[1]赵恩熙,李乐愚,李娜,等.基于“脾虚-浊瘀-热毒”理论探讨2型糖尿病铁死亡的科学内涵[J].陕西中医,2025,46(8):1077-1081.[doi:DOI:10.3969/j.issn.1000-7369.2025.08.013]
　ZHAO Enxi,LI Leyu,LI Na,et al.To explore the scientific connotation of ferroptosis in T2DM based on the theory of “spleen deficiency-phlegm and stasis-heat toxin”[J].,2025,46(8):1077-1081.[doi:DOI:10.3969/j.issn.1000-7369.2025.08.013]
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基于“脾虚-浊瘀-热毒”理论探讨2型糖尿病铁死亡的科学内涵

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年8期
页码:
1077-1081
栏目:
学术探讨
出版日期:
2025-08-05

文章信息/Info

Title:
To explore the scientific connotation of ferroptosis in T2DM based on the theory of “spleen deficiency-phlegm and stasis-heat toxin”
作者:
赵恩熙; 李乐愚; 李娜; 曾婷婷; 王宣懿; CHAI GAU Yong（马来西亚）
（广州中医药大学附属中山中医院，广东 中山 528400）
Author(s):
ZHAO Enxi; LI Leyu; LI Na; ZENG Tingting; WANG Xuanyi; CHAI GAU Yong
（Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine,Zhongshan 528400，China）
关键词:
2型糖尿病; 脾虚-浊瘀-热毒; 铁死亡; 线粒体; 脂质过氧化物堆积; 氧化应激
Keywords:
T2DM; Spleen deficiency-phlegm and stasis-heat toxin; Ferroptosis; Mitochondria; Lipid peroxide accumulation; Oxidative stress
分类号:
R 587.1
DOI:
DOI:10.3969/j.issn.1000-7369.2025.08.013
文献标志码:
A
摘要:
铁死亡与2型糖尿病（T2DM）及其诸多并发症密切相关。T2DM属于中医“消渴”的范畴，脾虚、浊瘀、热毒是消渴的重要病理因素。T2DM中“铁死亡”的发生机制与中医“脾虚-浊瘀-热毒”的病机演变有异曲同工之妙。线粒体作为能量场所，与中医脾的功能相似，脾虚失运导致津液输布失常，浊瘀互结，热毒内壅，微观表现为线粒体形态功能失调，能量代谢失常，脂质过氧化物不能被还原反应代谢，Fe2+通过Fenton反应氧化脂质产生大量羟基自由基和活性氧，诱发细胞铁死亡，影响机体糖代谢功能。基于此，提出消渴的根本病机为本虚标实，治疗应以健脾益气为根本，化浊逐瘀为主要方法，逆转热毒为重要手段。现以铁代谢异常、脂质堆积、氧化应激为切入点，具化糖尿病铁死亡，阐释“脾虚-浊瘀-热毒”理论的现代医学内涵，以期为中医药防治T2DM及其并发症提供新的思路和方法。
Abstract:
Ferroptosis has a broad and profound relationship with the type 2 diabetes mellitus (T2DM) and its various complications.In traditional Chinese medicine,T2DM belongs to “Xiaoke”.“Spleen deficiency-phlegm and stasis-heat toxin”,an important pathogenesis of “Xiaoke”,is similiar to the mechanisms of ferroptosis in T2DM.Mitochondria,an energy-producing organelle,is comparable in function to the spleen in traditional Chinese medicine.The spleen deficiency leads to abnormal distribution of body fluids,combination of turbidity and stasis and accumulation of heat toxin.On the micro level,it indicates malformation and dysfunction of mitochondria,as well as abnormal energy metabolism.Lipid peroxides cannot be metabolized by the reduction reaction and Fe2+ oxidizes lipids in Fenton-reaction,resulting in a large amount of hydroxyl radical and ROS,which promotes ferroptosis and glycometabolism disorder.Based on the above,it is proposed that the fundamental pathogenesis of Xiaoke is “deficiency in origin and excess in superficiality”.In the treatment,which is based on invigorating spleen and replenishing qi,dissolving turbidity and removing stasis is the primary approach,and removing heat toxin is an important means.This paper focuses on the iron metabolism disorder,lipid accumulation and oxidative stress to explore ferroptosis in T2DM to explain the implication of the “spleen deficiency-phlegm stasis-heat toxin” in modern medicine,aiming to provide theoretical references for the prevention and treatment of T2DM and its complications with traditional Chinese medicine.

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备注/Memo

备注/Memo:
广东省基础与应用基础研究基金资助项目（2022A1515011307）；广东省省级医疗卫生健康事业发展专项[中山卫健财（2024）9号]；广东省中山市科技局第一批社会公益项目（2022B1131，2021B1066）
更新日期/Last Update: 2025-08-08