| 楼雨沁,蒋旭宏.2型糖尿病发病中炎症因子的作用和中医从湿热论治的研究进展[J].浙江中医药大学学报,2024,48(7):881-885, 894. |
| 2型糖尿病发病中炎症因子的作用和中医从湿热论治的研究进展 |
| Research Progress on the Role of Inflammatory Factors in the Pathogenesis of Damp-Heat Type-2 Diabetes and Traditional Chinese Medicine Treatment |
| DOI：10.16466/j.issn1005-5509.2024.07.020 |
| 中文关键词: 2型糖尿病 炎症因子 胰岛素抵抗 胰岛 β细胞功能受损 湿热证 中医药 |
| 英文关键词: type 2 diabetes mellitus inflammatory factor insulin resistance pancreas β cell dysfunction damp heat syndrome traditionalChinese medicine |
| 基金项目:浙江省自然科学基金项目(LY20H270010)；浙江省中医药重点研究项目(2022ZZ016) Fund projects: Zhejiang Natural Science Foundation Project(LY20H270010);Zhejiang Province Traditional Chinese Medicine Key Research Project(2022ZZ016) |
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| 中文摘要: |
| [目的]归纳总结国内外对 2型糖尿病(diabetes mellitus type 2，T2DM)发病中炎症因子作用的认识、T2DM湿热证与炎症的相关性以及从湿热证治疗 T2DM的经验，以期为 T2DM治疗提供新思路。[方法]查阅 T2DM相关资料，阅读相关文献，总结国内外关于炎症因子在 T2DM发病中作用的研究结果，总结湿热证与炎症的相关性以及中医从湿热论治 T2DM的经验。[结果] T2DM的发病与炎症因子关系密切，T2DM患者血清中炎性因子如肿瘤坏死因子 -α(tumor necrosis factor-α，TNF-α)、白细胞介素 -6(interleukin-6，IL-6)等均高于正常水平。炎症因子在 T2DM发病中的作用包括阻碍胰岛素受体底物(insulin receptor substrate， IRS)正常酪氨酸磷酸化，加速 IRS与磷脂酸肌醇 3-激酶(phosphatidylinositol 3-kinases，PI3K)解离以及 IRS的降解，影响下游的 PI3K磷酸化，干扰胰岛素信号经此通路下传，引发胰岛素抵抗(insulin resistance，IR)；促进核因子-κB(nuclear factor-κB，NF-κB)活化，通过正反馈机制不断加重炎症状态，导致 IR；直接或间接引起胰岛 β细胞破坏和胰岛素分泌功能减退。中医辨证 T2DM患者多为湿热证，湿热证 T2DM的 TNF-α、IL-6、超敏 C反应蛋白(hypersensitive-C reactive protein，hs-CRP)水平更高，脂代谢紊乱、IR及炎症状态更为严重，提示 T2DM湿热证与机体的炎症状态存在较强相关性。中医通过应用各种清热化湿中药复方与单药治疗 T2DM湿热证，能够降低机体炎症因子水平。[结论] T2DM、炎症、湿热证之间存在相关性，T2DM多属于湿热证，运用清热化湿中药复方与单方治疗 T2DM湿热证有效，从湿热论治 T2DM可成为治疗 T2DM的新思路。 |
| 英文摘要: |
| [Objective] To summarize the research and understanding on the role of inflammatory factors in the onset of type-2 diabetes(T2DM) at home and abroad，the correlation between damp-heat syndrome and inflammation in T2DM，and the experience of traditional Chinese medicine(TCM) in treating T2DM from damp-heat syndrome，so as to provide new ideas for the treatment of T2DM. [Methods] Reviewing relevant information on T2DM，reading relevant literature，summarizing the research results on the role of inflammatory factors in the pathogenesis of T2DM at home and abroad，summarizing the correlation between damp-heat syndrome and inflammation in TCM， and summarizing the experience of treating T2DM from the perspective of damp-heat in TCM. [Results] The onset of T2DM is closelyrelated to inflammatory factors，inflammatory factors such as tumor necrosis factor-α(TNF-α)，interleukin-6(IL-6) in the serum of T2DMpatients are higher than normal levels. The role of inflammatory factors in the pathogenesis of T2DM includes hindering normal tyrosinephosphorylation in the insulin receptor substrate(IRS)，accelerating the dissociation and degradation of IRS and phosphatidylinositol 3-kinases(PI3K)，affecting downstream PI3K phosphorylation，interfering with insulin signaling through the pathway，and triggering insulinresistance(IR); promoting nuclear factor-κB(NF-κB) activation continuously exacerbates the inflammatory state through a positive feedbackmechanism，promoting IR; directly or indirectly causing pancreatic islets β cellular destruction and decreasing insulin secretion function.TCM syndrome differentiation of T2DM patients is mostly characterized by damp-heat syndrome，the levels of IL-6 and hypersensitive-C reactive protein(hs-CRP) in T2DM damp heat syndrome are higher. Lipid metabolism disorders，IR and inflammation are more severe. There is a strong correlation between T2DM damp-heat syndrome and the inflammatory state of the body. TCM can reduce the level ofinflammatory factors in the body by using various TCM formulas and single drugs to treat T2DM damp-heat syndrome. [Conclusion] There is a correlation among T2DM，inflammation and damp-heat syndrome. T2DM mostly belongs to damp-heat syndrome. The use of TCMformulas for clearing heat and removing dampness and single drugs is effective in treating T2DM damp-heat syndrome，which is a new approach to treat T2DM from the perspective of damp-heat theory. |
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