胆汁酸受体在糖尿病中的作用及中医药干预的研究进展

Role of Bile Acid Receptor in Diabetes and Research Progress of Traditional Chinese Medicine Intervention

糖尿病(diabetes mellitus,DM)是一种以血糖水平升高为特征的慢性代谢性疾病,并发症复杂严重,西药治疗DM难度高,副作用大。采用中医药治疗DM获得良好成效,其具有疗效稳定,副作用小,并可同时防治DM并发症等作用。近年来研究发现胆汁酸在葡萄糖稳态中具有重要作用,可调节DM糖脂代谢及糖核激素分泌。现从胆汁酸核受体法尼醇X受体(farnesoid X receptor,FXR)、孕烷X受体(pregnane X receptor,PXR)和维生素D受体(vitamin D receptor,VDR),以及膜受体武田G蛋白受体5(takeda G protein-coupled receptor 5,TGR5)、鞘氨醇-1-磷酸受体2(sphingosine-1-phosphate receptor 2,S1PR2)和毒蕈碱型胆碱能受体M2(cholinergic receptor muscarinic 2,CHRM2)与DM相互关联的角度,总结了胆汁酸各受体通过调控糖代谢、脂代谢、胰岛素分泌、胰岛素抵抗及炎症等方面治疗DM的相关研究,并分析了目前中药复方及有效成分通过调控胆汁酸各受体治疗DM可能的作用机制,提出胆汁酸受体对DM中肥胖型DM的影响作用较大等观点,以期为中医药通过调控胆汁酸受体治疗DM提供研究基础与新思路。

Diabetes mellitus(DM)is a chronic metabolic disease characterized by elevated blood glucose levels.Its complications are complex and serious.It is difficult to treat DM with western medicine,and its side effects are large.The use of traditional Chinese medicine in the treatment of DM has achieved good results,with stable efficacy,minimal side effects,and the ability to simultaneously prevent and treat complications of DM.In recent years,studies have found that bile acids play an important role in glucose homeostasis,regulating DM glucose and lipid metabolism as well as glucocorticoid secretion.This article discusses the bile acid nuclear receptors Farnesoid X receptor(FXR),Pregnane X receptor(PXR),Vitamin D receptor(VDR),as well as membrane receptors Takeda G protein-coupled receptor 5(TGR5),Sphingosine-1-phosphate receptor 2(S1PR2),and muscarinic cholinergic receptor M2(CHRM2),From the perspective of the correlation between CHRM2 and DM,this study summarizes the relevant research on the treatment of DM by regulating various receptors of bile acids through regulating glucose metabolism,lipid metabolism,insulin secretion,insulin resistance,and inflammation.It also analyzes the possible mechanism of action of traditional Chinese medicine formulas and active ingredients in treating DM by regulating various receptors of bile acids,and proposes that bile acid receptors have a significant impact on obese DM,in order to provide research basis and new ideas for traditional Chinese medicine to treat DM by regulating bile acid receptors.