[1] ZHAO Yaping ?YANG Lixia ?GAN Decheng ?ZHU Xiangdong ?LIANG Yonglin,.Research Progress of Gegen Qinlian Decoction in Treatment ofDamp Heat Type 2 Diabetes Based on Intestinal Flora [J]. Modern Traditional Chinese Medicine, 2023, (02): 1-7. [doi: 10.13424/j.cnki.mtcm.2023.02.001]
Research Progress of Gegen Qinlian Decoction in Treatment ofDamp Heat Type 2 Diabetes Based on Intestinal Flora
- Article number:
- 1672-0571(2023)02-0001-07
- Keywords:
- Key words:Intestinal flora; Gegen Qinlian Decoction; Damp heat syndrome; Type 2 diabetes; Insulin resistance
- ZTFLH:
- R255.4
- Code:
- A
- Abstract:
- Abstract：In recent years,the incidence rate of type 2 diabetes (T2DM) is increasing worldwide.Microbiology research has confirmed that the occurrence of its disease is closely related to the imbalance of the number and proportion of intestinal flora,and has become a research hotspot.Existing experiments have found that intestinal flora disorder can affect the occurrence and development of T2DM through the mechanism of short chain fatty acid theory,bile acid metabolism theory,endotoxin theory,branched chain amino acid theory,etc.Damp-heat syndrome is the most common syndrome type in T2DM patients,and insulin resistance is the most serious in this type of patients.Animal experimental studies have found that Gegen Qinlian Decoction can act on intestinal flora through specific molecular mechanisms and pathways,regulate the function of β cells of pancreas islets,improve insulin sensitivity,reduce oxidative stress reaction for regulating blood glucose and reducing insulin resistance,providing a more scientific basis for clinical treatment of T2DM patients.However,due to the large and complex number of flora,the existing data are mostly focused on animal experiments,and the specificity of the research flora is insufficient.Therefore,in the future,it is necessary to further strengthen the research on the specific flora of the disease and increase the statistics of clinical large sample data.
References:
[1]李璐,王玉琳,秦鸿宇,等.小檗碱调节肠肝轴治疗非酒精性脂肪肝病的研究进展[J].中草药,2021,52(5):1501-1509.
[2]欧璐,李晓琴,李宇,等.加味黄连温胆汤治疗新诊2型糖尿病痰(湿)热互结证临床观察[J].中国实验方剂学杂志,2021,27(1):128-134.
[3]刘嘉钰,王艳东.肠道菌群在代谢疾病中作用的研究进展[J].中国慢性病预防与控制,2020,28(8):627-631.
[4]赵祥,刘红玲,杨盼,等.滴灌对苜蓿根际土壤细菌多样性和群落结构的影响[J].微生物学通报,2019,46(10):2579-2590.
[5]徐波,黄小英,岳仁宋.基于“内伤伏邪”理论探讨肠道菌群紊乱致糖尿病发病的机理[J].成都中医药大学学报,2020,43(4):19-21,26.
[6]李金埕,刘尚建,荆鲁,等.国医大师吕仁和从“脾常备化”认识糖尿病发病机制[J].中医学报,2021,36(8):1679-1682.
[7]魏军平,柏力萄,魏璠.浅论“消渴”与糖尿病名候疏义[J].世界科学技术-中医药现代化,2019,21(1):54-58.
[8]田苗,马伯艳,刘春红,等.浅析“湿热”在胰岛素抵抗发生发展中的作用[J].中医药学报,2018,46(1):88-90.
[9]王雅芸,鲁一兵.肠道菌群和老年2型糖尿病的研究进展[J].实用老年医学,2018,32(5):412-416.
[10]张钰涵,梅其炳,牛银波.短链脂肪酸调控骨代谢的作用及机制的研究进展[J].微生物学通报,2021,48(11):4306-4314.
[11]孔文文,王朝霞.粪便代谢产物及与肠道微生态相关性研究进展[J].中国实用儿科杂志,2018,33(5):391-395.
[12]杨玥,吴晓康.中医药干预肠道菌群防治糖尿病的研究进展[J].中国实验方剂学杂志,2021,27(7):219-227.
[13]白永松,马恺笛,孟庆维,等.脱氧雪腐镰刀菌烯醇致动物厌食和呕吐机制的探讨[J].动物营养学报,2021,33(3):1230-1239.
