摘要
糖尿病认知障碍(DCI)起病隐匿,可进一步发展为痴呆,早期防治是关键。浊为机体代谢产物或者精微物质失其正化所生,是DCI的滋生土壤。糖尿病患者饮食不节,脾胃纳化失调,致精微失其正化,蓄积为糖浊,进而变化痰瘀、浊毒等,蕴结脑窍,损伤认知,此属浊邪害清。神经炎症是诱发DCI的关键因素,主要受代谢重编程调控。脂质和乳酸蓄积作为代谢重编程的直接结果,是导致神经炎症的关键介质,与血液高糖水平均属于中医浊邪范畴。糖尿病环境下代谢重编程,诱导脂质和乳酸蓄积,介导神经炎症,与浊邪害清病机的发展颇为契合。以代谢重编程为切入点,探讨DCI浊邪害清病机的现代生物学认识,为中医药防治DCI提供新思路。
The diabetic cognitive impairment(DCI)starts insidiously and can further develop into dementia.Early prevention and treatment are the key measure."Turbidity"refers to the body's metabolic products or the substances that cannot be transported and transformed normally,which is the breeding ground for DCI.The improper diet of diabetes patients leads to the imbalance of spleen and stomach absorption and induces the accumulation of essence into sugar turbidity.When the turbid remains for a long period of time,it will turn into phlegm,stasis,and turbid toxins and damage the clear orifice,resulting in cognitive impairment,which belongs to the category of"turbid evil invading the clear orifice".Neuroinflammation is a key factor inducing DCI,which is mainly regulated by metabolic reprogramming.As the direct product of metabolic reprogramming,lipid and lactate accumulation are key mediators of neuroinflammation,along with high glucose,belonging to the category of"turbid evil"in traditional Chinese medicine.Metabolic reprogramming in the microenvironment of diabetes induces lactate and lipid accumulation,and mediates neuroinflammation,which is quite consistent with the development of TCM pathogenesis of"turbid evil invading the orifices".This paper aims to explore the modern biological understanding of the pathogenesis of turbid evil invading the clear orifice in DCI from the perspective of metabolic reprogramming,and to provide new ideas for its research of prevention and treatment in traditional Chinese medicine.
作者
冯慧
凌云
周春祥
陶伟伟
FENG Hui;LING Yun;ZHOU Chunxiang;TAO Weiwei(School of Chinese Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;School of Integrated Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China)
出处
《南京中医药大学学报》
CAS
CSCD
北大核心
2024年第8期759-764,共6页
Journal of Nanjing University of Traditional Chinese Medicine
基金
江苏省高等学校基础科学(自然科学)研究项目(23KJB360007)
江苏省科技发展计划青年人才项目(QN202102)
国家中医药管理局高水平中医药重点学科建设项目(国中医药人教函[2023]85号)。
关键词
浊邪害清
糖尿病认知障碍
代谢重编程
神经炎症
脂质蓄积
乳酸蓄积
turbid evil invading the clear orifice
diabetic cognitive impairment
metabolic reprogramming
neuroinflammation
lipid accumulation
lactic acid accumulation
