浏览全部资源
扫码关注微信
1.北京中医药大学 教育部中医养生学重点实验室,中医养生学北京市重点实验室,北京 100029
2.北京中医药大学 生命科学学院,北京 102488
Published:05 September 2023,
Published Online:13 February 2023,
Received:04 November 2022,
扫 描 看 全 文
吴悠,亓智玮,刘铜华等.滋肾丸及组方药物抗糖尿病研究进展[J].中国实验方剂学杂志,2023,29(17):212-220.
WU You,QI Zhiwei,LIU Tonghua,et al.Anti-diabetic Effect of Zishenwan and Its Herbal Components: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(17):212-220.
吴悠,亓智玮,刘铜华等.滋肾丸及组方药物抗糖尿病研究进展[J].中国实验方剂学杂志,2023,29(17):212-220. DOI: 10.13422/j.cnki.syfjx.20230503.
WU You,QI Zhiwei,LIU Tonghua,et al.Anti-diabetic Effect of Zishenwan and Its Herbal Components: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(17):212-220. DOI: 10.13422/j.cnki.syfjx.20230503.
滋肾丸又名通关丸,由知母、黄柏、肉桂3味中药配伍而成,被认为是清热泻火、滋阴化气的经典方剂,被用于治疗癃闭及肾痹等疾病。在近代,滋肾丸又演变为一个常用药对,用于治疗糖尿病(中医消渴病)表现为“下消”者。该文系统综述了滋肾丸的中医理论沿袭,并基于现代药理学研究,总结了既往对滋肾丸成分分析、滋肾丸改善糖尿病相关疾病和其3味组方成分的单味药与糖尿病治疗之间的相关研究,对其药物成分和3个组方药物治疗糖尿病的机制进行了总结论述。综述发现,滋肾丸可以通过抗炎、增强胰岛素敏感性、抑制肾小管上皮焦亡等机制改善糖尿病和糖尿病肾病。而滋肾丸中知母、黄柏、肉桂单味药及其含有的多种成分,包括芒果苷、知母皂苷、小檗碱、药根碱、肉桂酸、肉桂醛等,可通过多种机制如改善胰岛素靶器官的胰岛素抵抗、抑制炎症、抗氧化、调节脂代谢、刺激胰岛素分泌、调节肠道菌群等改善糖尿病、维持糖代谢稳态。该综述为后续滋肾丸干预糖尿病相关机制研究奠定理论基础和相关参考。
Zishenwan, also known as Tongguanwan, is composed of three herbs:Anemarrhenae Rhizoma, Phellodendri Chinensis Cortex, and Cinnamomi Cortex, which thus is thought to be the representative formula to clear heat, purge fire, nourish Yin, and tonify Qi, and it is often used for treating anuresis and renal arthralgia. In recent years, this formula has become a commonly used combination of herbs and is used to treat diabetes (consumptive thirst disease) diagnosed with "lower consumption" syndrome. This article systematically reviewed the development of traditional Chinese medicine (TCM) theory for Zishenwan. Moreover, based on modern pharmacological research, the previous studies on the components of Zishenwan, the improvement of diabetes-related diseases by Zishenwan, and the relationship between the single herd of Zishenwan and the treatment of diabetes were summarized, and the chemical components and the mechanisms for treating diabetes by the three herbs were discussed. It is found that Zishenwan can alleviate diabetes and diabetic nephropathy by performing anti-inflammation, enhancing insulin sensitivity, and inhibiting pyroptosis of renal tubular epithelial cells. Three herbs in Zishenwan and several components of them, including mangiferin, timosaponins, berberine, jatrorrhizine, cinnamaldehyde, and cinnamic acid can ameliorate diabetes and maintain stable glycometabolism by a variety of mechanisms such as improving insulin resistance in insulin target tissues, suppressing inflammation, anti-oxidation, regulating lipid metabolism, enhancing insulin secretion, and regulating gut microbiota. This review provides a theoretical foundation and reference for subsequent studies on the mechanisms of the anti-diabetic effect of Zishenwan.
滋肾丸糖尿病机制知母黄柏肉桂
ZishenwandiabetesmechanismAnemarrhenae RhizomaPhellodendri Chinensis CortexCinnamomi Cortex
李东垣.兰室秘藏[M].文魁,丁国华整理.北京:人民卫生出版社,2012:97-98.
国家药典委员会.中华人民共和国药典:一部[M].北京:中国医药科技出版社,1977:842-843.
张璐.张氏医通[M].李静芳,建一,校注.北京:中国中医药出版社,1995:455.
吴昆.医方考[M].北京:中国科学技术出版社,1996.
罗天益.卫生宝鉴[M].北京:中国医药科技出版社,2011:50.
汪机.医学原理[M].北京:中国中医药出版社,2015:169-184.
