摘要
近年来,随着经济的快速发展,生活方式的改变,导致糖尿病的患病率逐年升高,其已经成为威胁全人类健康的世界性难题。根据流行病学研究,大多数糖尿病患者主要为2型糖尿病(T2DM),并伴有胰岛素抵抗和胰岛素分泌不足。炎症、肥胖、氧化应激以及细胞凋亡等诸多因素相互作用导致了胰岛素抵抗的发生。目前,临床常用的降糖药物主要包括,胰岛素及相关制剂,双胍类,磺酰脲类,α-糖苷酶抑制剂,格列奈类,噻唑烷二酮类,二肽基肽酶-Ⅳ抑制剂等。虽然适当的运动、生活方式的改变和口服降糖药物对治疗轻度T2DM是有效的。但对于严重糖尿病患者或合并相关并发症者需要长期、联合用药,这就提高药物副作用和不良反应的发生风险。中药治疗糖尿病在我国已经使用已有几千年历史,如黄连解毒汤、养阴健脾汤常用于治疗T2DM。同样,许多单味中药在治疗T2DM方面也发挥着自身优势,如麦冬、人参、苦瓜、吴茱萸、泽泻、黄芪、三七、知母、山药等中药在降血糖、改善胰岛素抵抗等方面具有理想的效果。然而,相当一部分方剂或单味药中的药效物质及作用靶点还不明确。最近,越来越多的天然产物被证明具有抗T2DM特性,并且其可能的治疗机制已经被探索。本文旨在全面综述目前天然活性物质黄酮类、多酚类、生物碱、萜类、多糖及醌类物质对T2DM的作用及相关靶点,为更好的研发治疗糖尿病及其并发症药物提供理论支持。
In recent years,with the rapid development of economy and the change of life style,the prevalence rate of diabetes has increased year by year,which has become a worldwide problem threatening the health of all mankind.According to epidemiological studies,most patients with diabetes are mainly type 2 diabetes mellitus(T2DM),accompanied by insulin resistance and insufficient insulin secretion.The interaction of many factors such as inflammation,obesity,oxidative stress and apoptosis leads to the occurrence of insulin resistance.At present,the commonly used hypoglycemic drugs include insulin and related preparations,biguanides,sulfonylureas,α-glycosidase inhibitors,glinids,thiazolidinediones,dipeptidyl peptidase-Ⅳinhibitors and so on.Although appropriate exercise,lifestyle changes and oral hypoglycemic drugs are effective in the treatment of mild T2DM.However,long-term and combined medication is needed for patients with severe diabetes or with related complications,which increases the risk of drug side effects and adverse reactions.Chinese herbal medicine has been used in China for thousands of years,such as Huanglian jiedutang and Yangyin Jianpitang.Similarly,many single traditional Chinese medicines also have their own advantages in the treatment of T2DM,such as Ophiopogonis Radix,Ginseng Radix et Rhizoma,Momordica Charantia,Euodiae Fructus,Alismatis Rhizoma,Astragali Radix,Notoginseng Radix et Rhizoma,Anemarrhenae Rhizoma,Dioscoreae Rhizoma and other traditional Chinese medicines have ideal effects in reducing blood sugar and improving insulin resistance.However,the active substances and targets in a considerable number of prescriptions or single medicines are not clear.Recently,more and more natural products have been proved to have anti-T2DM properties,and their possible therapeutic mechanisms have been explored.The purpose of this paper is to comprehensively review the effects and related targets of natural active substances such as flavonoids,polyphenols,alkaloids,terpenoids,polysaccharides and quinones on T2DM,and to provide theoretical support for better research and development of drugs for the treatment of diabetes and its complications.
作者
郭明鑫
吴霞
冯毅凡
GUO Ming-xin;WU Xia;FENG Yi-fan(New Drug Research and Development Center of Guangdong Pharmaceutical University,Guangzhou 510006,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2020年第17期212-218,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
广东省自然科学基金项目(2018A030313907)。
关键词
天然产物
2型糖尿病(T2DM)
T2DM治疗
胰岛素抵抗
发病机制
natural products
type 2 diabetes mellitus
treatment of type 2 diabetes mellitus
insulin resistance
pathogenesis
