摘要
高血糖的长期存在导致代谢记忆效应的出现是糖尿病大血管病变形成的重要原因,尽早控制代谢记忆为防治糖尿病及其并发症的关键所在。晚期糖基化终末产物的过度形成不仅是引起代谢记忆的重要因素,也是引发糖尿病大血管病变的核心机制。中医认为,伏邪是糖尿病大血管病变形成的关键病机,而尽早采用祛邪通络之法则是防治该病的必要手段。伏邪理论在春秋战国时已现萌芽,后经不断发展,于明清处得以成熟。所谓伏邪,即伏而不即发之邪。伏邪之说首见于《黄帝内经》,原指伏气温病,随后其含义不断扩展,现指一切伏而不即发的邪气。作为诸多疾病的病因病机,伏邪理论被广泛用于临床,并指导疾病的治疗。在机体内部,随着晚期糖基化终末产物的不断蓄积,可诱发体内的后续级联效应,最终促进糖尿病大血管病变的生成发展。这与中医内因痰瘀伏邪藏匿体内,而诱导机体出现代谢紊乱并产生疾病的过程极为类似。因此,在伏邪理论的指导下,解析晚期糖基化终产物阻断代谢记忆、防治糖尿病大血管病变的作用机制,一方面将为探索伏邪理论通过调控晚期糖基化终末产物的生成而影响糖尿病大血管病变的疾病进程提供科学依据;另一方面也能为伏邪理论在糖尿病大血管病变中的发生发展提供物质变化基础。
The long-term existence of hyperglycemia leads to the occurrence of metabolic memory effect,which is an important reason for the formation of diabetic macrovascular disease,so the early control of metabolic memory is the key to the prevention and treatment of diabetes and its complications.The excessive formation of advanced glycation end products(AGEs)is not only an important factor to cause metabolic memory,but also the core mechanism for diabetic macrovascular disease.It is believed in traditional Chinese medicine(TCM)that Fu-xie(incubative pathogen)is the key pathogenesis of the formation of diabetic vascular diseases,and it is necessary to adopt the principle of removing pathogenic factors and opening collaterals as early as possible to prevent and cure the disease.During the Spring and Autumn Period and the Warring States Period,the theory of Fu-xie was germinated,and got mature in the Ming and Qing dynasties after the continuous development.The so-called Fu-xie means that the pathogens are of a potential nature but not cause diseases immediately.The theory of Fu-xie first appeared in Huangdi Neijing,with an original meaning of epidemic febrile disease occurring after incubation,and then its meaning continues to expand,now referring to all potential pathogenic factors that would not immediately cause diseases.As the cause and pathogenesis of many diseases,the theory of Fu-xie is widely used in clinical practice to guide the treatment of diseases.In the body,the accumulation of AEGs can induce the subsequent cascade effect in the body,and finally promote the formation and development of diabetic macrovascular diseases.This is very similar to the process of inducing metabolic disorder and disease in TCM due to the accumulation of phlegm and silt.Therefore,under the guidance of Fu-xie theory,the mechanism of AEGs in blocking metabolic memory and preventing and treating diabetic macrovascular disease was analyzed in this paper.On the one hand,it will provide a scientific basis for the exploration of Fu-xie theory affecting the disease course of diabetic macrovascular disease by regulating the generation of AEGs.On the other hand,it can also provide the material change basis for the development of Fu-xie theory in the occurrence and development of diabetic macroangiopathy.
作者
成林
高泓
袁海泼
刘桠
CHENG Lin;GAO Hong;YUAN Hai-po;LIU Ya(Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610075,China;Affiliated Hospital of Chengdu University of TCM,Chengdu 610075,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2020年第24期211-218,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
四川省中医药管理局科学技术研究专项(2018JC015)。
关键词
代谢记忆
晚期糖基化终末产物
伏邪
糖尿病大血管病变
metabolic memory
advanced glycation end products(AGEs)
Fu-xie theory
diabetic macrovascular disease