黄宫绣.本草求真[M].北京:人民卫生出版社,1987:185-186.
贺利芳.知母、黄柏、肉桂为主治疗肾阴虚型糖尿病[J].内蒙古中医药,2014,33(31):128.
张继元.通关丸在临床中的应用[J].光明中医,2008,23(6):843-844.
詹慧春,曹长恩,郝春梅,等.中医药治疗前列腺增生症的临床研究概况[J].实用中西医结合临床,2003,3(1):59-61.
刘统治,金国娥,胡雪冰.李东垣滋肾丸治疗小便淋闭[J].中医药临床杂志,2018,30(6):1033-1035.
方朝晖,赵进东,忻凌,等.古代35则消渴医案辨证用药规律探析[C]//中华中医药学会(China Association of Chinese Medicine).中华中医药学会糖尿病分会2016年学术年会暨第十七次中医糖尿病大会论文汇编.[出版者不详],2016:1.
李晓飞.养阴清热法对2型糖尿病患者胰岛素抵抗的影响[J].大家健康:下旬版,2015(11):28-29.
艾为民,梅诗耀,蒋小红,等.益气养阴清热法联合二甲双胍对2型糖尿病患者代谢指标的影响[J].当代医学,2020,26(31):117-118.
韩碧翠,高淑铮,张福.清热养阴、活血通络法治疗早中期糖尿病肾病疗效及对炎症状态、生活质量的影响[J].现代中西医结合杂志,2020,29(31):3500-3503.
秦田雨,董笑克,孙文,等.基因组学技术推动中医药精准医学研究现状分析与展望[J].现代生物医学进展,2018,18(13):2549,2597-2600.
中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华内分泌代谢杂志,2021,37(4):311-398.
孙文杰,赵能江,李博,等.《中国2型糖尿病防治指南(2020年版)》推荐中成药品种述评[J].中国中医药信息杂志,2022,29(3):1-5.
张春玲,范顺明,罗婷,等.滋肾丸HPLC指纹图谱及多种成分含量测定研究[J].中药材,2020,43(5):1176-1180.
陆薪如,秦民坚,徐德然.HPLC-ESI-MS/MS法鉴定通关丸的主要化学成分[J].中国天然药物,2008,6(4):283-291.
戴荣华.滋肾丸药效物质基础研究[D].沈阳:沈阳药科大学,2004.
刘晓卫.滋肾丸活性成分的吸收特征和体内变化过程研究[D].上海:第二军医大学,2014.
TANG Y H,SUN Z L,FAN M S,et al.Anti-diabetic effects of TongGuanWan, a Chinese traditional herbal formula, in C57BL/KsJ-db/db mice[J].Planta Med,2012,78(1):18-23.
GUO X,WU Y,ZHANG C,et al.Network pharmacology analysis of zishenwan for diabetic nephropathy and experimental verification of its anti-inflammatory mechanism[J].Drug Des Devel Ther,2021,15:1577-1594.
戴荣华,张园园,毕开顺.滋肾丸配伍机制研究[J].中国中药杂志,2004,29(9):897-899.
周琴妹,陈晓斌,邵家德,等.滋肾丸及其提取物的体外抑菌试验[J].中国药师,2007,10(5):412-413.
WU Y,SUN B,GUO X,et al.Zishen pill alleviates diabetes in db/db mice via activation of PI3K/Akt pathway in the liver[J].Chin Med,2022,17(1):128.
郭晓媛,张程斐,吴悠,等.滋肾丸对糖尿病肾病小鼠肾小管上皮细胞焦亡及上皮-间充质转化的影响[J].中国实验方剂学杂志,2021,27(21):27-36.
吉星.知母提取物的成分分析及对T2DM大鼠干预代谢组学初探[D].广州:广东药学院,2010.
钟艳梅,冯毅凡.知母醇提物药效学研究[J].亚太传统医药,2016,12(16):16-17.
高帅.知母活性成分提取工艺优化及降糖活性研究[D].杭州:浙江工业大学,2013.
HAN J,YANG N,ZHANG F,et al.Rhizoma Anemarrhenae extract ameliorates hyperglycemia and insulin resistance via activation of AMP-activated protein kinase in diabetic rodents[J].J Ethnopharmacol,2015,172:368-376.
王靖,葛盛芳,陈琦,等.知母多糖降血糖活性研究[J].中草药,1996(10):605-606.
刘印,陈兆杰.知母多糖治疗糖尿病大鼠[J].中成药,2017,39(9):1761-1765.
侯红瑞,陈玲,孙国勇,等.知母多糖对链脲佐菌素诱导糖尿病大鼠的降血糖作用[J].食品工业科技,2018,39(12):69-72,78.
