黄连及其配伍在消渴病中的应用

Application of Huanglian(Coptidis Rhizoma)and Its Compatibility in Xiaoke

黄连味苦性寒,善泄善燥,是消渴病治疗中应用颇广的传统中药之一。现代研究表明黄连的主要成分小檗碱可通过多条细胞信号通路发挥作用,提高糖尿病患者胰岛β细胞抗氧化应激能力,改善胰岛功能,提高胰岛素敏感性,降低患者血糖及糖化血红蛋白水平,并且可减少血管内皮损伤,降低糖尿病血管并发症的风险。黄连单药使用即可对消渴病起到良好的治疗效果,与木香、葛根、人参、天花粉、黄芩、知母等相伍成药对,既可增强临床效果,又可防其苦寒败胃。黄连复方葛根芩连汤、大黄黄连泻心汤、黄连解毒汤、半夏泻心汤、黄连温胆汤、小陷胸汤则可通过多靶点、多途径、多环节发挥作用,达到降糖减脂、改善患者临床症状的效果。总之黄连及其配伍可通过抑制糖异生、调节肠道菌群结构、改善胰岛功能、降低胰岛素抵抗等多重途径,标本兼治,实现降糖降脂、延缓糖尿病进展之功效。对黄连单药及其药对、复方在消渴病治疗中的应用作以叙述,以期为消渴病的临床治疗提供思路。

Huanglian(Coptidis Rhizoma)is bitter and cold in flavor,good at draining and drying,and is one of the traditional Chinese medicines widely used in the treatment of Xiaoke.Modern research has shown that berberine,the main component of Huanglian(Coptidis Rhizoma)can play a role in improving the anti-oxidative stress ability of pancreatic isletβ-cells in diabetic patients through multiple cell signaling pathways,improving pancreatic islet function and insulin sensitivity,lowering the blood glucose and glycosylated hemoglobin levels and reducing endothelial damage and lowering the risk of vascular complications in diabetes.Huanglian(Coptidis Rhizoma)can be used as a single medicine to treat Xiaoke,and can be used in compatibility of Muxiang(Aucklandiae Radix),Gegen(Puerariae Lobatae Radix),Renshen(Ginseng Radix Et Rhizoma),Tianhuafen(Trichosanthis Radix),Huangqin(Scutellariae Radix)and Zhimu(Anemarrhenae Rhizoma),which can not only enhance its glucose-lowering effect,but also prevent it from corrupting the stomach with bitter and cold drugs.The compounds of Huanglian(Coptidis Rhizoma)including Gegen Qinlian Decoction(葛根芩连汤),Dahuang Huanglian Xiexin Decoction(大黄黄连泻心汤),Huanglian Jiedu Decoction(黄连解毒汤),Banxia Xiexin Decoction(半夏泻心汤),Huanglian Wendan Decoction(黄连温胆汤)and Xiaoxianxiong Decoction(小陷胸汤)can achieve the effect of lowering glucose and reducing lipids as well as improving the patients'clinical symptoms through multi-targets,multi-pathways and multi-links.Huanglian(Coptidis Rhizoma)and its combinations can inhibit gluconeogenesis,regulate the structure of intestinal flora,improve the function of pancreatic islets,reduce insulin resistance and other multiple effects,so as to achieve the efficacy of hypoglycemia and hypolipidemia and delay the progression of diabetes mellitus.In this paper,it described the application of Huanglian(Coptidis Rhizoma)as a single drug and its pairs and combinations in the treatment of diabetes mellitus,with a view to providing ideas for the treatment of diabetes mellitus.