治疗糖尿病中成药的处方、药理以及作用机理(英)

糖尿病是一种常见的内分泌代谢紊乱性疾病,属中医“消渴”范畴。其基本病理为胰岛素分泌绝对或相对不足,其特征为高血糖。尽管临床上用于降糖的一线药物仍以西药为主,中药的辅助和替代治疗因其作用温和、不良反应低而越来越受到糖尿病人的欢迎。本文对在中国已批准上市的治疗糖尿病的8种中成药进行综述,分析了其降血糖的药理作用。该8种中成药临床用于轻、中度Ⅱ型糖尿病,证属气阴两虚、气虚内热型和气阴两虚挟瘀者,其组方体现了中医辨证论治之长处,兼顾了益气、养阴、补肾、健脾、清热、活血化瘀等整体观念。从药物的主要化学成分及其药理研究报道来看,以上8种中成药作用机理大致分为三类:①富含植物多糖的中药,如愈三消、参芪、益津和人参糖肽,对损伤的胰岛和β细胞有保护作用,能通过促进β细胞的修复和再生来提高胰岛素分泌,达到降糖目的;②活血化瘀类中药如渴乐宁、芪蛭、消渴安等能有效改善血粘度、降低血脂,减少心脑血管并发症的发生,并通过改善微循环、提高机体系统免疫力和代谢能力直接或间接地起到纠正糖、脂肪代谢紊乱的作用;③金芪降糖制剂含有降糖作用较强的生物碱如小檗碱等,药理研究表明能明显改善胰岛素抗性、恢复机体对胰岛素的敏感性。此外,一些植物成分能拮抗升糖激素、抑制醛糖还原酶，所含微量元素、、（如铬）能增加糖代谢。总之，中药具备多靶点、多层次综合治疗作用和功能调节作用，对糖尿病的治疗不仅仅针对降低血糖，其突出优势在于能有效地阻止和延缓糖尿病合并症的发生和发展，改善口渴、多饮、多食、乏力等症状，提高病人的生活质量.

Antidiabetic Drugs of Plant Origin Used in China: Compositions, Pharmacology, and Hypoglycemic Mechanisms

The paper reviewed compositions and pharmacological effects of eight antidiabetic herbal drugs that have been approved by health regulatory agency for commercial use in China. Investigators attributed the hypoglycemic effect of these products to their ability to restore the functions of pancreatic tissues and cause an increase in insulin output, to inhibit the intestinal absorption of glucose , or to the facilitation of metabolites in insulin - dependent processes. Treatment with herbal drugs has an effect on protecting beta cells and smoothing out fluctuations in glucose levels. The use of these naturally derived agents in conjunction with conventional drug treatments such as an chemical agent or insulin permits the use of lower doses of the drug and / or decreased frequency of administration which decreases the side effects most commonly observed.