白颖 暴雪丽 赵丹丹

摘要 胰岛素抵抗（Insulin Resistance，IR）是2型糖尿病的重要病理特征，其发病机制复杂，包括肥胖、遗传等因素引起的多种激素水平紊乱，慢性轻度炎症反应，氧化应激和能量代谢障碍导致线粒体功能受损等，基本可分为受体前、受体和受体后3个环节。中药复方、中成药、单味中药或其有效成分、针灸等疗法都能在一定程度上改善IR，从细胞、分子水平展开的相关研究也越来越细致、深入。

关键词 中医;胰岛素抵抗;2型糖尿病;发病机制;中药;中药复方;中成药;机制研究

Abstract Insulin resistance（IR）is an important pathological feature of type 2 diabetes mellitus（T2MD）.Its complicated pathogenesis includes disorder of various kinds of hormones caused by factors such as obesity and inheritance，chronic low inflammatory reaction，and impaired mitochondrial function caused by oxidative stress，energy metabolic disturbance，which can be basically divided into three stages：pre-receptor，receptor and post-receptor stage.It has been proved that herbal compound prescriptions，patent medicine，single types of herb or its active component，and other therapies such as acupuncture can to some extent alleviate IR.Related research from cellular and molecular levels has also become more detailed and deeper.Starting with the pathogenesis of IR described in traditional Chinese medicine（TCM）and Western medicine，this paper reviews the mechanism research of TCM intervention of IR in recent years，and offers a reference for relative research in future.

Keywords Traditional Chinese medicine; Insulin resistance; Type 2 Diabetes; Pathogenesis; Chinese medicine; Compound Chinese Medicine; Chinese patent medicine; Mechanism research

中图分类号：R242;R587.1文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.07.026

胰岛素作为人体内最重要的血糖调节激素，能够使葡萄糖进入肌肉、脂肪等组织细胞，促进葡萄糖在组织细胞的摄取和利用，促进脂肪、蛋白质、糖原等的合成。遗传、肥胖、高血糖或某些药物等因素的影响使得胰岛素的生物学效应下降或机体对胰岛素的反应性减弱，导致葡萄糖的摄取利用率降低，称为胰岛素抵抗（Insulin Resistance，IR）。IR是2型糖尿病的重要发病环节，有报道称，超过70%的糖尿病患者存在IR，同时IR也是高血压、冠心病、代谢综合征、多囊卵巢综合征等其他多种疾病的共同病理基础[1]。因此，深入研究IR的發生机制及其防治具有非常重大的临床意义。

越来越多的研究证实，无论是中药复方、中成药，还是单味中药及其有效成分，或者针灸等治疗都能有效改善IR，说明中医药对IR的防治具有独特优势。中医药治疗2型糖尿病能够有效降糖、减轻靶器官损害，就是通过改善IR实现的[2]。……