基于藏族医学“整体观”认识的防治糖尿病肾病新药发现思路
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摘要
糖尿病肾病(DN)是一种严重的糖尿病(DM)并发症,是引起终末期肾衰竭最常见的原因之一。DN的发生率随着DM患者数量增加而增高,早期防治是关键。DM和DN属于藏族医药(简称藏医和藏药)的特色优势病种,基于体内三大因素(三因,包括隆、赤巴、培根)动态平衡的"整体观"是藏医对DM和DN的独特认识,有着丰富而独特的临床用药经验。该文论述了基于"整体观"对DM及DN的藏医认识,挖掘临床治疗DN的常用藏药及藏医方剂,以期为DN的治疗及新药发现提供新思路,进一步发挥藏族医药的特色优势。
Diabetic nephropathy( DN) is a kind of severe diabetes mellitus( DM) complications,which is one of the most common cause of end-stage renal failure. The incidence of DN increases with the increase of the number of DM patients, and early prevention is the key. DM and DN are characteristic advantages of Tibetan medicine,the " holistic view" of dynamic balance based on the three major factors in the body( Sanyin,included rlung, mkhris-pa and bad-gan) is a unique understanding of DM and DN among Tibetan medical practitioners,and which has rich and unique clinical and medication experiences in DN treatment. This paper discussed the medical theory " holistic view" on the Tibetan medicine for DM and DN,dug commonly used Tibetan drugs and Tibetan medical prescriptions for clinical treatment of DN,in order to provide new ideas for the treatment of DN and the discovery of new drugs for DN,and give full play to the unique advantages of Tibetan medicine.
Diabetic nephropathy( DN) is a kind of severe diabetes mellitus( DM) complications,which is one of the most common cause of end-stage renal failure. The incidence of DN increases with the increase of the number of DM patients, and early prevention is the key. DM and DN are characteristic advantages of Tibetan medicine,the " holistic view" of dynamic balance based on the three major factors in the body( Sanyin,included rlung, mkhris-pa and bad-gan) is a unique understanding of DM and DN among Tibetan medical practitioners,and which has rich and unique clinical and medication experiences in DN treatment. This paper discussed the medical theory " holistic view" on the Tibetan medicine for DM and DN,dug commonly used Tibetan drugs and Tibetan medical prescriptions for clinical treatment of DN,in order to provide new ideas for the treatment of DN and the discovery of new drugs for DN,and give full play to the unique advantages of Tibetan medicine.
引文
[1] Duran-Salgado M B, Rubio-Guerra A F. Diabetic nephropathy and inflammation[J]. World J Diabetes,2014,5(3):393-398.
[2]扎西东智.简述三因学说在藏医学中的运用[J].中国民族医药杂志,2012,18(4):1-5.
[3]东知项杰,拉玛阿拉,俄措卓玛.浅谈藏医对糖尿病的认识及治疗[J].中国藏学,2010,26(4):163-165.
[4]宇妥·元丹贡布.四部医典[M].马世林,罗达尚,毛继祖,等,译.上海:上海科学技术出版社,1987:32-36.
[5]第司·桑吉嘉措.蓝琉璃[M].毛继祖,卡洛,毛韶玲,译校.上海:上海科学技术出版社,2012:381-382.
[6]田华,母传贤,尤丽菊,等.姜黄素对糖尿病肾病大鼠肾脏的保护作用及其机制[J].吉林大学学报:医学版,2013,39(4):747-750,866.
[7] HUANG J,HUANG K,LAN T,et al. Curcumin ameliorates diabetic nephropathy by inhibiting the activation of the Sph K1-S1P signaling pathway[J]. Mol Cell Endocrinol,2013,365(2):231-240.
[8]范东旭,包海鹰.小檗属植物中生物碱成分及药理活性研究概述[J].人参研究,2012,24(2):55-62.
[9]宇妥·元丹衮波.医学四续[M].毛继祖,译.上海:上海科学技术出版社,2012:175.
[10]宇妥·元丹贡布.四部医典[M].李永年,译.北京:人民卫生出版社,1983:26.
[11]王智森,陆付耳.中藏医对糖尿病病因病机的认识[J].中西医结合研究,2011,3(6):313-316.