高雁,张爽,宋泽璧,等.盐知母化学成分α-葡萄糖苷酶抑制作用研究[J].中国医药科学,2016,6(21):60-62.
YUAN Y L,GUO C R,CUI L L,et al.Timosaponin B-Ⅱ ameliorates diabetic nephropathy via TXNIP, mTOR, and NF-κB signaling pathways in alloxan-induced mice[J].Drug Des Devel Ther,2015,9:6247-6258.
TIAN X,LIU F,LI Z,et al.Enhanced anti-diabetic effect of berberine combined with timosaponin B2 in goto-kakizaki rats, associated with increased variety and exposure of effective substances through intestinal absorption[J].Front Pharmacol,2019,10:19.
何乐毅凡.芒果苷改善胰岛素抵抗作用机制研究[D].北京:北京中医药大学,2020.
WU Y,LIU W,YANG T,et al.Oral administration of mangiferin ameliorates diabetes in animal models: A Meta-analysis and systematic review[J].Nutr Res,2021,87:57-69.
董二会,王爱国,杨建波,等.川黄柏抗糖尿病活性部位化学成分研究[J].中药材,2012,35(9):1441-1443.
李先宽,冯杉,郑艳超,等.黄柏与关黄柏的化学成分及生物活性研究进展[J].药物评价研究,2019,42(5):1033-1037.
高妍,周海芳,刘朵,等.黄柏化学成分分析及其药理作用研究进展[J].亚太传统医药,2019,15(4):207-209.
KIM S,KIM Y,KO K H,et al.Butanol extract of 1∶1 mixture of Phellodendron cortex and Aralia cortex stimulates PI3-kinase and ERK2 with increase of glycogen levels in HepG2 cells[J].Phytother Res,1998,12(4):255-260.
TIAN X,XU Z,HU P,et al.Determination of the antidiabetic chemical basis of Phellodendri Chinensis Cortex by integrating hepatic disposition in vivo and hepatic gluconeogenese inhibition in vitro[J].J Ethnopharmacol,2020,263:113215.
范顺明,张春玲,王佳琪,等.知母-黄柏药对盐炙前后配伍对2型糖尿病大鼠糖脂代谢的影响[J].中国实验方剂学杂志,2021,27(3):22-29.
LI Z,GENG Y,JIANG J,et al.Antioxidant and anti-inflammatory activities of berberine in the treatment of diabetes mellitus[J].Evid Based Complement Alternat Med,2014,2014:289264.
GAO C R,ZHANG J Q,HUANG Q L.Experimental study on berberin raised insulin sensitivity in insulin resistance rat models[J].Chin J Integr Tradit West Med,1997,17(3):162-164.
CHANG W,ZHANG M,LI J,et al.Berberine improves insulin resistance in cardiomyocytes via activation of 5'-adenosine monophosphate-activated protein kinase[J].Metabolism,2013,62(8):1159-1167.
李博洋,闵清,王刚,等.小檗碱治疗糖尿病及其并发症的研究进展[J].湖北科技学院学报:医学版,2021,35(5):448-452.
CHANG W,CHEN L,HATCH G M.Berberine as a therapy for type 2 diabetes and its complications: From mechanism of action to clinical studies[J].Biochem Cell Biol,2015,93(5):479-486.
HAN Y,XIANG Y,SHI Y,et al.Pharmacokinetics and pharmacological activities of berberine in diabetes mellitus treatment[J].Evid Based Complement Alternat Med,2021,21:9987097.
赵建强,吕庆彪,张存志.小檗碱干预糖尿病前期人群延缓糖尿病发展的临床研究[J].实用糖尿病杂志,2018,14(5):31-33.
胡金华,胡婷婷,王静华,等.盐酸小檗碱联合二甲双胍对2型糖尿病合并NAFLD患者体脂成分和肝脏脂肪含量的影响[J].浙江医学,2021,43(21):2327-2331.
陈浩英.2型糖尿病伴脂肪肝患者临床治疗中予以盐酸小檗碱治疗对临床症状的改善作用[J].黑龙江中医药,2021,50(4):6-7.
PATEL M B,MISHRA S.Isoquinoline alkaloids from Tinospora cordifolia inhibit rat lens aldose reductase[J].Phytother Res,2012,26(9):1342-1347.
王云山,张洪,张晓春.药根碱对糖尿病模型大鼠血管Akt/AMPK/eNOS信号通路的影响[J].医药导报,2017,36(10):1107-1111.
朱水兰,雷婷,高旭,等.药根碱多重调控脂肪胰岛素抵抗细胞葡萄糖转运蛋白的降糖效应研究[J].中国中药杂志,2018,43(6):1215-1220.
马航,胡慭然,邹宗尧,等.黄连生物碱降糖作用研究及构效关系初探[J].中国药理学通报,2015(11):1575-1579.
