基于中西医临床病证特点的2型糖尿病动物模型评价

Evaluation of Type 2 Diabetes Mellitus Animal Models Based on Clinical Disease-syndrome Characteristics of Traditional Chinese Medicine and Western Medicine

目的:基于2型糖尿病(T2DM)的临床病证特点,对现有T2DM动物模型进行总结评估,为完善T2DM动物模型的建立提供参考。方法:通过查阅国内外文献,依据T2DM的中西医临床诊断标准,对T2DM动物模型的造模方法、造模机制、临床吻合度等进行归纳分析。结果:总结发现以高脂高糖饲喂造成胰岛素抵抗(IR)合用链脲佐菌素(STZ)注射造成胰岛细胞损伤的联合诱导法,临床吻合度高,模型稳定,应用广泛。而中医证型动物模型多在上法基础上,加以中医理论指导下的饥饱劳欲失常,采用中药灌胃、物理刺激等方法建立,其中气阴两虚型临床吻合度较高。结论:现有T2DM动物模型的西医临床吻合度多高于中医。按照中医病因学说、方药反证法、望诊等模拟中医临床“望闻问切”的方法来判断相关动物证型具有可行性。但中医证型模型动物仍较少,且四诊信息不完整,缺乏统一的证型辨证标准,因此需要建立更为完善的评价标准,使动物模型更切合临床实际,为后续T2DM的发病机制、诊断与防治等研究提供基础。

Objective:Based on the clinical disease-syndrome characteristics of type 2 diabetes mellitus(T2DM),this study aimed to summarize and evaluate existing T2DM animal models,providing a reference for improving the establishment of these models.Methods:By reviewing literature in China and abroad,and following the clinical diagnostic criteria of T2DM from both Western and traditional Chinese medicine(TCM)perspectives,this study analyzed and summarized the modeling methods,mechanisms,and clinical coincidence of various T2DM animal models.Results:The study found that the combination of high-fat and high-sugar feeding to induce insulin resistance(IR),along with streptozotocin(STZ)injection to cause pancreaticβ-cell damage,resulted in a highly clinically relevant,stable,and widely used model.TCM-based animal models often built on this foundation by incorporating TCM theories such as imbalances in diet,exertion,and rest,and by using methods like drug gavage and physical stimulation.Among these,the qi-yin deficiency model showed higher clinical coincidence.Conclusion:Existing T2DM animal models generally exhibit higher clinical coincidence from a Western medicine perspective than from a TCM perspective.It is feasible to use TCM etiology,the reverse application of formulas,and observational diagnostic methods that simulate“observation,auscultation and olfaction,inquiry,and pulse diagnosis”in TCM to identify corresponding animal models.Nonetheless,TCM-based animal models remain limited,with incomplete diagnostic information and a lack of standardized diagnostic criteria.Therefore,there is a need to establish more comprehensive evaluation standards to make animal models more closely aligned with clinical practice,thereby providing a foundation for further research into the pathogenesis,diagnosis,and prevention and treatment of T2DM.