天麻素防治糖尿病及其并发症的研究进展
Research Progress for Gastrodin in Prevention and Treatment of Diabetes and Its Complications
DOI: 10.12677/TCM.2020.92020, PDF,   
作者: 陈 成：扬州大学医学院，江苏 扬州
关键词: 天麻素；II型糖尿病；糖尿病并发症；Gastrodin； Type II Diabetes； Diabetic Complications
摘要: 天麻素是名贵中药材天麻的主要活性成分，近年来发现它对II型糖尿病及其并发症具有疗效。天麻素防治糖尿病的机制主要有降血糖、降血脂、改善胰岛素抵抗、抗氧化应激和抗炎。除此以外，天麻素还能防治糖尿病心脑血管并发症、糖尿病周围神经病变，糖尿病视网膜病变、糖尿病足、糖尿病肾病、非酒精性脂肪性肝病等。现对天麻素防治II型糖尿病及其并发症的相关作用和机制展开综述。
Abstract: Gastrodin is the main active constituent in precious Chinese medicine Tianma. In recent years, it has been found to be effective in treating type II diabetes and its complications. The mechanisms of gastrodin in preventing and treating diabetes mainly include lowering blood sugar, reducing blood lipid, improving insulin resistance, anti-oxidative stress and anti-inflammation. In addition, gastrodin can also prevent and treat diabetic cardiovascular and cerebrovascular complications, diabetic peripheral neuropathy, diabetic retinopathy, diabetic foot, diabetic nephropathy, nonal-coholic fatty liver disease, etc. Now the related effects and mechanisms of gastrodin in preventing and treating type II diabetes and its complications are reviewed.
文章引用：陈成. 天麻素防治糖尿病及其并发症的研究进展[J]. 中医学, 2020, 9(2): 126-135. https://doi.org/10.12677/TCM.2020.92020

参考文献

[1] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017版)[J]. 中华糖尿病杂志, 2018, 10(1): 4-67.
[2] 童国相, 王莎, 高国应, 等. 肥胖患者血清Apelin水平与血糖、血脂和胰岛素抵抗的相关性分析[J]. 临床误诊误治, 2019, 32(3): 90-93.
[3] 钟贝芬, 杜磊, 李众, 等. 基于细胞色素P450单加氧酶介导的4-甲酚氧化降解途径的天麻素生物合成[J]. 湖南师范大学自然科学学报, 2018(4): 33-40.
[4] 韩磊, 乔爱敏, 刘青. 天麻素的抗糖尿病作用实验[J]. 华侨大学学报(自然科学版), 2013, 34(6): 682-686.
[5] 张勇, 武燕彬, 孔维佳. 天麻素在KK-Ay小鼠中抗糖尿病作用的实验研究[J]. 中国药理学通报, 2018, 34(7): 917-924.
[6] 张勇, 孔维佳. 天麻素在L6肌管中促进葡萄糖消耗的作用和机制研究[J]. 中国医药导报, 2019, 16(4): 22-25.
[7] Kim, M.J., et al. (2017) Gastro-dia elata Blume Rhizome Aqueous Extract Improves Arterial Thrombosis, Dyslipidemia, and Insulin Response in Testosterone-Deficient Rats. Evidence-Based Complementary and Alternative Medicine, 2017, Article ID: 2848570. [Google Scholar] [CrossRef] [PubMed]
[8] 许晓龙. 天麻素调脂及抗早期动脉粥样硬化的临床及实验研究[D]: [硕士学位论文]. 武汉: 湖北中医药大学, 2015.
[9] 黄河祥. 2型糖尿病肾病患者同型半胱氨酸水平与胰岛素抵抗的关系探讨[J]. 中国药物与临床, 2019, 19(19): 3339-3340.
[10] 白永, 范晓明, 郭家智, 等. 天麻素对胰岛素抵抗模型中CBS表达的影响[J]. 昆明医科大学学报, 2014, 35(4): 6-9.
[11] 乔爱敏, 栗俞程, 刘珍伶, 等. 天麻素对高糖诱导的人脐静脉内皮细胞氧化应激的影响[J]. 中草药, 2013, 44(15): 2118-2123.
[12] Zhang, H., et al. (2018) Gastrodin Induced HO-1 and Nrf2 Up-Regulation to Alleviate H2O2-Induced Oxidative Stress in Mouse Liver Sinusoidal Endothelial Cells through p38 MAPK Phosphorylation. Brazilian Journal of Medical and Biological Re-search, 51, e7439. [Google Scholar] [CrossRef] [PubMed]
[13] 韩学超, 徐菁蔓, 徐森, 等. 线粒体通透性转换孔在天麻素抗心肌细胞氧化应激损伤中的作用[J]. 南方医科大学学报, 2018, 38(11): 36-41.
