小檗碱治疗2型糖尿病降血糖机制的研究进展

近年来,随着人们生活水平的提高,2型糖尿病的发病率全球性增加,严重威胁人类健康。2型糖尿病是一种以高血糖为主要特征的渐进性代谢疾病。常规治疗包括控制饮食、使用口服降血糖药物或皮下注射胰岛素等。目前,除了化学药品如二甲双胍和噻唑烷二酮类以外,研究发现天然药物及传统中药复方具有温和的降糖作用或胰岛素增敏作用,还能够改善糖尿病并发症,在维持血糖稳态方面具有一定优势。小檗碱主要是从药用植物黄连中提取分离的一种具有多种药理活性的异喹啉类生物碱。目前认为小檗碱是治疗2型糖尿病最具前景的天然降糖药物之一。小檗碱降血糖的机制较为引人关注,该文就近年来小檗碱降血糖的药理作用机制研究进展进行综述,其中包括改善胰岛素抵抗、促进胰岛素及胰高血糖素样肽-1(GLP-1)的分泌、抑制肝脏糖异生、减少肠道细胞对糖的摄取吸收、抑制氧化应激及炎性反应、调控肠道菌群等。阐明小檗碱降血糖作用机制有助于更好地认识小檗碱治疗2型糖尿病的药理作用,并为小檗碱治疗2型糖尿病的合理应用提供依据。

Research Progress on Effect of Hypoglycemic Mechanism of Berberine in Treatment of Type 2 Diabetes Mellitus

In recent years, type 2 diabetes mellitus (T2DM) has an increasing incidence worldwide along with the improvement of people'' s living standards, and emerged as a serious threat to human health. T2DM is a progressive metabolic disease characterized by hyperglycemia, and its routine therapies include diet control, the use of oral hypoglycemic drugs or subcutaneous injection with insulin. At present, in addition to chemical drugs, such as metformin and thiazolidinediones, researchers have also found that natural medicines and traditional Chinese medicine compounds have mild hypoglycemic and insulin sensitizing effects. Besides, these drugs also have effects in alleviating diabetes complications and maintaining glucose homeostasis. Berberine is an isoquinoline alkaloid mainly isolated from Coptis chinensis with multiple pharmacological activities. Currently, berberine is considered to be one of the most promising natural hypoglycemic agents for the treatment of type 2 diabetes mellitus. However, mechanisms of the hypoglycemic effect of berberine were complex. In this review, we summarized the pharmacological mechanisms of hypoglycemic effect of berberine, including improving insulin resistance, promoting insulin and glucagon-like peptide-1 (GLP-1) secretion, inhibiting hepatic gluconeogenesis, reducing glucose absorption in intestinal cells, suppressing oxidative stress and inflammation and modulating gut microbiota, clarified the mechanisms of hypoglycemic effect of berberine could help to understand the pharmacology of berberine in the treatment of diabetes mellitus and provided evidence for rational application of berberine in the treatment of type 2 diabetes.