吴昊. 药根碱对HepG2细胞和金黄地鼠的降血脂活性及机制研究[D].重庆:西南大学,2014.
HOSKINS J A.The occurrence, metabolism and toxicity of cinnamic acid and related compounds[J].J Appl Toxicol,1984,4(6):283-292.
SHANG C,LIN H,FANG X,et al.Beneficial effects of cinnamon and its extracts in the management of cardiovascular diseases and diabetes[J].Food Funct,2021,12(24):12194-12220.
VERSPOHL E J,BAUER K,NEDDERMANN E.Antidiabetic effect of Cinnamomum cassia and Cinnamomum zeylanicum in vivo and in vitro[J].Phytother Res,2005,19(3):203-206.
COUTURIER K,BATANDIER C,AWADA M,et al.Cinnamon improves insulin sensitivity and alters the body composition in an animal model of the metabolic syndrome[J].Arch Biochem Biophys,2010,501(1):158-161.
MOHAMMED K,AHMED H,SHARAF H A,et al.Encapsulation of cinnamon oil in whey protein counteracts the disturbances in biochemical parameters, gene expression, and histological picture of the liver and pancreas of diabetic rats[J].Environ Sci Pollut Res Int,2020,27(3):2829-2843.
QIN B,NAGASAKI M,REN M,et al.Cinnamon extract prevents the insulin resistance induced by a high-fructose diet[J].Horm Metab Res,2004,36(2):119-125.
陆婷,盛宏光.肉桂提取物对2型糖尿病患者空腹血糖的影响[J].江苏大学学报:医学版,2013,23(1):46-48,52.
郑卓婷,刘洁,丁玲,等.中药肉桂对2型糖尿病患者空腹血糖及血脂影响的Meta分析[J].四川解剖学杂志,2021,29(1):1-6.
ABDELMAGEED M E,SHEHATOU G S,ABDELSALAM R A,et al.Cinnamaldehyde ameliorates STZ-induced rat diabetes through modulation of IRS1/PI3K/Akt2 pathway and AGEs/RAGE interaction[J].Naunyn Schmiedebergs Arch Pharmacol,2019,392(2):243-258.
ANAND P,MURALI K Y,TANDON V,et al.Insulinotropic effect of cinnamaldehyde on transcriptional regulation of pyruvate kinase, phosphoenolpyruvate carboxykinase, and GLUT4 translocation in experimental diabetic rats[J].Chem Biol Interact,2010,186(1):72-81.
ZHAO H,WU H,DUAN M,et al.Cinnamaldehyde improves metabolic functions in streptozotocin-induced diabetic mice by regulating gut microbiota[J].Drug Des Devel Ther,2021,15:2339-2355.
CAMACHO S,MICHLIG S,DE SENARCLENS-BEZENÇON C,et al.Anti-obesity and anti-hyperglycemic effects of cinnamaldehyde via altered ghrelin secretion and functional impact on food intake and gastric emptying[J].Sci Rep,2015,5:7919.
LI J,LIU T,WANG L,et al.Antihyperglycemic and antihyperlipidemic action of cinnamaldehyde in C57BLKS/J db/db mice[J].J Tradit Chin Med,2012,32(3):446-452.
WU Y,WANG M H,YANG T,et al.Mechanisms for improving hepatic glucolipid metabolism by cinnamic acid and cinnamic aldehyde: An insight provided by multi-omics[J].Front Nutr,2021,8:794841.
BICKERS D,CALOW P,GREIM H,et al.A toxicologic and dermatologic assessment of cinnamyl alcohol, cinnamaldehyde and cinnamic acid when used as fragrance ingredients[J].Food Chem Toxicol,2005,43(6):799-836.
WU Y,WANG M,YANG T,et al.Cinnamic acid ameliorates nonalcoholic fatty liver disease by suppressing hepatic lipogenesis and promoting fatty acid oxidation[J].Evid Based Complement Alternat Med,2021,2021:9561613.
HAFIZUR R M,HAMEED A,SHUKRANA M,et al.Cinnamic acid exerts anti-diabetic activity by improving glucose tolerance in vivo and by stimulating insulin secretion in vitro[J].Phytomedicine,2015,22(2):297-300.
ADISAKWATTANA S,PONGSUWAN J,WUNGCHAROEN C,et al.In vitro effects of cinnamic acid derivatives on protein tyrosine phosphatase 1B[J].J Enzyme Inhib Med Chem,2013,28(5):1067-1072.
LAKSHMI B S,SUJATHA S,ANAND S,et al.Cinnamic acid, from the bark of Cinnamomum cassia,regulates glucose transport via activation of GLUT4 on L6 myotubes in a phosphatidylinositol 3-kinase-independent manner[J].J Diabetes,2009,1(2):99-106.
0
Views
25
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution