Exploration of intestinal mucosal barrier injury in diabetes mellitus type 2 based on "dryness-heat and stagnation" theory

LI Jiaxin; WANG Qingfeng; AN Jiren; YANG Yufeng; SHI Yan

doi:10.3969/j.issn.1006-2157.2023.07.017

您当前的位置：

首页 >

文章列表页 >

Exploration of intestinal mucosal barrier injury in diabetes mellitus type 2 based on "dryness-heat and stagnation" theory

Theoretical Studies | 更新时间：2023-08-07

- Exploration of intestinal mucosal barrier injury in diabetes mellitus type 2 based on "dryness-heat and stagnation" theory
- Journal of Beijing University of Traditional Chinese Medicine Vol. 46, Issue 7, Pages: 992-998(2023)
- 作者机构：
  
  辽宁中医药大学　沈阳　110847
- 作者简介：
  
  Prof.YANG Yufeng, Ph.D., Master’s Supervisor.Liaoning University of Traditional Chinese Medicine, No.79, Chongshan East Road, Huanggu District, Shenyang 110032. E-mail: yyf701@163.com
- 基金信息：
  
  The National Basic Research and Development Program of China(2013CB532004);the Key Project of the Natural Science Foundation of Liaoning Province(20170540598);the Millions of Talents Project of Liaoning Province(2020921039);the project supported by Liaoning Province Xingliao Talents Plan for Young Talents(XLYC1807145)
- DOI：10.3969/j.issn.1006-2157.2023.07.017
  CLC： R259
- Received：13 December 2022，
  
  Published：30 July 2023
- 稿件说明：
移动端阅览
LI Jiaxin, WANG Qingfeng, AN Jiren, et al. Exploration of intestinal mucosal barrier injury in diabetes mellitus type 2 based on "dryness-heat and stagnation" theory[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(7): 992-998.
DOI：

LI Jiaxin, WANG Qingfeng, AN Jiren, et al. Exploration of intestinal mucosal barrier injury in diabetes mellitus type 2 based on "dryness-heat and stagnation" theory[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(7): 992-998. DOI： 10.3969/j.issn.1006-2157.2023.07.017.

摘要

近年来，2型糖尿病(T2DM)的发病率逐渐增高。研究表明，肠黏膜屏障损伤与T2DM的发生发展关系密切，肠黏膜屏障是肠道内容物与机体血液循环之间的重要屏障，包括免疫屏障、机械屏障、化学屏障和生物屏障，各种肠黏膜屏障损伤过程中均存在肠道炎症反应，肠道炎症反应也是肠黏膜屏障损伤导致T2DM的关键因素。“燥热怫郁”理论是中医消渴病诊疗理论的重要组成部分，由刘完素在《三消论》中首先提出，并应用于临床实践。饮食不节、脾胃亏虚为致病之本，而脾胃虚弱与肠道消化吸收及黏膜屏障功能损伤密切相关。燥热内生、腠理怫郁是消渴病的关键病机，中医学燥热内生的病机演变颇切合西医学慢性炎症反应的病理特点，肠道腠理的作用与西医学肠黏膜屏障功能相吻合。因此，基于“燥热怫郁”理论探讨肠黏膜屏障损伤与T2DM的关系，可为中医学论治T2DM提供理论依据。

Abstract

In recent years

the incidence of diabetes mellitus type 2 (T2DM) has gradually increased. Studies have shown that intestinal mucosal barrier injury is closely related to the occurrence and development of T2DM. The intestinal mucosal barrier is an important barrier between intestinal contents and the body's blood circulation

including the immune barrier

the mechanical barrier

the chemical barrier

and the biological barrier. Intestinal inflammatory reactions take place in various processes of intestinal mucosal barrier injury

which is also a key factor in T2DM-induced intestinal mucosal barrier injury. As an important part of the traditional Chinese medicine diagnosis and treatment theory of emaciation-thirst disease

"dryness-heat and stagnation" was first proposed and applied in clinical practice in Liu Wansu’s

San Xiao Lun

. Improper diet and deficiency of the spleen and stomach are the root causes of the disease

and the weakness of the spleen and stomach is closely related to intestinal digestion and absorption and reduced mucosal barrier function. The endogenous dryness-heat and stagnation of striae and interstices is the key pathogenesis of emaciation-thirst. The evolution of pathogenesis of endogenous dryness-heat in traditional Chinese medicine is quite consistent with the pathological characteristics of a chronic inflammatory response in western medicine. The action of striae and interstices of the intestine is consistent with the function of the intestinal mucosal barrier in western medicine. Therefore

the relationship between intestinal mucosal barrier injury and T2DM is discussed based on "dryness-heat and stagnation" theory

which will provide a theoretical basis for the treatment of T2DM.

关键词

Keywords

references

SUN H , SAEEDI P , KARURANGA S , et al . IDF diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 .[J/OL] . Diabetes Res Clin Pract , 2022 , 183 : 109119 [ 2022-11-10 ]. https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(21)00478-2/fulltext .

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]. 国际内分泌代谢杂志， 2021 ， 41 ( 5 ): 482 - 548 .

