糖尿病心肌病发病机制及中医药治疗概述

发布时间：2018-11-05 08:18

【摘要】：糖尿病的慢性并发症主要是大血管病变和微血管病变,其中微血管病变是糖尿病特异性并发症,其典型病变是微循环障碍和微血管基底膜增厚。其中心脏微血管病变和心肌代谢紊乱可引起心肌广泛灶性坏死,称为糖尿病心肌病。糖尿病心肌病的发病机制十分复杂,涉及多个方面,包括心肌纤维化,心肌糖脂代谢障碍,氧化应激,细胞因子异常,胰岛素抵抗,有丝分裂原活化蛋白激酶(MAPK)蛋白激酶及其家族蛋白酶信号通路,雷帕霉素靶体蛋白(m TOR)号通路,NF-E2-related factor 2-抗氧化反应元件(Nrf2-ARE)信号通路等。中医多从益气滋阴,活血通络方面考虑,所用药物主要集中在单味中药和中药复方两方面,大量动物实验和临床资料表明中医药在本病的治疗上效果良好。发挥中医学辨证论治特色,深入挖掘中草药资源,利用其组方特色和多剂型的特点,将其应用于糖尿病心肌病的治疗中,将是一件十分有意义的事情。本文对糖尿病心肌病的发病机制及中医药的防治研究做一回顾,为临床防治本病提供参考。
[Abstract]:The main chronic complications of diabetes mellitus are macroangiopathy and microangiopathy, in which microvascular lesion is the specific complication of diabetes, and its typical lesion is microcirculation disorder and microvascular basement membrane thickening. Cardiac microangiopathy and myocardial metabolic disorder can cause extensive focal necrosis of myocardium, known as diabetic cardiomyopathy. The pathogenesis of diabetic cardiomyopathy is complex and involves many aspects, including myocardial fibrosis, myocardial glucose and lipid metabolism disorders, oxidative stress, cytokine abnormalities, insulin resistance, Mitogen activated protein kinase (MAPK) protein kinase and its family protease signaling pathway, rapamycin target protein (m TOR) pathway, NF-E2-related factor 2-antioxidant response element (Nrf2-ARE) signal pathway and so on. Traditional Chinese medicine is mostly considered from the aspects of invigorating qi and nourishing yin, activating blood circulation and dredging collaterals. The medicine used is mainly concentrated in the two aspects of single Chinese medicine and traditional Chinese medicine compound. A large number of animal experiments and clinical data show that Chinese medicine has a good effect on the treatment of this disease. It will be very meaningful to give full play to the characteristics of syndrome differentiation and treatment of traditional Chinese medicine, to dig into the resources of Chinese herbal medicine, and to apply it to the treatment of diabetic cardiomyopathy by using the characteristics of prescription and multi-dosage form. This article reviews the pathogenesis of diabetic cardiomyopathy and the prevention and treatment of traditional Chinese medicine to provide a reference for clinical prevention and treatment of this disease.
【作者单位】：甘肃省中医院;甘肃中医药大学;甘肃省中医药研究院;
【基金】：国家自然科学基金项目(81560764)
【分类号】：R259

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