浏览全部资源
扫码关注微信
1.陕西中医药大学 第一临床医学院,陕西 咸阳 712000
2.陕西中医药大学 附属医院,陕西 咸阳 712000
Received:19 January 2022,
Published Online:18 March 2022,
Published:05 September 2022
移动端阅览
颉玙,张金梅,张敏等.中药多糖修复糖尿病创面作用机制研究进展[J].中国实验方剂学杂志,2022,28(17):258-266.
XIE Yu,ZHANG Jinmei,ZHANG Min,et al.Repairing Diabetic Wounds with Polysaccharides from Traditional Chinese Medicines: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(17):258-266.
颉玙,张金梅,张敏等.中药多糖修复糖尿病创面作用机制研究进展[J].中国实验方剂学杂志,2022,28(17):258-266. DOI: 10.13422/j.cnki.syfjx.20221004.
XIE Yu,ZHANG Jinmei,ZHANG Min,et al.Repairing Diabetic Wounds with Polysaccharides from Traditional Chinese Medicines: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(17):258-266. DOI: 10.13422/j.cnki.syfjx.20221004.
截止2020年我国糖尿病患者总人数超过1.2亿,糖尿病创面是糖尿病最常见的并发症之一,其患病率逐年上升且具有一定的致残率和致死率。中草药治疗糖尿病创面历史悠久,具有良好的疗效和安全性。近年来,越来越多的学者以各中草药的多糖活性成分为研究重点,探讨中药多糖对糖尿病创面的修复机制。中药多糖被认为是中药的主要活性成分,几乎每种中药多糖都具有一种或多种降糖机制。然而现研究大多集中于探索单味中药多糖的修复机制,鲜有对其进行深入探讨及归纳总结,因此该文通过检索并整理相关文献,归纳中药多糖修复糖尿病创面的作用机制,从调控创面炎症反应,改善炎症微环境、降血糖机制及促进成纤维细胞迁移与增殖、调控创面生长因子促进血管新生、抑制氧化应激反应、调节免疫功能等方面对中药多糖修复糖尿病创面的作用机制展开综述,并对未来可能的研究方向提出一些建议,以期开发出符合国际标准又具有中医特色的糖尿病创面修复新疗法,同时为糖尿病创面的治疗提供临床参考。
As of 2020, there are more than 120 million diabetic patients in China. Diabetic wounds is one of the common complications of diabetes with increasing incidence and has the potential to cause disability and mortality. Traditional Chinese medicine (TCM) has a long history in treating diabetic wounds, demonstrating significant efficacy and safety. In recent years, increasing researchers have explored the mechanisms of polysaccharides from TCM in the repair of diabetic wounds. Polysaccharides are the main active ingredients of TCM and employ one or more blood sugar-lowering mechanisms. However, most studies focus on the repair mechanism of single polysaccharides, and there is little in-depth discussion and summary. To provide a new therapy for diabetic wounds, which meets international standards and has the characteristics of TCM, and provide reference for the clinical treatment of diabetic wounds, we reviewed relevant literature to summarize the mechanisms of TCM polysaccharides in treating diabetic wounds. The mechanisms include inhibiting inflammation to improve wound microenvironment, lowering blood sugar, promoting fibroblast migration and proliferation, regulating wound growth factor to promote angiogenesis, inhibiting oxidative stress response, and regulating immune function. Finally, we put forward some possible research directions in the future.
LI Y , TENG D , SHI X , et al . Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: National cross sectional study [J]. BMJ , 2020 , 369 : m997 .
RENA G , HARDIE D G , PEARSON E R . The mechanisms of action of metformin [J]. Diabetologia , 2017 , 60 ( 9 ): 1577 - 1585 .
BOULTON A J M , MALIK R A , AREZZO J C , et al . Diabetic somatic neuropathies [J]. Diabetes care , 2004 , 27 ( 6 ): 1458 - 1486 .
DAVIS J L , LEWIS S B , GERICH J E , et al . Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine [J]. JAMA , 1977 , 238 ( 21 ): 2291 - 2292 .
