2型糖尿病肌少症中西医结合研究进展

Research progress of integrated traditional Chinese and Western medicine in type 2 diabetic mellitus with sarcopenia

关键词:  2型糖尿病  肌少症  脾主肌肉  蛋白质代谢

Key words:  type 2 diabetes mellitus  sarcopenia  spleen dominating muscle  protein metabolism

摘要:

肌少症作为2型糖尿病（T2DM）的慢性并发症，严重降低老年人生活质量，加重医疗及社会负担。目前，西医对于肌少症诊断标准尚无统一认识，具体病因病机仍不明确，尚无针对性治疗方法。糖尿病会刺激老龄患者肌肉丢失加重，出现肌肉与脂肪成分改变。而血糖相较于年龄，可能对骨骼肌损害更为严重。骨骼肌作为胰岛素最大的靶器官，肌肉蛋白质代谢紊乱可能是糖尿病肌少症关键病机。中医认为"脾主肌肉"，临床观察与T2DM肌少症发病的可能机制高度相关，且可用于中医内外治疗的理论指导。通过对糖尿病肌少症中西医研究进展综述，旨在为疾病机制阐释及中医防控提供新思路。

Abstract:

As a chronic complication of type 2 diabetes mellitus (T2DM),sarcopenia seriously affects the quality of life of the elderly and increases the medical and social burden. At present,there is no unified understanding of the diagnostic criteria of sarcopenia in western medicine,and the specific etiology and pathogenesis are not clear. Meanwhile,there is no targeted treatment yet. Diabetes can stimulate the aging patients to lose more muscle and change the composition of muscle and fat. Blood glucose may cause more serious damage to skeletal muscle than age. As the largest target organ of insulin,skeletal muscle protein metabolism imbalance may be the key pathogenesis of diabetic sarcopenia. Traditional Chinese medicine believes that "spleen dominates muscle",and clinical observation is highly related to the possible mechanism of T2DM sarcopenia,which can be used as theoretical guidance for internal and external treatment of traditional Chinese medicine. By summarizing the research progress of traditional Chinese medicine and western medicine on diabetic sarcopenia,this paper aims to provide new ideas for the explanation of disease mechanism and prevention and control of traditional Chinese medicine.