中国中医科学院 广安门医院,北京 100053
王梓仪,博士,主治医师,从事中医药防治心血管疾病临床与基础研究,E-mail:464974834@qq.com
何庆勇,博士,主任医师,从事中医药防治心血管疾病临床与基础研究,E-mail:heqingyongg@163.com
收稿:2024-12-13,
录用:2025-01-21,
网络出版:2025-02-07,
纸质出版:2025-04-05
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王梓仪,范星宇,贾裕智等.基于中西医临床病症特点的2型糖尿病合并高血压动物模型分析[J].中国实验方剂学杂志,2025,31(07):230-236.
WANG Ziyi,FAN Xingyu,JIA Yuzhi,et al.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):230-236.
王梓仪,范星宇,贾裕智等.基于中西医临床病症特点的2型糖尿病合并高血压动物模型分析[J].中国实验方剂学杂志,2025,31(07):230-236. DOI: 10.13422/j.cnki.syfjx.20250995.
WANG Ziyi,FAN Xingyu,JIA Yuzhi,et al.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):230-236. DOI: 10.13422/j.cnki.syfjx.20250995.
2型糖尿病(T2DM)与高血压是常见多发的慢性非传染性疾病,在临床常同时存在,导致大量心血管事件与死亡,且病死率远超过血脂紊乱、肥胖等其他因素。该研究基于T2DM合并高血压的国内外诊断标准、指南及动物模型评价方法,对现有的T2DM合并高血压的中西医临床病症特点进行总结评价与分析。西医吻合度较高的模型有手术诱导法、化学药物诱导法中给自发性高血压(SHR)大鼠注射链脲佐菌素(STZ)、膳食诱导法中高脂高盐饮食诱导SD大鼠结合STZ注射,中医吻合度较高的模型为手术诱导法,综合中西医吻合度及优缺点,较为理想的T2DM合并高血压动物模型为手术诱导法中的两肾一夹(2K1C)法的基础上再运用高脂高糖膳食联合STZ注射,但以上模型均缺乏中医特色,评价指标特异性差。该研究发现现有T2DM合并高血压动物模型缺乏病证结合模型,原因可能与动物宏观信息的中医证候辨识与归属问题有关。对此提出了探索和完善病证结合动物模型评价标准,精准判断T2DM合并高血压动物模型各证候病理特征的模拟程度,从而建立理想的T2DM合并高血压病证结合动物模型模拟人体该共病的发生与发展过程,以期为进一步研究T2DM的发病机制及其中医药防治方案提供理想的研究手段,对糖尿病合并高血压的治疗、预防及其并发症的转归具有重要意义;同时在共患病的基础证候模型上取得突破并推广,有望为中医科学研究跨越式发展奠定基础。
Type 2 diabetes mellitus (T2DM) and hypertension are common and frequent chronic non-communicable diseases, which often coexist in clinical practice, resulting in a large number of cardiovascular events and deaths, and their case fatality rate far exceeds that of other factors such as dyslipidemia and obesity. Based on the diagnostic standards, guidelines, and animal model evaluation methods of T2DM with hypertension at home and abroad, this study summarized, evaluated, and analyzed the characteristics of the existing animal models of T2DM with hypertension based on the clinical symptoms in traditional Chinese and Western medicine. The animal models showing high fitting degrees with the clinical symptoms in Western medicine are mainly established by injection of streptozocin (STZ) in SHR rats in the surgical induction and chemical induction methods and feeding a high-fat and high-salt diet combined with STZ injection in SD rats in the dietary induction methods. The models showcasing high fitting degrees with the clinical symptoms in traditional Chinese medicine (TCM) are mainly established by the surgical induction method. Considering the fitting degrees and the advantages and disadvantages, the ideal modeling method for T2DM with hypertension is the two-kidney, one clip (2K1C) method (a surgical induction method) combined with feeding a high-fat and high-sugar diet and STZ injection. However, the available models lack the characteristics of TCM and the evaluation indicators have poor specificity. This study found that there are few animal models of T2DM with hypertension considering the characteristics of both disease and syndrome, which may be related to the identification and attribution of TCM syndromes in animal macroscopic information. In view of this problem, it is suggested that the evaluation criteria should be established and improved for the animal models combining disease and syndrome, which can help to evaluate the fitting degree of the pathological characteristics of different syndromes in the animal models of T2DM with hypertension. In this way, ideal animal models of T2DM with hypertension can be established to simulate the disease occurrence and development in the human body. The animal models are expected to provide an ideal approach for the further research on the pathogenesis of T2DM and its prevention and treatment with TCM, which is of great significance for the treatment and prevention of T2DM with hypertension and the prognosis of its complications. At the same time, breakthroughs in the basic syndrome models of comorbidities are expected to lay a foundation for the leapfrog development of TCM research.