[14]Baggio LL,Drucker DJ.Glucagon-like peptide-1 receptor co-agonists for treating metabolic disease[J].Molecular Metabolism,2021,46:101090.
[15]Guida C,Stephen SD,Watson M,et al.PYY plays a key role in the resolution of diabetes following bariatric surgery in humans[J].EBioMedicine,2019,40:67-76.
[16]郭蕊,韦祁山,李雯彬,等.短链脂肪酸通过肠脑轴改善肥胖的研究进展[J].临床荟萃,2019,34(12):1148-1152.
[17]何海,黄翰文,施晓艳,等.丹皮酚调控ApoE-/-小鼠胆汁酸代谢发挥抗动脉粥样硬化作用[J].中国动脉硬化杂志,2021,29(2):123-128,165.
[18]王文晓,乐世俊,刘娟,等.基于肠道菌群的中药改善胰岛素抵抗的作用机制研究进展[J].中草药,2020,51(1):216-228.
[19]Jiang CT,Xie C,Li F,et al.Intestinal farnesoid X receptor signaling promotes nonalcoholic fatty liver disease[J].The Journal of Clinical Investigation,2015,125(1):386-402.
[20]颜勇,李旭忠,周舟,等.法尼醇X受体对代谢调控作用的研究进展[J].中华糖尿病杂志,2016,8(5):306-309.
[21]Li F,Jiang CT,Krausz KW,et al.Microbiome remodelling leads to inhibition of intestinal farnesoid X receptor signalling anddecreased obesity[J].Nature Communications,2013,4:2384.
[22]周子钧,纪越,李俊辰,等.肠道菌群在2型糖尿病中的作用机制及中药的调控作用[J].医学综述,2021,27(16):3237-3243.
[23]Hudish LI,Reusch JE,Sussel L.Β Cell dysfunction during progression of metabolic syndrome to type 2 diabetes[J].The Journal of Clinical Investigation,2019,129(10):4001-4008.
[24]Xi YF.Role of farnesoid X receptor in hepatic steatosis in nonalcoholic fatty liver disease[J].Biomedicine & Pharmacotherapy,2020,121:109609.
[25]Saad MJ,Santos A,Prada PO.Linking gut microbiota and inflammation to obesity and insulin resistance[J].Physiology (Bethesda,Md),2016,31(4):283-293.
[26]Medzhitov R,Horng T.Transcriptional control of the inflammatory response[J].Nature Reviews Immunology,2009,9(10):69-2703.
[27]陈晓宁,封托,侯祥,等.雌性罗氏鼢鼠肠道微生物群落与功能预测的初步分析[J].野生动物学报,2021,42(2):411-419.
[28]刘洪玉,乔虹.2型糖尿病与肠道菌群关系的研究进展[J].中华老年多器官疾病杂志,2022,21(1):55-58.
[29]李欣,吴伟华.肠道稳态与慢性低度系统性炎症[J].医学综述,2018,24(7):1354-1359.
[30]Gojda J,Cahova M.Gut microbiota as the link between elevated BCAA serum levels and insulin resistance[J].Biomolecules,2021,11(10):1414.
[31]Newgard CB,An J,Bain JR,et al.A branched-chain amino acid-related metabolic signature that differentiates obese and lean humans and contributes to insulin resistance[J].Cell Metabolism,2009,9(4):311-326.
[32]甘巧,孟庆雄.肠道菌群及其代谢产物与T2DM发病机制及干预措施[J].中国生物工程杂志,2022,42(3):62-71.
[33]王凡雅,张日新.益气养阴活血通络法治疗早期糖尿病肾病的临床研究[J].现代中医药,2020,40(4):76-79.
[34]巩振东,刘春莹.糖尿病肾病水肿的中医药治疗研究进展[J].现代中医药,2015,35(2):79-82.
[35]Pedersen HK,Gudmundsdottir V,Nielsen HB,et al.Human gut microbes impact host serum metabolome and insulin sensitivity
[J].Nature,2016,535(7612):376-381.
[36]Liu RX,Hong J,Xu XQ,et al.Gut microbiome and serum metabolome alterations in obesity and after weight-loss intervention[J].Nature Medicine,2017,23(7):859868.
[37]严景妍,李兵,曾治君.从二阳结论治2型糖尿病Meta分析[J].中医临床研究,2018,10(19):139-143.