[12]赖先荣,张艺,孟宪丽.一种小檗皮提取物及该提取物和小檗皮的用途:中国,ZL201110296460. X[P].2013-12-14.
[13]岳丽珺,张燕,向丽,等.藏药吉尔巴对糖尿病性视网膜病变的影响及机制研究[J].中国实验方剂学杂志,2013,19(20):149-153.
[14]张燕,孟宪丽,岳丽珺,等.藏药小檗皮对糖尿病模型小鼠血糖水平影响的初步研究[J].现代生物医学进展,2013,13(19):3607,3619-3622.
[15]岳丽珺,孟宪丽,张燕,等.藏药小檗皮对糖尿病大鼠视网膜PKC-β、VEGF、HIF-1α表达的影响[J].世界科学技术—中医药现代化,2014,16(1):181-186.
[16]李君,王庆丽,孙湘,等.缺氧诱导因子-1在糖尿病肾病大鼠肾脏的表达水平[J].中国老年学杂志,2011,31(22):4394-4396.
[17]赵辛元,李伟民,李彩蓉,等.低氧诱导因子-1α在糖尿病肾病中的表达及其意义[J].咸宁学院学报:医学版,2011,25(6):483-484.
[18] XIE X,CHANG X,CHEN L,et al. Berberine ameliorates experimental diabetes-induced renal inflammation and fibronectin by inhibiting the activation of Rho A/ROCK signaling[J]. Mol Cell Endocrinol,2013,381(1/2):56-65.
[19] LAN T,LIU W,XIE X,et al. Berberine suppresses high glucose-induced TGF-β1and fibronectin synt-hesis in mesangial cells through inhibition of sphingosine kinase1/AP-1 pathway[J]. Eur J Pharmacol,2012,697(1/3):165-172.
[20]李航,骆英,熊景,等.盐酸小檗碱治疗糖尿病肾病的临床和实验研究进展[J].中国中西医结合杂志,2012,32(12):1714-1717.
[21]胡炜.余甘子提取物对糖尿病大鼠肌肉和脂肪组织胰岛素信号通路的影响[J].中国组织工程研究,2012,16(11):2007-2010.
[22] D'souza J J,D'souza P P,Fazal F,et al. Anti-diabetic effects of the indian indigenous fruit Emblica officinalis Gaertn:active constituents and modes of action[J]. Food Funct,2014,5(4):635-644.
[23]李明玺,黄卫锋,姚亮亮,等.余甘子提取物降血糖活性及其主要成分研究[J].现代食品科技,2017,33(9):96-101.
[24]张素军,冯尚彩.蒺藜皂苷对正常和2型糖尿病大鼠餐后血糖水平的影响[J].实用药物与临床,2012,15(1):1-3.
[25]李斌,李鑫,范源.诃子药理作用研究进展[J].药学研究,2015,34(10):591-595,603.
[26] Khandelwal N,Dhundi S N,Yadav P,et al. Prvention and management of diabetes mellitus in Ayurveda[J].Inpharma Weekly,2012,1039(1):6-7.
[27] Sabu M C,Kuttan R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property[J]. J Ethnopharmacol,2002,81(2):155-160.
[28] Latha R C R,Daisy P. Influence of Terminalia bellerica Roxb. fruit extracts on biochemical parameters in streptozotocin diabetic rats[J]. Int J Pharmacol,2010,6(2):89-96.
[29]杨海峰.藏医对糖尿病的认识及治疗探究[J].糖尿病新世界,2015,13(35):183-184.
[30]张艺,周林,德洛.基于药效成分体内代谢的藏药方剂配伍规律研究思路与方法[J].中国民族医药杂志,2011,17(7):33-35.
[31]拉玛阿拉.藏药十八味诃子利尿丸治疗糖尿病的临床价值[J].智慧健康,2017,3(19):40-41.
[32]梁沛余,尹磊晶,华欠桑多,等.藏药十八味诃子利尿丸对高原糖尿病大鼠血糖的影响[J].包头医学院学报,2016,32(12):3-5.
