黄连温胆汤加减治疗2型糖尿病伴失眠 (痰热内扰型)的研究进展

Research Progress on Modified Huanglian Wendan Decoction in Treating Type 2 Diabetes Mellitus Complicated with Insomnia (Syndrome of Phlegm-Heat Harassing the Heart)

摘要: 目前我国2型糖尿病发病率持续升高，该病合并失眠发生率显著高于普通人群，睡眠异常会扰乱神经内分泌功能，进一步升高血糖，增加降糖治疗难度。痰热内扰证是2型糖尿病合并失眠最常见证型。本文检索近十年相关文献，从病因病机、组方配伍、药理机制及临床应用等方面，梳理黄连温胆汤加减治疗本病的研究进展。研究表明，黄连温胆汤可调节糖脂代谢、改善神经递质水平，兼具降糖与安神功效；单方应用或中西医结合治疗均疗效确切，相较于镇静类西药，该复方不良反应少、无药物成瘾性。现有研究仍存在样本量小、单中心居多、机制研究不够深入等问题，未来需开展大样本、多中心临床试验，深入阐释其作用机制，为临床应用提供循证依据。

Abstract: Currently, the incidence of type 2 diabetes mellitus (T2DM) in China continues to rise. The prevalence of insomnia in T2DM patients is significantly higher than that in the general population. Sleep disturbances can disrupt neuroendocrine functions, further elevating blood glucose levels and increasing the difficulty of hypoglycemic treatment. The syndrome of phlegm-heat harassing the heart is the most common traditional Chinese medicine (TCM) syndrome in T2DM complicated with insomnia. This paper reviews relevant literature from the past decade, summarizing the research progress on the modified Huanglian Wendan Decoction in treating this condition from the aspects of etiology and pathogenesis, formula compatibility, pharmacological mechanisms, and clinical applications. Studies indicate that Huanglian Wendan Decoction can regulate glucose and lipid metabolism and improve neurotransmitter levels, exhibiting dual effects of lowering blood glucose and calming the mind. Both monotherapy and integrated traditional Chinese and Western medicine treatments have shown definitive efficacy. Compared with sedative Western medications, this compound formula has fewer adverse reactions and no drug dependence. However, existing studies still face limitations, such as small sample sizes, predominantly single-center designs, and insufficiently in-depth mechanistic research. Future studies require large-sample, multi-center clinical trials to further elucidate its underlying mechanisms and provide robust evidence-based support for clinical application.