文献类型：期刊文献

中文题名：糖尿病心肌病发病机制及中医药治疗概述

英文题名：Pathogenesis of Diabetic Cardiomyopathy and Overview Traditional Chinese Medicine Treatment

作者：薛建军[1];范强[2];杨丽霞[3];汪永锋[2];孟祥云[1,3];薛燕芳[2];白宇[2];姜良恩[2]

第一作者：薛建军

机构：[1]甘肃省中医院;[2]甘肃中医药大学;[3]甘肃省中医药研究院

第一机构：甘肃省中医院

年份：2017

卷号：23

期号：22

起止页码：211

中文期刊名：中国实验方剂学杂志

外文期刊名：Chinese Journal of Experimental Traditional Medical Formulae

收录：CSTPCD;;北大核心:【北大核心2014】；CSCD:【CSCD_E2017_2018】；

基金：国家自然科学基金项目(81560764)

语种：中文

中文关键词：糖尿病心肌病;发病机制;单味中药;中药复方;治疗

外文关键词：diabetic cardiomyopathy; pathogenesis; single herb; traditional Chinese medicinecompound ; treatment

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。
Chronic complications of diabetes are mainly macrovascular disease and microvascular disease,in which microvascular disease is a diabetic-specific complication, with microcirculation disturbance and microvascular basement membrane thickening as the typical lesions. Specifically,heart microvascular disease and myocardial metabolic disorders can cause extensive myocardial necrosis, which is known as diabetic cardiomyopathy. The pathogenesis of diabetic cardiomyopathy is very complex,involving many aspects,including myocardial fibrosis,myocardial glucose and lipid metabolism,oxidative stress,cytokine abnormalities,insulin resistance,mitogen-activated protein kinase（ AMPK） protein kinase and its associated protease signaling pathway,mammalian target of rapamycin（ m TOR） signaling pathway,and NF-E2-related factor 2-antioxidant response element（ Nrf2-ARE） signaling pathway. Traditional Chinese medicine（ TCM） doctors mainly consider in the aspects of activating blood and unblocking collaterals,and focus on single herb and TCM compounds. A large number of animal experiments and clinical data show that TCMs have a good effect in the treatment of this disease.It is a very meaningful to bring TCM＇s characteristic of treatment based on syndrome differentiation,deeply dig Chinese herbal medicine resources,and apply its characteristics of composition and multiple dosage forms in the treatment of diabetic cardiomyopathy. This article reviews the pathogenesis of diabetic cardiomyopathy and the studies for prevention and treatment of TCM,and provides a reference for clinical prevention and treatment of this disease.