摘要
糖尿病是一种持续高血糖引发的终身非传染性疾病,对人们的健康造成了巨大的威胁。糖尿病认知功能障碍是糖尿病糖脂代谢紊乱导致的神经功能损伤,表现为注意力不集中,学习记忆能力下降,继而发展为阿尔茨海默症。其发病机理尚未完全清楚。目前,临床上对糖尿病认知功能障碍的治疗以降糖药为主,没有专门预防治疗糖尿病认知功能障碍的药物,且大多数西药在发挥治疗作用的同时也伴随着严重的不良反应,极易出现耐药性和肝损伤。近年来,中医药在糖尿病认知功能障碍方面的基础研究越来越多且取得显著效果。现代医学认为糖尿病属于中医'消渴'范畴,糖尿病认知功能障碍是'消渴'合并'痴呆''健忘'。'气阴两虚'贯穿于'消渴'全过程,若'气阴两虚'不能有效控制则发生'气不行血''瘀血阻滞',败血内蕴化为毒,损伤脑络导致脑病发生。中药可通过降低血糖,抑制神经元损伤,β淀粉样蛋白(Aβ)沉积及Tau蛋白异常磷酸化程度等方面改善糖尿病认知功能障碍。本文从糖尿病状态下的糖脂代谢紊乱、血脑屏障损伤、炎症反应、氧化应激和非酶糖基化、胰岛素抵抗等方面对其发病机制进行综述,同时探讨有关中医对糖尿病认知功能障碍的认识及中药对其的预防治疗,以期能够为中药防治糖尿病认知功能障碍的研究提供参考。
Diabetes is a lifelong non-communicable disease caused by continuous high blood sugar,which poses a great threat to people’s health.Diabetic cognitive dysfunction is the neurological impairment caused by the disorder of glucose and lipid metabolism in diabetes mellitus,which is characterized by inattention,decreased learning and memory ability,and then developed into alzheimer’s disease.The pathogenesis of diabetic cognitive dysfunction is not fully understood.there are no effective drugs for this disease,hypoglycemic drugs are mainly used in the clinical treatment of diabetic cognitive dysfunction,and most drugs are accompanied by serious adverse reactions while playing a therapeutic role,drug resistance and liver injury are easy to occur.In recent years,there have been a lot of research achievements on the prevention and treatment of cognitive dysfunction in diabetes mellitus with traditional Chinese medicine(TCM).Modern medicine believes that diabetes belongs to the category of consumptive thirst of TCM,and the diabetic cognitive dysfunction is consumptive thirst combined with dementia and forgetfulness.Qi and Yin deficiency runs through the whole process of consumptive thirst,the Qi injured,Then the Qi defficiency would cause blood circulation malfunction,long-time poor blood condition would cause blood stagnating in the brain and blocking the brain,which would lead to the brain disease.TCM can improve the diabetic cognitive dysfunction by lowering blood sugar,inhibiting neuron damage,deposition of Amyloid beta(Aβ)and abnormal phosphorylation of Tau protein.This article reviews the pathogenesis of diabetic cognitive dysfunction from glucolipid metabolic disorders,disruption of blood brain barrier,inflammation,oxidative stress and non enzymatic glycosylation,insulin resistance in diabetes etc.,and explores the prevention and treatment of diabetic cognitive dysfunction by Chinese medicine,to provide a reference for the research and development of drug prevention and treatment of diabetic cognitive dysfunct
作者
张桂仙
袁娅金
熊薇
刘丽俊
周宁娜
ZHANG Gui-xian;YUAN Ya-jin;XIONG Wei;LIU Li-jun;ZHOU Ning-na(Yunnan University of Traditional Chinese Medicine,Kunming 650500,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2019年第23期215-221,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(81860714)
云南省中医药领军人才项目(10470101829)
云南省科技计划项目(2016FA035)
关键词
糖尿病
认知功能障碍
发病机制
中医药
diabetes mellitus
cognitive dysfunction
pathogenesis
traditional Chinese medicine