北京高血压防治协会 , 中国老年学和老年医学学会 , 北京市社区卫生协会 , 等 . 成人高血压合并2型糖尿病和血脂异常基层防治中国专家共识(2024年版) [J]. 中国全科医学 , 2024 , 27 ( 28 ): 3453 - 3475,3482 .
Beijing Hypertension Association,China Association of Gerontology and Geriatrics,Beijing Community Health ServiceAssociation,et al . Chinese expert consensus on grassroots prevention and treatment of hypertension combined with type 2 diabetes mellitus and dyslipidemia in adults 2024 [J]. Chin Gen Pract , 2024 , 27 ( 28 ): 3453 - 3475,3482 .
中华医学会 , 中华医学会临床药学分会 , 中华医学会杂志社 , 等 . 高血压基层合理用药指南 [J]. 中华全科医师杂志 , 2021 , 20 ( 1 ): 21 - 28 .
Chinese Medical Association , Chinese Society ofclinical Pharmacy , Chinese Medical journals Publishing House , et al . Guideline for rational medication of hypertension in primary care [J]. Chin J Gen Pract , 2021 , 20 ( 1 ): 21 - 28 .
钱秋海 , 倪青 , 黄延芹 . 糖尿病高血压病证结合诊疗指南 [J]. 环球中医药 , 2024 , 17 ( 1 ): 173 - 187 .
QIAN Q H , NI Q , HUANG Y Q . Guidelines for the diagnosis and treatment of diabetes mellitus with hypertension [J]. Glob Tradit Chin Med , 2024 , 17 ( 1 ): 173 - 187 .
CLIMIE R E , VAN SLOTEN T T , BRUNO R M , et al . Macrovasculature and microvasculature at the crossroads between type 2 diabetes mellitus and hypertension [J]. Hypertension , 2019 , 73 ( 6 ): 1138 - 1149 .
MANCUSI C , IZZO R , DI GIOIA G , et al . Insulin resistance the hinge between hypertension and type 2 diabetes [J]. High Blood Press Cardiovasc Prev , 2020 , 27 ( 6 ): 515 - 526 .
TSAPAS A , KARAGIANNIS T , KAKOTRICHI P , et al . Comparative efficacy of glucose-lowering medications on body weight and blood pressure in patients with type 2 diabetes:A systematic review and network Meta-analysis [J]. Diabetes Obes Metab , 2021 , 23 ( 9 ): 2116 - 2124 .
ZHANG J , YAO X , CHEN Y , et al . Degree of blood glucose control and risk of hypertension in Chinese adults with T2DM:A cross-sectional study [J]. Diabetes Metab Syndr Obes , 2024 , 17 : 3227 - 3238 .
JIA G , SOWERS J R . Hypertension in diabetes:An update of basic mechanisms and clinical disease [J]. Hypertension , 2021 , 78 ( 5 ): 1197 - 1205 .
中华医学会内分泌学分会 . 中国糖尿病患者血压管理的专家共识 [J]. 中华内分泌代谢杂志 , 2012 , 28 ( 8 ): 614 - 618 .
Chinese Society of Endocrinology . Expert consensus on blood pressure management in Chinese diabetic patients [J]. Chin J Endocrinol Metab , 2012 , 28 ( 8 ): 614 - 618 .
杨柳媛 , 许陆达 , 林欢 , 等 . 基于数据挖掘分析中医药治疗糖尿病合并高血压病的用药规律 [J]. 中医临床研究 , 2021 , 13 ( 12 ): 51 - 55 .
YANG L Y , XU L D , LIN H , et al . Medication law and theoretical analysis in treating diabetes combined with hypertension based on date mining technology [J]. Clin J Chin Med , 2021 , 13 ( 12 ): 51 - 55 .
周美辰 , 向明芝 , 廖垚 , 等 . 中医药治疗糖尿病合并高血压的研究进展 [J]. 医学综述 , 2019 , 25 ( 23 ): 4731 - 4735 .
ZHOU M C , XIANG M Z , LIAO Y , et al . Research progress of traditional Chinese medicine in treating diabetes mellitus combined with hypertension [J]. Med Recapit , 2019 , 25 ( 23 ): 4731 - 4735 .
刘旺 . 2型糖尿病合并高血压中医证候及相关因素的研究 [D]. 长春 : 长春中医药大学 , 2022 .