UÇKAY I , ARAGÓN-SÁNCHEZ J , LEW D , et al . Diabetic foot infections: What have we learned in the last 30 years? [J]. Int J Infect Dis , 2015 , 40 : 81 - 91 .
HUANG X , LIANG P , JIANG B , et al . Hyperbaric oxygen potentiates diabetic wound healing by promoting fibroblast cell proliferation and endothelial cell angiogenesis [J]. Life Sci , 2020 , 259 : 118246 .
WU J , SHI S , WANG H , et al . Mechanisms underlying the effect of polysaccharides in the treatment of type 2 diabetes: A review [J]. Carbohydr Polym , 2016 , 144 : 474 - 494 .
代云云 , 谢晓蓉 , 王鹏波 , 等 . 中药多糖降脂作用机理的研究进展 [J]. 中药药理与临床 , 2021 , 37 ( 5 ): 219 - 224 .
杨杰 , 卫东锋 , 张占军 , 等 . 中药多糖对血管内皮细胞的保护作用及机制研究进展 [J]. 中国中医药信息杂志 , 2016 , 23 ( 12 ): 119 - 124 .
赵艳 . 白及多糖调控NLRP3炎症小体促糖尿病足溃疡愈合机制研究 [D]. 武汉 : 湖北医药学院 , 2021 .
李笑眉 . 白芨多糖水凝胶促进糖尿病创面愈合的应用研究 [D]. 大连 : 大连医科大学 , 2021 .
俞林花 , 聂绪强 , 潘会君 , 等 . 白及多糖对糖尿病溃疡创面愈合的作用研究 [J]. 中国中药杂志 , 2011 , 36 ( 11 ): 1487 - 1491 .
张正军 , 肖正华 , 陈定宇 , 等 . 黄芪多糖对糖尿病足溃疡渗出液成纤维细胞MMP-2、MMP-9表达的影响 [J]. 中国糖尿病杂志 , 2007 , 15 ( 4 ): 202 - 203 .
ZOU F , MAO X Q , WANG N , et al . Astragalus polysaccharides alleviates glucose toxicity and restores glucose homeostasis in diabetic states via activation of AMPK [J]. Acta Pharmacol Sin , 2009 , 30 ( 12 ): 1607 - 1615 .
李光善 , 李萍 , 盛巡 , 等 . 黄芪多糖、桂皮醛、川芎嗪对实验性糖尿病大鼠创面成纤维细胞增殖作用的影响 [J]. 中国中医基础医学杂志 , 2004 , 10 ( 4 ): 20 - 22 .
周倩 , 王燕 , 肖正华 , 等 . 黄芪多糖对糖尿病足溃疡成纤维细胞胶原合成的影响 [J]. 解剖学研究 , 2011 , 33 ( 2 ): 135 - 137 .
TU S , SHAO A , REN L , et al . Angiogenesis effect of Astragalus polysaccharide combined with endothelial progenitor cells therapy in diabetic male rat following experimental hind limb ischemia [J]. Chin Med J (Engl) , 2014 , 127 ( 11 ): 2121 - 2128 .
陈蔚 , 李益明 , 俞茂华 , 等 . 黄芪多糖对糖尿病鼠T细胞亚群的免疫调节作用 [J]. 中国现代医学杂志 , 2007 , 17 ( 1 ): 28 - 31,35 .
WANG T , LIAO Q , WU Y , et al . A composite hydrogel loading natural polysaccharides derived from Periplaneta americana herbal residue for diabetic wound healing [J]. Int J Biol Macromol , 2020 , 164 : 3846 - 3857 .
郑月月 , 石小霞 , 柳德学 , 等 . 芦荟多糖对糖尿病足溃疡大鼠创面愈合的影响 [J]. 中国临床药理学杂志 , 2021 , 37 ( 2 ): 153 - 156 .
王林莉 . 太子参多糖及其联合干细胞移植对大鼠糖尿病足溃疡创面修复作用研究 [D]. 福州 : 福建中医药大学 , 2020 .