[14] 张磊, 陈红梅, 李汛, 等. 天麻素对STZ损伤INS-1细胞的保护和修复作用[J]. 中华内分泌外科杂志, 2011, 5(4): 222-224.
[15] 魏伊秋, 李满, 余佳. 慢性炎症与胰岛素抵抗机制关系的研究进展[J]. 临床与病理杂志, 2019, 39(3): 196-201.
[16] 冯宇, 章海锋, 傅明亮, 等. 黄绿蜜环菌生物合成的天麻素抗炎及免疫调节活性评价[J]. 中国食品学报, 2011, 11(7): 41-45.
[17] Xi, Z.N., Qiao, Y.H., Wang, J.F., et al. (2019) Gastrodin Relieves Inflammation Injury Induced by Lipopolysaccharides in MRC-5 Cells by Up-Regulation of miR-103. Journal of Cellular and Molecular Medicine, 24, 1451-1459. [Google Scholar] [CrossRef] [PubMed]
[18] 孟德姣, 黄玲, 何慧敏, 等. 天麻素抑制脂多糖诱导的BV-2小胶质细胞炎症反应及机制研究[J]. 现代生物医学进展, 2018, 18(6): 1020-1023.
[19] 张媛元, 毛瑞阳, 杜晓红, 等. 天麻素对终末糖基化产物诱导神经小胶质细胞炎症因子表达的影响[J]. 中草药, 2011, 42(2): 330-334.
[20] 陈湖海, 黄涛, 孙慧伶, 等. 天麻素治疗冠心病心绞痛的临床效果[J]. 中国医药导报, 2016, 13(14): 126-128.
[21] 王毓. 天麻素注射液治疗2型糖尿病合并短暂性脑缺血发作的临床观察与分析[J]. 糖尿病新世界, 2015(11): 36-37.
[22] 黄静漪. 天麻素注射液治疗2型糖尿病合并脑梗塞患者的临床疗效[J]. 糖尿病新世界, 2019(3): 69-70.
[23] Xie, Y.L., et al. (2015) Vasorelaxation Effect of Gastrodin on Isolated Thoracic Aorta Rings of Rats. Chinese Journal of Integrative Medicine, 21, 944-948. [Google Scholar] [CrossRef] [PubMed]
[24] Chen, S., Hao, X., Yu, L., et al. (2017) Gastrodin Causes Vasodilation by Activating K ATP Channels in Vascular Smooth Muscles via PKA-Dependent Signaling Pathway. Journal of Receptor and Signal Transduction Research, 37, 1-7. [Google Scholar] [CrossRef] [PubMed]
[25] 陈湖海, 黄涛, 刘辉. 天麻素对高血压大鼠血压变化、血管保护作用及氧化应激反应机制研究[J]. 世界中医药, 2016(11): 2385-2388.
[26] Liu, W., Wang, L.Y., Yu, J.H., et al. (2015) Gastrodin Reduces Blood Pressure by Intervening with RAAS and PPAR\r, γ\r, in SHRs. Evidence-Based Complementary and Alternative Medicine, 2015, Article ID: 828427. [Google Scholar] [CrossRef] [PubMed]
[27] Liu, Y., Tang, X.L., Pei, J.F., et al. (2010) Gastrodin Interaction with Human Fibrinogen: Anticoagulant Effects and Binding Studies. Chemistry, 12, 7807-7815. [Google Scholar] [CrossRef] [PubMed]
[28] 朱丽华, 关红菁, 王朗, 等. 天麻素对血小板衍生生长因子-BB诱导大鼠血管平滑肌细胞迁移的影响[J]. 国际脑血管病杂志, 2012, 20(3): 189-192.
[29] Jiang, H. (2012) Gastro-din Inhibits Cell Proliferation in Vascular Smooth Muscle Cells and Attenuates Neointima Formation in Vivo. Interna-tional Journal of Molecular Medicine, 30, 1034-1040. [Google Scholar] [CrossRef] [PubMed]
[30] 于滨, 桂冠, 杨欣, 等. 天麻素对Ox-LDL诱导牛主动脉内皮细胞黏附HL-60细胞的抑制作用[J]. 中国新药杂志, 2013(9): 40-44.
