic cardiomyopathy by Astragali Radix-Puerariae Lobatae Radix herb pair

糖尿病心肌病(diabetic cardiomyopathy,DCM)发病率高、预后差,严重影响人类的生活质量及生命健康,但目前西医尚缺乏有效改善患者预后的治疗方案。中医将本病归属于“消渴心病”的范畴,指出其病机多为气阴两虚、痰瘀阻络,益气养阴通络多为其主要治则。通过从黄芪-葛根药对物质基础、药对配伍及药理活性方面进行综述,分析二者联合使用通过改善心肌细胞糖脂代谢紊乱及微循环障碍、抑制氧化应激及炎症反应、上调自噬及下调凋亡、调节肠道菌群等多种方式保护心肌细胞,为黄芪-葛根药对治疗DCM提供理论借鉴,为研发抗DCM中药新药提供理论指导和科学依据。

Diabetic cardiomyopathy(DCM)has a high incidence and poor prognosis,which seriously affects the quality of life and health of human beings.However,there is still a lack of effective treatment to improve the prognosis of patients in western medicine.Traditional Chinese medicine attributes this disease to the category of“diabetes heart disease”,pointing out that its pathogenesis is mostly deficiency of both qi and yin,phlegm and blood stasis blocking collaterals,and benefiting qi,nourishing yin and dredging collaterals are its main therapeutic principles.Therefore,this paper reviews the material basis,compatibility and pharmacological activity of Huangqi(Astragali Radix)and Gegen(Puerariae Lobatae Radix).It is pointed out that the combination of Astragali Radix and Puerariae Lobatae Radix can protect cardiomyocytes by improving glucose and lipid metabolism disorder and microcirculation disorder of cardiomyocytes,inhibiting oxidative stress and inflammatory reaction,up-regulating autophagy and down-regulating apoptosis,and regulating intestinal flora,so as to provide theoretical reference for the treatment of DCM by Astragali Radix and Puerariae Lobatae Radix,and provide theoretical guidance and scientific basis for the development of new Chinese medicine against DCM.