徐锦龙 , 徐爱仁 , 应景艳 , 等 . 太子参多糖对实验性糖尿病大鼠血糖及胰岛素的影响 [J]. 中华中医药学刊 , 2012 , 30 ( 2 ): 423 - 424 .
徐先祥 , 黄玉香 , 夏伦祝 , 等 . 太子参多糖对糖尿病小鼠抗氧化能力与胰腺病理的影响 [J]. 食品工业科技 , 2012 , 33 ( 24 ): 392 - 393 .
CAI H , LIU F , ZUO P , et al . Practical application of antidiabetic efficacy of Lycium barbarum polysaccharide in patients with type 2 diabetes [J]. Med Chem , 2015 , 11 ( 4 ): 383 - 390 .
孙桂菊 , 王少康 , 张勇 , 等 . 枸杞多糖、茶叶多糖混合物对Ⅱ型糖尿病大鼠降血糖作用及对糖尿病并发症相关指标的影响 [J]. 食品研究与开发 , 2003 , 24 ( 2 ): 75 - 78 .
LI S , CHEN H , WANG J , et al . Involvement of the PI3K/Akt signal pathway in the hypoglycemic effects of tea polysaccharides on diabetic mice [J]. Int J Biol Macromol , 2015 , 81 : 967 - 974 .
LI S P , ZHANG G H , ZENG Q , et al . Hypoglycemic activity of polysaccharide,with antioxidation,isolated from cultured Cordyceps mycelia [J]. Phytomedicine , 2006 , 13 ( 6 ): 428 - 433 .
黄志江 , 季晖 , 李萍 , 等 . 人工虫草多糖降血糖作用及其机制研究 [J]. 中国药科大学学报 , 2002 , 33 ( 1 ): 51 - 54 .
CHEN L C , JIANG B K , ZHENG W H , et al . Preparation,characterization and anti-diabetic activity of polysaccharides from adlay seed [J]. Int J Biol Macromol , 2019 , 139 : 605 - 613 .
刘成梅 , 付桂明 , 涂宗财 , 等 . 百合多糖降血糖功能研究 [J]. 食品科学 , 2002 ( 6 ): 113 - 114 .
胡国强 , 杨保华 , 张忠泉 . 山药多糖对大鼠血糖及胰岛释放的影响 [J]. 山东中医杂志 , 2004 , 23 ( 4 ): 230 - 231 .
马迅 , 雷红 , 李谦 , 等 . 灰树花子实体多糖的分子组成与降血糖作用 [J]. 药物生物技术 , 2007 , 14 ( 5 ): 328 - 333 .
JIAO Y , WANG X , JIANG X , et al . Antidiabetic effects of Morus alba fruit polysaccharides on high-fat diet- and streptozotocin-induced type 2 diabetes in rats [J]. J Ethnopharmacol , 2017 , 199 : 119 - 127 .
WANG D , ZHAO X , LIU Y . Hypoglycemic and hypolipidemic effects of a polysaccharide from flower buds of Lonicera japonica in streptozotocin-induced diabetic rats [J]. Int J Biol Macromol , 2017 , 102 : 396 - 404 .
MAO D , TIAN X Y , MAO D , et al . A polysaccharide extract from the medicinal plant Maidong inhibits the IKK-NF- κ B pathway and IL-1 β -induced islet inflammation and increases insulin secretion [J]. J Biol Chem , 2020 , 295 ( 36 ): 12573 - 12587 .
XIAO Z Q , WANG Y L , GAN S R , et al . Polysaccharides from Liriopes Radix ameliorates hyperglycemia via various potential mechanisms in diabetic rats [J]. J Sci Food Agric , 2014 , 94 ( 5 ): 975 - 982 .
LI Y , CAO Z , LI Q , et al . Effects of dendrobium polysaccharides on the functions of human skin fibroblasts and expression of matrix metalloproteinase-2 under high-glucose conditions [J]. Int J Endocrinol , 2021 , 2021 : 1092975 .