[31] Sui, Y., Bian, L., Ai, Q., et al. (2019) Ga-strodin Inhibits Inflammasome through the STAT3 Signal Pathways in TNA2 Astrocytes and Reactive Astrocytes in Experimentally Induced Cerebral Ischemia in Rats. NeuroMolecular Medicine, 21, 275-286. [Google Scholar] [CrossRef] [PubMed]
[32] Liu, W., Su, B.-L., Wang, Z.S., et al. (2012) Gastrodin Im-proved Baroreflex Sensitivity and Increased Gamma-Amino Butyric Acid Content in Brains without Decreasing Blood Pressure in Spontaneously Hypertensive Rats. CNS Neuroscience & Therapeutics, 18, 873-875. [Google Scholar] [CrossRef] [PubMed]
[33] Li, S.P., et al. (2019) Gastrodin Pretreatment Alleviates Rat Brain Injury Caused by Cerebral Ischemic-Reperfusion. Brain Research, 1712, 207-216. [Google Scholar] [CrossRef] [PubMed]
[34] Sun, W.J., Lu, H.Q., Lyu, L., et al. (2019) Gastrodin Ameli-orates Microvascular Reperfusion Injury-Induced Pyroptosis by Regulating the NLRP3/Caspase-1 Pathway. Journal of Physiology and Biochemistry, 75, 531-547. [Google Scholar] [CrossRef] [PubMed]
[35] Fu, S., Chen, L., Wu, Y., Tang, Y., et al. (2018) Gastrodin Pre-treatment Alleviates Myocardial Ischemia/Reperfusion Injury through Promoting Autophagic Flux. Biochemical and Biophysical Research Communications, 503, 2421-2428. [Google Scholar] [CrossRef] [PubMed]
[36] Li, X., Zhu, Q., Liu, Y., et al. (2017) Gastrodin Protects Myocar-dial Cells against Hypoxia/Reoxygenation Injury in Neonatal Rats by Inhibiting Cell Autophagy through the Activation of mTOR Signals in PI3K-Akt Pathway. Journal of Pharmacy and Pharmacology, 70, 259-267. [Google Scholar] [CrossRef] [PubMed]
[37] Ye, T.Y., Meng, X.B., Zhai, Y.D., et al. (2018) Gastrodin Ameliorates Cognitive Dysfunction in Diabetes Rat Model via the Suppression of Endoplasmic Reticulum Stress and NLRP3 In-flammasome Activation. Frontiers in Pharmacology, 9, 1346. [Google Scholar] [CrossRef] [PubMed]
[38] Qi, Y.-H., Zhu, R., Wang, Q., et al. (2019) Early Intervention with Gastrodin Reduces Striatal Neurotoxicity in Adult Rats with Experimentally-Induced Diabetes Mellitus. Molecular Medicine Reports, 19, 3114-3122. [Google Scholar] [CrossRef] [PubMed]
[39] Li, M. and Qian, S.M. (2016) Gastrodin Protects Neural Progenitor Cells against Amyloid β(1-42)-Induced Neurotoxicity and Improves Hippocampal Neurogenesis in Amyloid β(1-42)-Injected Mice. Journal of Molecular Neuroscience, 60, 21-32. [Google Scholar] [CrossRef] [PubMed]
[40] Shu, C., Chen, C., Zhang, D.P., et al. (2012) Gastrodin Protects against Cardiac Hypertrophy and Fibrosis. Molecular and Cellular Biochemistry, 359, 9-16. [Google Scholar] [CrossRef] [PubMed]
[41] Stino, A.M. and Smith, A.G. (2017) Peripheral Neuropathy in Prediabetes and the Metabolic Syndrome. Journal of Diabetes Investigation, 8, 646-655. [Google Scholar] [CrossRef] [PubMed]
[42] 袁玉松, 徐海林, 芦浩, 等. 糖尿病周围神经病变研究进展[J]. 中华肩肘外科电子杂志, 2019, 7(1): 92-97.
[43] 王文平, 张玉璞, 张金月. 穴位注射治疗糖尿病周围神经病变30例临床观察[J]. 中国民族民间医药杂志, 2016, 25(7): 107.
[44] 赵兴锋. 穴位注射天麻素注射液辅助硫辛酸治疗糖尿病周围神经病变疗效观察[J]. 现代中西医结合杂志, 2015, 25(5): 517-519.
[45] 金善姬, 金文龙. 天麻素注射液治疗糖尿病周围神经病变临床观察[J]. 现代医药卫生, 2006, 22(19): 2923-2923.
[46] 赵光宇, 易恬, 黄秀琼, 等. 天麻素注射液对蟾蜍离体坐骨神经干动作电位的影响[J]. 中国民族民间医药, 2011(1): 46-47.
[47] 李乾. 天麻及天麻素对兔坐骨神经再生修复影响的实验研究[D]: [硕士学位论文]. 桂林: 桂林医学院, 2012.