LIU W . Study on TCM Syndrome and related factors of type 2 diabetes complicated with hypertension [D]. Changchun : Changchun University of Chinese Medicine , 2022 .
中国中医科学院 . 中医循证临床实践指南——中医内科 [M]. 北京 : 中国中医药出版社 , 2011 .
China Academy of Chinese Medical Sciences . Guidelines for evidence based clinical practice in traditional Chinese medicine—internal medicine of traditional Chinese medicine [M]. Beijing : China Press of Chinese Medicine , 2011 .
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]. 中华糖尿病杂志 , 2021 , 13 ( 4 ): 315 - 409 .
Chinese Diabetes Society . Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) [J]. Chin J Diabetes Mellitus , 2021 , 13 ( 4 ): 315 - 409 .
MANCIA G , KREUTZ R , BRUNSTRÖM M , et al . 2023 ESH guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European society of hypertension:Endorsed by the International society of hypertension (ISH) and the European renal association (ERA) [J]. J Hypertens , 2023 , 41 ( 12 ): 1874 - 2071 .
中国高血压防治指南修订委员会 , 高血压联盟(中国 , 中国医疗保健国际交流促进会高血压病学分会 , 等 . 中国高血压防治指南(2024年修订版) [J]. 中华高血压杂志:中英文 , 2024 , 32 ( 7 ): 603 - 700 .
Chinese Guidelines for the Management of Hypertension , Chinese Hypertension League , Chinese Society of Cardiology , et al . Chinese guidelines for the prevention and treatment of hypertension (revised 2024 edition) [J]. Chin J Hypertens , 2024 , 32 ( 7 ): 603 - 700 .
田硕 , 曹利华 , 苗明三 , 等 . 基于临床中西医病症特点的中医药动物模型评价新方法 [J]. 中药药理与临床 , 2017 , 33 ( 6 ): 165 - 169 .
TIAN S , CAO L H , MIAO M S , et al . A new method for the evaluation of animal models used in traditional Chinese medicine based on the clinical characteristics of Chinese and Western medicine [J]. Pharmacol Clin Chin Mater Med , 2017 , 33 ( 6 ): 165 - 169 .
中华中医药学会 . 糖尿病中医防治指南 [M]. 北京 : 中国中医药出版社 , 2007 : 47 - 49 .
China Association of Chinese Medicine . Guide for diabetes prevention and control of traditional Chinese medicine [M]. Beijing : China Press of Chinese Medicine , 2007 : 47 - 49 .
郑莜萸 . 中药新药临床研究指导原则(试行) [M]. 北京 : 中国医药科技出版社 , 2002 : 68 .
ZHENG X Y . Guidelines for clinical research of traditional chinese medicine new drugs (trial) [M]. Beijing : China Health Media Group , 2002 : 68 .
国家中医药管理局 . 中医病证诊断疗效标准 [M]. 北京 : 中国医药科技出版社 , 2012 : 126 - 127 .
National Administration of Traditional Chinese Medicine . Diagnostic and therapeutic standards for traditional Chinese medicine diseases and syndromes [M]. Beijing : China Health Media Group , 2012 : 126 - 127 .
RIEHLE C , BAUERSACHS J . Of mice and men:Models and mechanisms of diabetic cardiomyopathy [J]. Basic Res Cardiol , 2018 , 114 ( 1 ): 2 .
JAMA H A , MURALITHARAN R R , XU C , et al . Rodent models of hypertension [J]. Br J Pharmacol , 2022 , 179 ( 5 ): 918 - 937 .
万斌 , 孙丽薇 , 张巧香 , 等 . 2型糖尿病合并肾性高血压模型的建立及评价 [J]. 动物医学进展 , 2016 , 37 ( 5 ): 53 - 59 .
WAN B , SUN L W , ZHANG Q X , et al . Establishment and assessment of model of type 2 diabetes mellitus(T2DM)complicated renal hypertension [J]. Prog Vet Med , 2016 , 37 ( 5 ): 53 - 59 .
杜晓 , 闫旭龙 , 陈梅 , 等 . 两肾一夹型高血压合并2型糖尿病大鼠模型的实验研究 [J]. 包头医学院学报 , 2014 , 30 ( 6 ): 13 - 17 .
DU X , YAN X L , CHEN M , et al . Experimental study on the rat models of two-kidney and one-clip hypertension combined with type 2 diabetes [J]. J Baotou Med Coll , 2014 , 30 ( 6 ): 13 - 17 .
张冰 , 程罡 , 刘洪英 , 等 . 一种糖尿病-高血压大鼠模型的建立 [J]. 药学学报 , 2009 , 44 ( 6 ): 575 - 580 .