[38]杨茜,邹大进.肥胖与2型糖尿病的共同起源:能量过剩引发肝脏胰岛素抵抗[J].中华糖尿病杂志,2016,8(2):116-119.
[39]Sui M,Chen GF,Mao XD,et al.Gegen Qinlian Decoction ameliorates hepatic insulin resistance by silent information Regulator1 (SIRT1)-dependent deacetylation of forkhead box O1 (FOXO1)[J].Medical Science Monitor:International Medical Journal of Experimental and Clinical Research,2019,25:8544-8553.
[40]Zhou Q,Song N,Wang SQ,et al.Effect of Gegen Qinlian Decoction on hepatic gluconeogenesis in ZDF rats with type 2 diabetes mellitus based on the farnesol X receptor/ceramide signaling pathway regulating mitochondrial metabolism and endoplasmic Reticulum stress[J].Evidence-Based Complementary and Alternative Medicine:ECAM,2021,2021:9922292.
[41]龙伟清,彭永健,何晓敏,等.青钱柳叶提取物对2型糖尿病模型大鼠的治疗作用[J].中药材,2015,38(11):2386-2389.
[42]张煦坚,赵振群,刘万林.激素性股骨头缺血坏死发病机制中的内质网应激[J].中国组织工程研究,2021,25(11):1759-1765.
[43]Tu J,Zhu S,Li B,et al.Gegen Qinlian Decoction coordinately regulates PPARγ and PPARα to improve glucose and lipid homeostasis in diabetic rats and insulin resistance 3T3-L1 adipocytes[J].Frontiers in Pharmacology,2020,11:811.
[44]丁然然,杨明霞.复方中药治疗糖尿病及其并发症的研究进展[J].实用中医内科杂志,2022,36(5):36-39.
[45]Luo XX,Zhu SL,Li BT,et al.Gegen Qinlian Decoction activates PPARγ to ameliorate adipocytic insulin resistance in diabetic SD rats and IR-3T3-L1 adipocytes[J].China Journal of Chinese Materia Medica,2017,42(23):4641-4648.
[46]Moraes-Vieira PM,Saghatelian A,Kahn BB.GLUT4 expression in adipocytes regulates denovo lipogenesis and levels of a novel class of lipids with antidiabetic and anti-inflammatory effects[J].Diabetes,2016,65(7):1808-1815.
[47]Tian JX,Bai BB,Gao ZZ,et al.Alleviation effects of GQD,a traditional Chinese medicine formula,on diabetes rats linked to modulation of the gut microbiome[J].Frontiers in Cellular and Infection Microbiology,2021,11:740236.
[48]Hotamisligil GS.Inflammation and metabolic disorders[J].Nature,2006,444(7121):860-867.
[49]韩栩珂,陈一丁,陈慧臻,等.2型糖尿病神经源性膀胱大鼠模型的建立与评价[J].中国组织工程研究,2022,26(17):2713-2719.
[50]杨光,何浩强,陈光,等.中药调节肠道菌群干预冠心病及其危险因素的研究进展[J].中国中药杂志,2020,45(1):29-36.
[51]王洋,韩玉生,赵福红,等.基于肠道菌群探讨黄精水提物改善高脂高糖饮食所致大鼠认知功能损伤的作用机制[J].中医药信息,2022,39(3):33-42.
[52]李贺赟,刘文科.黄连、清半夏、瓜蒌子治疗痰热互结型代谢综合征经验:仝小林三味小方撷萃[J].吉林中医药,2020,40(1):12-14.
[53]洪雪珮,庞书勤,葛莉,等.薯蓣粥对2型糖尿病大鼠肠道通透性的影响[J].食品工业科技,2022,43(4):379-386.
[54]林艺娟,丁健,黄循铷,等.粪菌移植对小鼠实验性结肠炎TLR4信号通路及肠黏膜屏障的影响[J].中国微生态学杂志,2021,33(3):256-263,270.
[55]仝小林,姬航宇,李敏,等.脾瘅新论[J].中华中医药杂志,2009,24(8):988-991.
[56]黄柔,喻嵘,谭艳,等.基于“脾瘅”理论探讨2型糖尿病合并非酒精性脂肪性肝病[J].亚太传统医药,2021,17(2):159-161.
Memo
基金项目：甘肃省教育厅产业支撑计划项目（2021CYZC-03）；甘肃省教育科技创新项目产业支撑计划项目（2021CYZC-03）