[33]付成瑞,李宝生.山奈酚的抗肿瘤作用[J].国际肿瘤学杂志,2013,40(12):892-895.
[34]帝玛尔·丹增彭措.晶珠本草[M].上海:上海科学技术出版社,1986:76.
[35]童东,王文倩,罗煜,等.藏药四味姜黄方对STZ诱导糖尿病肾病大鼠模型的剂量配比关系的初步研究[J].中成药,2018,40(3):516-524.
[36] Yea S J,Seong B,Jang Y,et al. A data mining approach to selecting herbs with similar efficacy:targeted selection methods based on medical subject headings(MeSH)[J]. J Ethnopharmacol,2016,182:27-34.
[37]李志勇,柴兴云,袁涛,等.互鉴互融——论民族药的现代研究思路[J].中国中药杂志,2017,42(7):1213-1219.
[38]魏志成,童东,杨娟,等.基于网络药理学的沙棘总黄酮治疗心肌缺血的作用机制研究[J].中国中药杂志,2017,42(7):1238-1244.
[39]卢柳拂,林梦瑶,黄锁义,等.少数民族地区右江流域特色民族药研究进展[J].中国实验方剂学杂志,2018,24(1):191-200.
[40]郭慧,崔扬,王秋红,等.基于代谢组学技术的中药复方研究近况[J].中国实验方剂学杂志,2017,23(1):213-219.
[2]扎西东智.简述三因学说在藏医学中的运用[J].中国民族医药杂志,2012,18(4):1-5.
[3]东知项杰,拉玛阿拉,俄措卓玛.浅谈藏医对糖尿病的认识及治疗[J].中国藏学,2010,26(4):163-165.
[4]宇妥·元丹贡布.四部医典[M].马世林,罗达尚,毛继祖,等,译.上海:上海科学技术出版社,1987:32-36.
[5]第司·桑吉嘉措.蓝琉璃[M].毛继祖,卡洛,毛韶玲,译校.上海:上海科学技术出版社,2012:381-382.
[6]田华,母传贤,尤丽菊,等.姜黄素对糖尿病肾病大鼠肾脏的保护作用及其机制[J].吉林大学学报:医学版,2013,39(4):747-750,866.
[7] HUANG J,HUANG K,LAN T,et al. Curcumin ameliorates diabetic nephropathy by inhibiting the activation of the Sph K1-S1P signaling pathway[J]. Mol Cell Endocrinol,2013,365(2):231-240.
[8]范东旭,包海鹰.小檗属植物中生物碱成分及药理活性研究概述[J].人参研究,2012,24(2):55-62.
[9]宇妥·元丹衮波.医学四续[M].毛继祖,译.上海:上海科学技术出版社,2012:175.
[10]宇妥·元丹贡布.四部医典[M].李永年,译.北京:人民卫生出版社,1983:26.
[11]王智森,陆付耳.中藏医对糖尿病病因病机的认识[J].中西医结合研究,2011,3(6):313-316.
[12]赖先荣,张艺,孟宪丽.一种小檗皮提取物及该提取物和小檗皮的用途:中国,ZL201110296460. X[P].2013-12-14.
[13]岳丽珺,张燕,向丽,等.藏药吉尔巴对糖尿病性视网膜病变的影响及机制研究[J].中国实验方剂学杂志,2013,19(20):149-153.
[14]张燕,孟宪丽,岳丽珺,等.藏药小檗皮对糖尿病模型小鼠血糖水平影响的初步研究[J].现代生物医学进展,2013,13(19):3607,3619-3622.
[15]岳丽珺,孟宪丽,张燕,等.藏药小檗皮对糖尿病大鼠视网膜PKC-β、VEGF、HIF-1α表达的影响[J].世界科学技术—中医药现代化,2014,16(1):181-186.
[16]李君,王庆丽,孙湘,等.缺氧诱导因子-1在糖尿病肾病大鼠肾脏的表达水平[J].中国老年学杂志,2011,31(22):4394-4396.
[17]赵辛元,李伟民,李彩蓉,等.低氧诱导因子-1α在糖尿病肾病中的表达及其意义[J].咸宁学院学报:医学版,2011,25(6):483-484.