ZHANG B , CHENG G , LIU H Y , et al . Establishment of a diabetic-hypertensive rat model [J]. Acta Pharm Sin , 2009 , 44 ( 6 ): 575 - 580 .
DIAS L D , CASALI K R , LEGUISAMO N M , et al . Renal denervation in an animal model of diabetes and hypertension:Impact on the autonomic nervous system and nephropathy [J]. Cardiovasc Diabetol , 2011 , 10 ( 1 ): 33 - 49 .
刘莉 , 罗鹏 , 周田田 , 等 . 厄贝沙坦对高血压合并2型糖尿病大鼠胰岛素抵抗IRS-1/PI3K/GLUT4信号通路的影响 [J]. 中国临床解剖学杂志 , 2021 , 39 ( 5 ): 563 - 568 .
LIU L , LUO P , ZHOU T T , et al . Effect of irbesartan on insulin resistance IRS-1/PI3K/GLUT4 signaling pathway in rats with hypertension and type 2 diabetes mellitus [J]. Chin J Clin Anat , 2021 , 39 ( 5 ): 563 - 568 .
孙兆峰 , 王利 , 张玲 , 等 . 伴高血压2型糖尿病大鼠模型的建立 [J]. 中国老年学杂志 , 2009 , 29 ( 9 ): 1078 - 1080 .
SUN Z F , WANG L , ZHANG L , et al . Establishment of a rat model with hypertension type 2 diabetes [J]. Chin J Gerontol , 2009 , 29 ( 9 ): 1078 - 1080 .
黄俊霞 , 陈祖盛 , 张阳 , 等 . 2型糖尿病伴发高血压大鼠模型的建立 [J]. 中国应用生理学杂志 , 2017 , 33 ( 4 ): 329 - 333 .
HUANG J X , CHEN Z S , ZHANG Y , et al . Establishment of rat model of type 2 diabetescomplicated with hypertension [J]. Chin J Appl Physiol , 2017 , 33 ( 4 ): 329 - 333 .
GHOLAM M F , LIU L P , SEARCY L A , et al . Dapagliflozin treatment augments bioactive phosphatidylethanolamine concentrations in kidney cortex membrane fractions of hypertensive diabetic db/db mice and alters the density of lipid rafts in mouse proximal tubule cells [J]. Int J Mol Sci , 2023 , 24 ( 2 ): 1408 .
KRÄKER K , HERSE F , GOLIC M , et al . Effects of empagliflozin and target-organ damage in a novel rodent model of heart failure induced by combined hypertension and diabetes [J]. Sci Rep , 2020 , 10 ( 1 ): 14061 .
COHEN A M , ROSENMANN E , ROSENTHAL T . The Cohen diabetic(non-insulin-dependent) hypertensive rat model.Description of the model and pathologic findings [J]. Am J Hypertens , 1994 , 6 ( 12 ): 989 - 995 .
张译心 , 王鑫 , 刘博 , 等 . 2型糖尿病气阴两虚病证结合动物模型的制备及评价指标的建立 [J]. 中国实验动物学报 , 2021 , 29 ( 2 ): 219 - 229 .
ZHANG Y X , WANG X , LIU B , et al . Preparation of animal model of type 2 diabetes with Qi-Yin deficiency syndrome and establishment of evaluation index [J]. Acta Lab Anim Sci Sin , 2021 , 29 ( 2 ): 219 - 229 .
苗明三 , 马林纳 , 彭孟凡 , 等 . 中医药动物模型研究现状 [J]. 中国比较医学杂志 , 2022 , 32 ( 1 ): 141 - 146 .
MIAO M S , MA L N , PENG M F , et al . Animal model research and applications in traditional Chinese medicine [J]. Chin J Comp Med , 2022 , 32 ( 1 ): 141 - 146 .
方肇勤 , 潘志强 , 卢文丽 , 等 . 大鼠/小鼠是证候研究的主要模式生物 [J]. 中国中医基础医学杂志 , 2009 , 15 ( 5 ): 252 - 253 .
FANG Z Q , PAN Z Q , LU W L , et al . Rats/mice are the main model organisms for pattern studies [J]. China J Basic Med Tradit Chin Med , 2009 , 15 ( 5 ): 252 - 253 .
林传权 . 病证结合动物模型研究的进展及存在问题分析 [J]. 中华中医药杂志 , 2019 , 34 ( 8 ): 4 .
LIN C Q . Analysis of progress and problems in research of animal model combination withdisease and syndrome [J]. China J Tradit Chin Med Pharm , 2019 , 34 ( 8 ): 4 .
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