摘要
近年来,随着社会、自然环境、饮食结构与行为心理因素的不断变化,2型糖尿病(T2DM)已成为危害人类健康的主要公共卫生问题,其发病机制复杂,存在多层次、多环节代谢异常。T2DM的基础病理是胰岛素抵抗合并胰岛细胞功能障碍,而胰岛细胞功能障碍是T2DM病情进展的核心。因此,保护胰岛细胞免受损伤是治疗T2DM的重要环节。导致胰岛细胞受损的因素众多,越来越多的研究发现,铁死亡作为一种新的受调控的程序性细胞死亡与胰岛细胞受损关联密切。目前,中医治疗胰岛细胞铁死亡的理论研究依据不足,需要进一步挖掘其理论内涵,补充更多的理论基础。基于《难经》关于脾脏的记载、《内经》关于脾瘅、消渴、消瘅等病机论述、张锡纯《医学衷中参西录》“脾胰同源”学说及现代医家的研究成果,发现胰岛细胞功能障碍是中医脾功能失常的关键内涵,临床根据糖尿病分期、证候及病机特点,施以健脾益气、滋脾清热、行脾化浊等从脾论治的方法可以改善胰岛功能,抑制胰岛细胞受损。由此推论胰岛细胞铁死亡与脾失健运息息相关,而从脾论治胰岛细胞铁死亡将成为新的探索路径。
In recent years,with the continuous changes in society,natural environment,dietary structure,and behavioral and psychological factors,type 2 diabetes mellitus(T2DM)has become a major public health issue that poses a threat to human health.Its pathogenesis is complex,involving multi-level and multi-link metabolic abnormalities.The basic pathology of T2DM is insulin resistance combined with islet cell dysfunction,which is the core of the progression of T2DM.Therefore,protecting islet cells from damage is an important aspect of treating T2DM.There are many factors that lead to the damage of islet cells.Increasing research has found that ferroptosis,as a new type of regulated programmed cell death,is closely related to the damage of islet cells.At present,the theoretical basis for the treatment of ferroptosis in islet cells with traditional Chinese medicine is insufficient,and further exploration of its theoretical implications and supplementation of more theoretical foundations are needed.Based on the records of spleen in"Nan Jing",the pathogenesis discussions of spleen disease,diabetes mellitus,and consumptive disease in"Nei Jing",the theory of"spleen and pancreas homology"in Zhang Xichun's"Medical Doctrine of Integrating Chinese and Western Medicine",and the research results of modern medical experts,it is found that islet cell dysfunction is the key connotation of spleen dysfunction in traditional Chinese medicine.Clinically,according to the staging,syndrome,and pathogenesis characteristics of diabetes,methods of strengthening the spleen and invigorating qi,nourishing the spleen and clearing heat,and improving the spleen and resolving turbidity can be used to improve islet function and inhibit the damage of islet cells.Therefore,it is inferred that ferroptosis of islet cells is closely related to the spleen's failure to function properly,and treating ferroptosis of islet cells from the spleen will become a new path of exploration.
作者
田朝阳
马雷雷
张碧溦
喇孝瑾
张桐
王静雅
李嘉钰
韩茹杰
李继安
Tian Zhaoyang;Ma Leilei;Zhang Biwei(College of Traditional Chinese Medical,the North China University of Science and Technology,Tangshan 063210,China)
出处
《华北理工大学学报（医学版）》
2024年第2期164-168,共5页
Journal of North China University of Science and Technology：Health Sciences Edition
基金
河北省自然科学基金资助项目(编号:H2023209038)
科技部对发展中国家常规性科技援助项目(编号:KY201904005)
河北省中医药管理局科研计划项目(编号:2020222)。
关键词
2型糖尿病
脾胰同源
胰岛细胞
从脾论治
铁死亡
Type 2 diabetes mellitus
Homology of spleen and pancreas
Islet cells
Perspective of spleen
Ferroptosis
作者简介
田朝阳(1991-),男,在读硕士研究生。研究方向:糖尿病的中医药研究与治疗;通讯作者:李继安,Email:lnyy@vip.sina.com。