[48] de Oliveira, M.R., Brasil, F.B. and Furstenau, C.R. (2019) Nrf2 Mediates the Anti-Apoptotic and Anti-Inflammatory Effects Induced by Gastrodin in Hydrogen Peroxide-Treated SH-SY5Y Cells. Journal of Molecular Neuroscience, 69, 115-122. [Google Scholar] [CrossRef] [PubMed]
[49] 付红运. 天麻素对体外培养雪旺细胞增殖及其NGF表达的影响[D]: [硕士学位论文]. 桂林: 桂林医学院, 2013.
[50] 高浏璐, 肖梅梅, 董辉, 等. 天麻素在慢性痛中的作用及作用机制研究[J]. 神经解剖学杂志, 2015, 31(4): 529-532.
[51] 杨晓春, 许建彪, 梅妍, 等. 天麻素及乙酰天麻素对糖尿病视网膜神经节细胞的保护作用[J]. 眼科新进展, 2015, 35(1): 25-27.
[52] 江枫, 颜华. 小胶质细胞在糖尿病视网膜病变发病及治疗机制中的研究进展[J]. 中华眼底病杂志, 2018(4): 412-415.
[53] Wang, J.W., Liu, Y.M., Zhao, X.F., et al. (2017) Gastrodin Protects Retinal Ganglion Cells through Inhibiting Microglial-Mediated Neuroinflammation in an Acute Ocular Hypertension Model. International Journal of Ophthalmology, No. 10, 5-11.
[54] Zhang, T.H., Huang, C.M., Gao, X., et al. (2018) Gastrodin Inhibits High Glucose-Induced Human Retinal Endothelial Cell Apoptosis by Regulating the SIRT1/TLR4/NF-κBp65 Signaling Pathway. Molecular Medicine Reports, 17, 7774-7780. [Google Scholar] [CrossRef] [PubMed]
[55] 张英泽, 边刚. 中西医结合治疗糖尿病足78例[J]. 中国民族民间医药, 2011(6): 86.
[56] Lin, J., Shi, Y., Miao, J., et al. (2019) Gastrodin Alleviates Oxidative Stress Induced Apoptosis and Cellular Dysfunction in Human Umbilical Vein Endothelial Cells via the Nuclear Fac-tor-Erythroid 2-Related Factor 2/Heme Oxygenase-1 Pathway and Accelerates Wound Healing in Vivo. Frontiers in Pharmacology, 10, 1273. [Google Scholar] [CrossRef] [PubMed]
[57] 中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(V)[J]. 中华糖尿病杂志, 2019, 11(6): 387-397.
[58] Chen, J., Gu, Y.T., Xie, J.J., et al. (2018) Gastrodin Reduces IL-1β-Induced Apoptosis, Inflammation, and Matrix Catabolism in Osteoarthritis Chondrocytes and Attenuates Rat Cartilage Degeneration, in Vivo. Biomedicine & Pharmacotherapy, 97, 642-651. [Google Scholar] [CrossRef] [PubMed]
[59] Feng, Z., et al. (2017) Gastrodin Inhibits Osteoclastogenesis via Down-Regulating the NFATc1 Signaling Pathway and Stimulates Osseointegration in Vitro. Biochemical and Biophysical Research Communications, 484, 820-826. [Google Scholar] [CrossRef] [PubMed]
[60] 刘琳, 卓莉. 糖尿病肾病病程演变的新认识[J]. 国际泌尿系统杂志, 2019, 39(6): 1149-1151.
[61] 华爽, 吕明慧, 刘倩颖, 等. 糖脂代谢病的发病机制: 多重打击学说[J]. 世界中医药, 2019, 14(3): 135-141.
[62] 耿雅娜. 天麻粉及天麻素治疗非酒精性脂肪性肝病的作用及机制研究[D]: [硕士学位论文]. 北京: 北京协和医学院(清华大学医学部), 2015.
[63] Ahmad, O., Wang, B., et al. (2019) Lipid Modulating Anti-Oxidant Stress Activity of Gastrodin on Nonalcoholic Fatty Liver Disease Larval Zebrafish Model. International Journal of Molecular Sciences, 20, pii: E1984. [Google Scholar] [CrossRef] [PubMed]
[64] 曲丽丽. 天麻素治疗非酒精性脂肪性肝病的抗炎和抗氧化机制研究[D]: [硕士学位论文]. 北京协和医学院(清华大学医学部), 2016.
[65] Qu, L.L., Yu, B., Li, Z., et al. (2016) Gastrodin Ameliorates Oxidative Stress and Proinflammatory Response in Nonalcoholic Fatty Liver Disease through the AMPK/Nrf2 Pathway. Phytotherapy Research, 30, 402-411. [Google Scholar] [CrossRef] [PubMed]
[66] 吴春丽, 时宝林, 于忠娟, 等. 乙酰天麻素治疗孕期偏头痛患者的临床研究[J]. 中国临床药理学杂志, 2019, 35(10): 42-44.