王山，倪艳，傅君芬．肠道屏障在肥胖相关代谢性疾病发生发展中的作用 [J]. 重庆医科大学学报， 2023 ， 48 ( 2 ): 226 - 234 .

刘完素．三消论 [M]// 宋乃光．刘完素医学全书．北京：中国中医药出版社， 2006 .

COX AJ , WEST NP , CRIPPS AW . Obesity, inflammation, and the gut microbiota [J]. Lancet Diabetes Endocrinol , 2015 , 3 ( 3 ): 207 - 215 .

ZHONG HJ , YUAN Y , XIE WR ， et al . Type 2 Diabetes Mellitus Is Associated with More Serious Small Intestinal Mucosal Injuries [J/OL] . PLoS One , 2016 , 11 ( 9 ): e0162354 [ 2022-11-10 ]. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162354 .

袁凤易，石准，杨芳明，等．二甲双胍对新诊断2型糖尿病患者肠道菌群影响的研究 [J]. 中国糖尿病杂志， 2022 ， 30 ( 9 ): 672 - 677 .

刘小翠，胡郁刚，陈伟忠．阿卡波糖对糖尿病患者肠道菌群的影响 [J]. 黑龙江医学， 2017 ， 41 ( 6 ): 541 - 542 .

张博荀．基于“肠道菌群—黏膜屏障”研究“黄芩－黄连”药对治疗T2DM的疗效机制及配伍效应 [D]. 成都：成都中医药大学， 2020 .

MONTEIRO-SEPULVEDA M , TOUCH S , MENDES-SA C , et al . Jejunal T Cell Inflammation in Human Obesity Correlates with Decreased Enterocyte Insulin Signaling [J]. Cell Metab , 2015 , 22 : 113 - 124 .

HONG CP , PARK A , YANG BG , et al . Gut-Specific Delivery of T-Helper 17 Cells Reduces Obesity and Insulin Resistance in Mice [J] . Gastroenterology , 2017 , 152 : 1998 - 2010 .

巩静．从肠道黏膜屏障与免疫系统探讨小檗碱改善糖脂代谢紊乱的机制 [D]. 武汉：华中科技大学， 2018 .

SALVO ROMERO E , ALONSO COTONER C , PARDO CAMACHO C ， et al . The intestinal barrier function and its involvement in digestive disease [J]. Rev Esp Enferm Dig ， 2015 ， 107 ( 11 ): 686 - 696 .

朱佳源，肖嫩群，谭周进．中药对肠道黏膜损伤的研究进展 [J]. 世界华人消化杂志， 2021 ， 29 ( 9 ): 449 - 454 .

PANWAR S , SHARMA S , TRIPATHI P ． Role of Barrier Integrity and Dysfunctions in Maintaining the Healthy Gut and Their Health Outcomes [J/OL] . Front Physiol , 2021 , 12 : 715611 [ 2022-11-10 ]. https://www.frontiersin.org/articles/10.3389/fphys.2021.715611/full .

ZHAO LJ , LOU HX , PENG Y , et al . Elevated levels of circulating short-chain fatty acids and bile acids in type 2 diabetes are linked to gut barrier disruption and disordered gut microbiota [J/OL] . Diabetes Res Clin Pract , 2020 , 169 : 108418 [ 2022-11-10 ]. https://linkinghub.elsevier.com/retrieve/pii/S0168822720306719 .

NASCIMENTO JC , MATHEUS VA , OLIVEIRA RB , et al . High-Fat Diet Induces Disruption of the Tight Junction-Mediated Paracellular Barrier in the Proximal Small Intestine Before the Onset of Type 2 Diabetes and Endotoxemia [J] . Dig Dis Sci , 2021 , 66 : 3359 - 3374 .

王翠菊，苗秀明，郭良清，等．七味白术散对糖尿病大鼠肠道屏障和TLR4/NF-κB信号通路的影响 [J]. 微生物学通报， 2023 ， 50 ( 1 ): 313 - 323 .

YAO B , PAN BC , TIAN T , et al . Baihu renshen decoction ameliorates type 2 diabetes mellitus in rats through affecting gut microbiota enhancing gut permeability and inhibiting TLR4/NF-κB-mediated inflammatory response [J/OL]. Front Cell Infect Microbiol , 2022 , 12 : 1051962 [ 2022-11-10 ]. https://www.frontiersin.org/articles/10.3389/fcimb.2022.1051962/full .

FAN XX , LI S , WU ZL ， et al . Glycine supplementation to breast-fed piglets attenuates post-weaning jejunal epithelial apoptosis: a functional role of CHOP signaling [J]. Amino Acids , 2019 , 51 ( 3 ): 463 - 473 .

REHMAN AU , SIDDIQUI NZ , FAROOQUI NA ， et al . Morchella esculenta mushroom polysaccharide attenuates diabetes and modulates intestinal permeability and gut microbiota in a type 2 diabetic mice model [J/OL] . Front Nutr , 2022 , 9 : 984695 [ 2022-11-10 ]. https://www.frontiersin.org/articles/10.3389/fnut.2022.984695/full .