[18] XIE X,CHANG X,CHEN L,et al. Berberine ameliorates experimental diabetes-induced renal inflammation and fibronectin by inhibiting the activation of Rho A/ROCK signaling[J]. Mol Cell Endocrinol,2013,381(1/2):56-65.
[19] LAN T,LIU W,XIE X,et al. Berberine suppresses high glucose-induced TGF-β1and fibronectin synt-hesis in mesangial cells through inhibition of sphingosine kinase1/AP-1 pathway[J]. Eur J Pharmacol,2012,697(1/3):165-172.
[20]李航,骆英,熊景,等.盐酸小檗碱治疗糖尿病肾病的临床和实验研究进展[J].中国中西医结合杂志,2012,32(12):1714-1717.
[21]胡炜.余甘子提取物对糖尿病大鼠肌肉和脂肪组织胰岛素信号通路的影响[J].中国组织工程研究,2012,16(11):2007-2010.
[22] D'souza J J,D'souza P P,Fazal F,et al. Anti-diabetic effects of the indian indigenous fruit Emblica officinalis Gaertn:active constituents and modes of action[J]. Food Funct,2014,5(4):635-644.
[23]李明玺,黄卫锋,姚亮亮,等.余甘子提取物降血糖活性及其主要成分研究[J].现代食品科技,2017,33(9):96-101.
[24]张素军,冯尚彩.蒺藜皂苷对正常和2型糖尿病大鼠餐后血糖水平的影响[J].实用药物与临床,2012,15(1):1-3.
[25]李斌,李鑫,范源.诃子药理作用研究进展[J].药学研究,2015,34(10):591-595,603.
[26] Khandelwal N,Dhundi S N,Yadav P,et al. Prvention and management of diabetes mellitus in Ayurveda[J].Inpharma Weekly,2012,1039(1):6-7.
[27] Sabu M C,Kuttan R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property[J]. J Ethnopharmacol,2002,81(2):155-160.
[28] Latha R C R,Daisy P. Influence of Terminalia bellerica Roxb. fruit extracts on biochemical parameters in streptozotocin diabetic rats[J]. Int J Pharmacol,2010,6(2):89-96.
[29]杨海峰.藏医对糖尿病的认识及治疗探究[J].糖尿病新世界,2015,13(35):183-184.
[30]张艺,周林,德洛.基于药效成分体内代谢的藏药方剂配伍规律研究思路与方法[J].中国民族医药杂志,2011,17(7):33-35.
[31]拉玛阿拉.藏药十八味诃子利尿丸治疗糖尿病的临床价值[J].智慧健康,2017,3(19):40-41.
[32]梁沛余,尹磊晶,华欠桑多,等.藏药十八味诃子利尿丸对高原糖尿病大鼠血糖的影响[J].包头医学院学报,2016,32(12):3-5.
[33]付成瑞,李宝生.山奈酚的抗肿瘤作用[J].国际肿瘤学杂志,2013,40(12):892-895.
[34]帝玛尔·丹增彭措.晶珠本草[M].上海:上海科学技术出版社,1986:76.
[35]童东,王文倩,罗煜,等.藏药四味姜黄方对STZ诱导糖尿病肾病大鼠模型的剂量配比关系的初步研究[J].中成药,2018,40(3):516-524.
[36] Yea S J,Seong B,Jang Y,et al. A data mining approach to selecting herbs with similar efficacy:targeted selection methods based on medical subject headings(MeSH)[J]. J Ethnopharmacol,2016,182:27-34.
[37]李志勇,柴兴云,袁涛,等.互鉴互融——论民族药的现代研究思路[J].中国中药杂志,2017,42(7):1213-1219.
[38]魏志成,童东,杨娟,等.基于网络药理学的沙棘总黄酮治疗心肌缺血的作用机制研究[J].中国中药杂志,2017,42(7):1238-1244.
[39]卢柳拂,林梦瑶,黄锁义,等.少数民族地区右江流域特色民族药研究进展[J].中国实验方剂学杂志,2018,24(1):191-200.
[40]郭慧,崔扬,王秋红,等.基于代谢组学技术的中药复方研究近况[J].中国实验方剂学杂志,2017,23(1):213-219.