中药治疗糖尿病作用机制研究进展

Research Progress on Mechanism of Chinese Medicines in Treating Diabetes

糖尿病(Diabetes mellitus,DM)是以长期高血糖为主要特征的内分泌代谢性疾病,严重威胁着人类的健康与生活质量,随着我国生活质量的提高以及不健康的生活方式,DM发病率持续升高并趋于年轻化,深入开展降血糖治疗的研究刻不容缓。DM以胰岛素的绝对或相对不足为病理基础,目前尚无根治手段,西医多采用注射胰岛素或口服降糖药物对症治疗,虽然效果显著,但长期使用易产生毒副作用。中药治疗DM具有多途径、多靶点的优势,通过促进胰岛素分泌、改善胰岛素抵抗、调节糖脂代谢、抗氧化应激等发挥降血糖作用,其疗效显著且毒副反应少。近年来,有关中药及复方对DM动物模型的作用机制研究较多,笔者通过回顾近年来相关文献,对单味中药、中药复方、中药有效成分降血糖作用机制及其相关实验设计等进行系统梳理,从促进胰岛素分泌、抑制糖异生、促进糖原合成、改善胰岛素抵抗、抑制糖苷酶活性、缓解氧化应激损伤、抑制炎症反应和调节肠道菌群等方面对中药降血糖的作用机制研究及实验设计进行归纳总结,以期为中药降血糖更广泛的临床应用及其深入的药效学机制研究提供参考。

Diabetes mellitus(DM)is an endocrine metabolic disease mainly characterized by chronic hyperglycemia,which seriously threatens the health and quality of life of human beings,and with the improvement of living standard and unhealthy lifestyle in China,the incidence of DM continues to rise and tends to be younger,so it is urgent to carry out indepth research on hypoglycemic treatment.DM is pathologically based on absolute or relative insulin deficiency,and there is no radical cure for it,and Western medicine mostly adopts insulin injection or oral hypoglycemic drugs for symptomatic treatment,which is effective but prone to toxic side effects in long-term use.Chinese medicine has the advantages of multi-path and multi-target in treating DM,and plays a role in lowering blood sugar by promoting insulin secretion,improving insulin resistance,regulating glucolipid metabolism and anti-oxidative stress,etc.Its efficacy is remarkable and the rate of toxic side effects is low.In recent years,there have been more studies on the mechanism of action of traditional Chinese medicine and compound prescriptions on animal models of DM.By reviewing the relevant literature in recent years,the author has systematically sorted out the mechanism of hypoglycemic action of single Chinese medicine,traditional Chinese medicine compound prescriptions,effective components of traditional Chinese medicine and their related experimental designs,from promoting insulin secretion,inhibiting gluconeogenesis,promoting glycogen synthesis,improving insulin resistance,inhibiting glycosidase activity,alleviating oxidative stress damage,inhibiting inflammatory response and regulating intestinal stress.The study and experimental design of the hypoglycemic mechanism of Chinese medicine were summarized in terms of promoting insulin secretion,inhibiting gluconeogenesis,promoting glycogen synthesis,improving insulin resistance,inhibiting glucosidase activity,alleviating oxidative stress damage,inhibiting inflammatory response and regulating intestinal flora,etc.,with a view to providing reference for the wider clinical application of Chinese medicine in hypoglycemia and its in-depth pharmacodynamic study.