徐萌 . 基于“肠道菌群－宿主”交互的助脾散精法对DGP大鼠胰岛损伤修复影响的研究 [D]. 成都：成都中医药大学， 2018 .

GURUNG M , LI ZP , YOU H , et al . Role of gut microbiota in type 2 diabetes pathophysiology [J/OL]. EBioMedicine , 2020 , 51 : 102590 [ 2022-11-10 ]. https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(19)30800-X/fulltext .

CIESIELSKA A , MATYJEK M , KWIATKOWSKA K ． TLR4 and CD14 trafficking and its influence on LPS-induced pro-inflammatory signaling [J] . Cell Mol Life Sci , 2021 , 78 ( 4 ): 1233 - 1261 .

彭海兰，李长辉．肠道菌群与2型糖尿病相关性的中西医探索 [J]. 江西中医药， 2022 ， 53 ( 6 ): 73 - 76 .

WANG L , LI PC , TANG ZS , et al . Structural modulation of the gut microbiota and the relationship with body weight: compared evaluation of liraglutide and saxagliptin treatment [J/OL]. Sci Rep , 2016 , 6 : 33251 [ 2022-11-10 ]. https://www.nature.com/articles/srep33251 .

王芬，何华亮，华静，等．基于肠道菌群功能预测观察葛根芩连汤对KKAy小鼠炎性因子的影响 [J]. 时珍国医国药， 2022 ， 33 ( 10 ): 2365 - 2368 .

DING SL , CHI MM , SCULL BP , et al . High-Fat Diet: Bacteria Interactions Promote Intestinal Inflammation Which Precedes and Correlates with Obesity and Insulin Resistance in Mouse [J/OL]. PLoS One , 2010 , 5 ( 8 ): e12191 [ 2022-11-10 ]. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0012191 .

IYER SS , GENSOLLEN T , GANDHI A , et al . Dietary and Microbial Oxazoles Induce Intestinal Inflammation by Modulating Aryl Hydrocarbon Receptor Responses [J]. Cell , 2018 , 173 ( 5 ): 1123 - 1134 .

YANG SW , YU M , SUN LH ， et al . Interferon－γ－induced intestinal epithelial barrier dysfunction by NF-κB/HIF－1α pathway [J] . J Interferon Cytokine Res , 2014 , 34 ( 3 ): 195 - 203 .

赵佶．圣济总录 [M]. 北京：人民卫生出版社， 1962 ： 1064 .

陈士铎．辨证奇闻 [M]. 孙恰熙，校注．北京：中国中医药出版社， 1995 ： 228 .

李用粹．证治汇补 [M]. 上海：上海卫生出版社， 1958 ： 316 .

冯兆张，冯氏锦囊秘录 [M]. 田思胜，校注．北京：中国中医药出版社， 1996 ： 358 - 359 .

尹朋，赵烨，朱晓宇，等．实验性脾虚大鼠小肠结构与免疫功能的变化 [J]. 中国兽医杂志， 2010 ， 46 ( 12 ): 16 - 19 .

刘守真．素问病机气宜保命集 [M]. 北京：人民卫生出版社， 1959 ： 76 .

刘完素．素问玄机原病式 [M]. 石学文，点校．沈阳：辽宁科学技术出版社， 1997 ： 15 .

马晶晶，杨辰华，张社峰，等． “风药开玄”在糖尿病治疗中的应用 [J]. 中华中医药杂志， 2021 ， 36 ( 12 ): 7199 - 7202 .

杨辰华．从“三焦－玄府”解析糖尿病气液病机与治则 [J]. 中医研究， 2021 ， 34 ( 1 ): 9 - 12 .

Views

493

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Exploring the effects of "liver-smoothing and spirit-regulating" acupuncture on intestinal flora, lipopolysaccharide, and hippocampal TLR4/NF-κB signaling pathway in depressive disorder mice based on the gut-brain axis

Mechanism of Qishen Yiqi Dropping Pills in regulating gut microbiota and ROS/TXNIP/NLRP3 signaling pathway to improve chronic heart failure in rats

Discussion on the diabetic lower extremity vascular disease from the theory of " dryness-heat and stagnation"

Mechanism of Qiangxin Decoction protecting cardiovascular endothelium in the treatment of chronic heart failure

Molecular mechanism of vascular softening pill regulating lncRNA-TUG1 to prevent atherosclerosis

Related Author

FU Wenbin

WU Qian

LIANG Xuesong

MA Junye

HUANG Xichang

HAN Sibo

LI Yawen

WU Bingxin

Related Institution

Second Clinical Medical College of Guangzhou University of Chinese Medicine

Acupuncture Rehabilitation Medical College of Guangzhou University of Chinese Medicine

Seventh Clinical Medical College of Guangzhou University of Chinese Medicine

The Second Affiliated Hospital of Guangzhou University of Chinese Medicine

Guang′anmen Hospital, China Academy of Chinese Medical Sciences

AI问答

Postal code：100029
Tel：(010)53911857 Email：jbutcm@bucm.edu.cn
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010802024621
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