张岚 , 刘学政 . 大黄多糖对糖尿病大鼠皮肤创面愈合的影响 [J]. 中国民康医学 , 2015 ( 14 ): 175 - 175 .
JIA J , ZHANG X , HU Y S , et al . Evaluation of in vivo antioxidant activities of Ganoderma lucidum polysaccharides in STZ-diabetic rats [J]. Food Chem , 2009 , 115 ( 1 ): 32 - 36 .
CHENG P G , PHAN C W , SABARATNAM V , et al . Polysaccharides-rich extract of Ganoderma lucidum (MA Curtis:Fr.) P.Karst accelerates wound healing in streptozotocin-induced diabetic rats [J]. Evid Based Complement Alternat Med , 2013 , 2013 : 671252 .
TIE L , YANG H Q , AN Y , et al . Ganoderma lucidum polysaccharide accelerates refractory wound healing by inhibition of mitochondrial oxidative stress in type 1 diabetes [J]. Cell Physiol Biochem , 2012 , 29 ( 3/4 ): 583 - 594 .
WANG B B , WANG J L , YUAN J , et al . Sugar composition analysis of Fuzi polysaccharides by HPLC-MSn and their protective effects on Schwann Cells exposed to high glucose [J]. Molecules , 2016 , 21 ( 11 ): 1496 .
段晋宁 , 肖旺 , 曾建红 , 等 . 莪术多糖对糖尿病大鼠血糖、抗脂质过氧化作用的影响与单糖组分分析 [J]. 时珍国医国药 , 2016 , 27 ( 3 ): 569 - 572 .
张然 , 袁从英 , 冯娜 , 等 . 车前子多糖对糖尿病小鼠氧化应激的影响 [J]. 天津医药 , 2011 , 39 ( 3 ): 253 - 255 .
吴建中 , 欧仕益 , 陈静 , 等 . 番石榴多糖对糖尿病小鼠的血糖及抗氧化能力的影响 [J]. 中成药 , 2007 , 29 ( 5 ): 668 - 671 .
余杰 , 李伟 , 张晓辉 . 金线莲多糖抗糖尿病作用的研究 [J]. 海峡药学 , 2013 , 25 ( 11 ): 37 - 40 .
王苏仪 , 常雪莹 , 赵帅 , 等 . 螺旋藻多糖对糖尿病大鼠血糖及抗氧化作用的影响 [J]. 职业与健康 , 2015 , 31 ( 23 ): 3229 - 3231,3235 .
王乾宇 , 何光志 , 黄高 . 杜仲多糖对糖尿病模型小鼠血清SOD、GSH-Px和MDA的影响 [J]. 江西中医药 , 2016 , 47 ( 4 ): 34 - 36 .
李宁 , 李肇进 , 张博 , 等 . 白芍多糖抗糖尿病作用的实验研究 [J]. 中药材 , 2016 , 39 ( 6 ): 1408 - 1410 .
CHEN S N , WU Y S , CHEN S , et al . Novel Application of immunomodulatory mushroom polysaccharide ( β -Glucan) and triterpenes for diabetic wound care [M]. London : IntechOpen , 2020 .
张峰 , 高永峰 , 张继国 . 四叶参多糖对糖尿病大鼠血糖及免疫功能的影响 [J]. 中国实验方剂学杂志 , 2012 , 18 ( 2 ): 184 - 186 .
GURTNER G C , WERNER S , BARRANDON Y , et al . Wound repair and regeneration [J]. Nature , 2008 , 453 ( 7193 ): 314 - 321 .
HUANG W , JIAO J , LIU J , et al . MFG-E8 accelerates wound healing in diabetes by regulating "NLRP3 inflammasome-neutrophil extracellular traps" axis [J]. Cell Death Discov , 2020 , 6 : 84 .
LIU D , YANG P , GAO M , et al . NLRP3 activation induced by neutrophil extracellular traps sustains inflammatory response in the diabetic wound [J]. Clin Sci (Lond) , 2019 , 133 ( 4 ): 565 - 582 .
