糖尿病心肌病中西医发病机制及治疗研究进展

Research Progress on the Pathogenesis and Treatment of Diabetic Cardiomyopathy in Traditional Chinese and Western Medicine

摘要: 糖尿病心肌病(Diabetic Cardiomyopathy, DCM)是糖尿病的重要心血管并发症，多伴有特异性心肌结构和功能的异常。流行病学调查显示，全球糖尿病患者中DCM患病率约为10%~30%，且随病程延长而增加，10年后患病率可上升12%~22%。目前，西医认为，糖尿病心肌病多与代谢紊乱、氧化应激、炎症反应、心肌纤维化、细胞凋亡等有关。而中医认为，DCM病机以气阴两虚为本，痰瘀互结为标，病位与心、脾、肾等多个脏腑有关。本文汇总近年糖尿病心肌病的中西医发病机制及治疗研究进展，分析不同疗法的应用特点与疗效差异，为临床实践提供参考。

Abstract: Diabetic cardiomyopathy (DCM) is a significant cardiovascular complication of diabetes, often accompanied by specific structural and functional abnormalities in the myocardium. Epidemiological studies indicate that the prevalence of DCM among diabetic patients worldwide is approximately 10%~30%, and it increases with prolonged disease duration, rising by 12%~22% after 10 years. Current Western medicine attributes DCM primarily to metabolic disorders, oxidative stress, inflammatory responses, myocardial fibrosis, and apoptosis. In contrast, traditional Chinese medicine (TCM) posits that the pathogenesis of DCM is fundamentally rooted in qi and yin deficiency, with phlegm and blood stasis interlocking as the secondary manifestation, involving multiple organs such as the heart, spleen, and kidney. This article summarizes recent advances in the pathogenesis and therapeutic research of DCM from both Western and TCM perspectives, analyzing the application characteristics and efficacy differences of various treatments to provide clinical practice references.