基于脾和内质网—线粒体相关性探析助脾运化法治疗糖尿病

Correlation Between Pi and Endoplasmic Reticulum and Mitochondria:Discussion on Treatment of Diabetes Mellitus by Assisting Pi Transformation

糖尿病为临床常见病、多发病,其发病机制与能量代谢失衡密切相关。内质网(ER)和线粒体作为关键的细胞器,参与机体多种代谢过程的调节。ER功能失衡及线粒体功能障碍可能导致胰岛素抵抗,血液中糖脂积累,进而引发能量代谢失衡,最终导致胰岛β细胞损伤与凋亡,从而加速糖尿病的形成与进展。中医学中脾与内质网和线粒体均有其相关性,脾主运化与现代医学中促进物质能量代谢的功能相似。当脾主运化失职,分清泌浊失司时,会酿生痰浊水湿,壅滞中焦,干扰物质与能量的正常代谢。日久脾气亏损,动力不足,精微失于输布,故物质和能量代谢作用减弱。助脾运化法可扶脾气、助脾运、畅气机,恢复脾主运化功能,促进能量代谢平衡。因此,本文基于ER—线粒体互作,从“脾土壅滞—ER应激”与“脾气亏损—线粒体功能障碍”两方面探析助脾运化法可恢复机体能量代谢稳态从而治疗糖尿病。这可能成为从亚细胞水平层面科学理解传统中医学理论的新思路,可为助脾运化中药复方治疗代谢性疾病的分子机制研究提供研究方向。

Diabetes is a common and frequently occurring clinical disease,closely linked to imbalances in energy metabolism. The endoplasmic reticulum(ER)and mitochondria,key organelles,play crucial roles in regulating various metabolic processes in the body. Imbalances in ER function and mitochondrial dysfunction can lead to insulin resistance and the accumulation of sugars and fats in the blood,subsequently causing disruptions in energy metabolism. This ultimately results in damage and apoptosis of pancreatic beta cells,thereby accelerating the onset and progression of diabetes. In Chinese medicine,the Pi is related to both the ER and mitochondria,with its primary function of transformation and transportation similar to the promotion of material and energy metabolism in modern medicine. When the Pi fails in its transformative functions,it leads to improper separation of the clear from the turbid,creating phlegm-dampness and stagnation in the middle burner,thus disrupting normal material and energy metabolism. Over time,a deficiency in Pi qi and the loss of essence disrupt the distribution,reducing power and weakening regulatory and metabolic actions. Assisting Pi transformation can support Pi qi and promote the flow of qi,the function of the Pi can be restored,and the balance of energy metabolism can be promoted. Therefore,based on the interaction between the ER and mitochondria,from two perspectives "Pi earth stagnation—ER stress" and "Pi qi deficiency—mitochondrial dysfunction",this article explores the assisting Pi transformation method for restoring the homeostasis of the body's energy metabolism to treat diabetes. This may be a new way to scientifically understand the Chinese medicine theory from the subcellular level,and provide a research direction for the molecular mechanism of the treatment of metabolic diseases by Chinese medicine compound of assisting Pi transformation.