MIRZA R E , FANG M M , WEINHEIMER-HAUS E M , et al . Sustained inflammasome activity in macrophages impairs wound healing in type 2 diabetic humans and mice [J]. Diabetes , 2014 , 63 ( 3 ): 1103 - 1114 .
KASIEWICZ L N , WHITEHEAD K A . Silencing TNF α with lipidoid nanoparticles downregulates both TNF α and MCP-1 in an in vitro co-culture model of diabetic foot ulcers [J]. Acta Biomater , 2016 , 32 : 120 - 128 .
LIU F , CHEN D D , SUN X , et al . Hydrogen sulfide improves wound healing via restoration of endothelial progenitor cell functions and activation of angiopoietin-1 in type 2 diabetes [J]. Diabetes , 2014 , 63 ( 5 ): 1763 - 1778 .
CARLING D . AMP-activated protein kinase:Balancing the scales [J]. Biochimie , 2005 , 87 ( 1 ): 87 - 91 .
HU J , PANG W , BAI S , et al . Hypoglycemic effect of polysaccharides with different molecular weight of Pseudostellaria heterophylla [J]. BMC Complementary Altern Med , 2013 , 13 ( 1 ): 1 - 9 .
JIN M , HUANG Q , ZHAO K , et al . Biological activities and potential health benefit effects of polysaccharides isolated from Lycium barbarum L [J]. Int J Biol Macromol , 2013 , 54 : 16 - 23 .
KARGES B , ROSENBAUER J , KAPELLEN T , et al . Hemoglobin A1c levels and risk of severe hypoglycemia in children and young adults with type 1 diabetes from Germany and Austria: A trend analysis in a cohort of 37,539 patients between 1995 and 2012 [J]. PLoS Med , 2014 , 11 ( 10 ): e1001742 .
WOODLEY D T . Distinct fibroblasts in the papillary and reticular dermis:Implications for wound healing [J]. Dermatol Clin , 2017 , 35 ( 1 ): 95 - 100 .
安玉兰 , 邓丽君 , 孙晴 , 等 . 基质金属蛋白酶(MMPs)在糖尿病足创面皮肤的表达水平及其临床意义 [J]. 青海医学院学报 , 2016 , 37 ( 2 ): 108 - 113 .
DOSHI B M , PERDRIZET G A , HIGHTOWER L E . Wound healing from a cellular stress response perspective [J]. Cell Stress Chaperones , 2008 , 13 ( 4 ): 393 - 399 .
陈芳 , 孙付宝 , 陈小将 , 等 . 糖尿病足患者血清VEGF、bFGF水平与下肢血管病变程度的关系 [J]. 临床和实验医学杂志 , 2021 , 20 ( 17 ): 1856 - 1859 .
CHEN J , LV L , LI Y , et al . Preparation and evaluation of Bletilla striata polysaccharide/graphene oxide composite hemostatic sponge [J]. Int J Biol Macromol , 2019 , 130 : 827 - 835 .
孙镜洁 , 肖敏 , 周志祥 . 锰超氧化物歧化酶(MnSOD)表达与活性调控及其与肿瘤的关系 [J]. 生理科学进展 , 2019 , 50 ( 2 ): 117 - 121 .
DIDŽIAPETRIENĖ J , BUBLEVIČ J , SMAILYTĖ G , et al . Significance of blood serum catalase activity and malondialdehyde level for survival prognosis of ovarian cancer patients [J]. Medicina , 2014 , 50 ( 4 ): 204 - 208 .
MINUTTI C M , KNIPPER J A , ALLEN J E , et al . Tissue-specific contribution of macrophages to wound healing [J]. Semin Cell Dev Biol , 2017 , 61 : 3 - 11 .
ZHU Z Y , MENG M , SUN H , et al . Immunostimulatory activity of glycopeptides from Paecilomyces sinensis under normal and cyclophosphamide induced immunosuppressive conditions in mice models [J]. Food Funct , 2016 , 7 ( 8 ): 3566 - 3576 .
0
Views
25
下载量
3
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution