房昉　赵杰　温伟波

[摘要] 胰島素抵抗与糖尿病、代谢综合征、非酒精性脂肪性肝病等多种疾病密切相关，中药治疗胰岛素抵抗已经成为热点。本文对胡椒、荜茇、葛根、半夏、苍术、石膏、茺蔚子、柴胡、荔枝核、川芎、红花、紫苏子、附子、肉桂、淫羊藿15种辛味中药的药性、现代药理学研究、相关临床报道等进行总结，尤其关注15味中药与胰岛素抵抗的关系。有较多的辛味中药可以改善胰岛素抵抗，部分辛味中药的有效成分对改善胰岛素抵抗作用明确，且已有较为清晰的作用机制；辛味中药改善胰岛素抵抗的机制可能与其促进津液的正常输布有关，但目前对辛味中药改善胰岛素抵抗的研究尚欠深入，今后可运用“以方测证”的思维方法进一步研究。

[关键词] 胰岛素抵抗；辛味中药；药理

[中图分类号] R282 [文献标识码] A [文章编号] 1673-7210（2016）12（a）-0097-05

Pungent Chinese materia medica and insulin resistance

FANG Fang1 ZHAO Jie2 WEN Weibo3

1.Department of Emergency， the First Hospital Affiliated to Yunnan University of Traditional Chinese Medicine， Yunnan Province， Kunming 650021， China； 2.Department of Endocrinology， the First Hospital Affiliated to Yunnan University of Traditional Chinese Medicine， Yunnan Province， Kunming 650021， China； 3.Department of Geriatrics， the First Hospital Affiliated to Yunnan University of Traditional Chinese Medicine， Yunnan Province， Kunming 650021， China

[Abstract] Insulin resisitance （IR） is closely related with many diseases， such as diabetes， metabolic syndrome， nonalcoholic fatty liver disease， NAFLD and so on. Using traditional Chinese medicine to treat IR has become very popular recently. This article has made conclusions about the property of the medicine， the modern pharmacology research and the related clinical reports of 15 kinds of pungent traditional Chinese medicine. They are Piper nigrum L.， Piper longum L.， Pueraria thomsonii Benth.， Pinellia ternata Breit.， Atractylodes lancea （Thunb.） DC.， Gypsum fibrosum， Fructus Leonuri， Bupleurum chinensie DC， Litchi chinensis Sonn.， Ligusticum chuanxiong Hort.， Carthamus tinctorius L.， Perilla frutescens （L.） Britt.， Aconitum carmichaeli Debx.， Cinnamomum cassia Presl， Epimedium brevicornum Maxim.. This article is most focused on the relationships between the 15 kinds of medicine and the IR. According to researches， traditional Chinese medicine with more pungent parts can improve IR. Parts of the active ingredients of pungent traditional Chinese medicine has a definite effect to improve IR and has a relative distinct effect mechanism. The mechanism of pungent traditional Chinese medicine to improve IR may be that it can maintain the normal transportation of the body fluid. However， the study that pungent traditional Chinese medicine improve IR has not been fully thorough at present. Therefore the thinking method of syndrome differentiation through formula effect assessment can be more studied in the future.

[Key words] Insulin resistance； Pungent Chinese materia medica； Pharmacology

胰岛素抵抗是指胰岛素作用的靶器官对外源性或内源性胰岛素作用的敏感性降低，即胰岛素生物学效应的降低，与糖尿病、代谢综合征、非酒精性脂肪性肝病等多种疾病密切相关。在分子细胞水平上，胰岛素抵抗主要体现为胰岛素信号通路的传导能力不足。从胰岛素信号与细胞表面胰岛素受体的结合一直到最后靶分子的传递过程，任何一个环节受损，都可能出现胰岛素抵抗。中药治疗胰岛素抵抗已经成为一大热点，并已有大量文献报道了中药对胰岛素抵抗的治疗作用，现将辛味中药与胰岛素抵抗的关系进行简要综述。……