炎症-血管新生串扰作为糖尿病大动脉血管病变的新靶点：临床证据、机制发现及中医药防治潜力

Inflammation-angiogenesis crosstalk as a novel target for diabetic macrovascular complications： Clinical evidence，mechanism insights，and the potential of traditonal Chinese medicine in prevention and treatment

关键词:  糖尿病大动脉血管病变  炎症-血管新生串扰  中药复方  中药单体

Key words:  diabetic macrovascular complications  inflammation-angiogenesis crosstalk  traditional Chinese medicine compound prescriptions  monomeric components of traditional Chinese medicine

摘要:

糖尿病大动脉血管病变以动脉粥样硬化为核心特征，高血糖通过氧化应激、糖基化终产物积累和慢性炎症等机制，导致内皮功能障碍、血管新生失衡及斑块不稳定性，进而引发冠心病、脑血管疾病和外周动脉疾病。其复杂的病理发生发展进程和致病机制限制了新药开发的进展。最新研究发现，炎症-血管新生串扰（IAC）可能是糖尿病血管并发症的“共同土壤”，靶向IAC有望突破当前治疗瓶颈。文章系统综述了糖尿病大动脉血管病变的发病机制，探讨了IAC及其临床意义。中医药在这一领域展现出独特优势，能够通过多靶点调控实现同步抑制炎症、促进功能性血管新生。深入解析了炎症-血管新生串扰机制及中医药的多途径干预策略，为糖尿病大动脉血管病变的防治提供了新思路。未来需进一步验证关键靶点的调控作用，推动中西医结合治疗的临床转化。

Abstract:

Diabetic macrovascular complications are characterized by atherosclerosisas a core feature. Hyperglycemia leads to endothelial dysfunction，imbalanced angiogenesis，and plaque instability through mechanisms such as oxidative stress，accumulation of advanced glycosylation end products，and chronic inflammation，thereby contributing to coronary artery disease，cerebrovascular disease，and peripheral arterial disease. The complex pathophysiological progression and underlying pathogenic mechanisms of these complications have hindered significant breakthroughs in new drug development. Recent studies suggest that inflammation-angiogenesis crosstalk（IAC） may serve as a “common soil” for diabetic vascular complications，and targeting IAC holds promise for overcoming current therapeutic limitations. This article systematically reviews the pathogenesis of diabetic macrovascular complications and explored the role and clinical significance of IAC. Traditional Chinese Medicine（TCM） exhibits unique advantages in this field by leveraging multi-target regulation to simultaneously suppress inflammation and promote functional angiogenesis. This review provides an in-depth analysis of the inflammation-angiogenesis crosstalk mechanism and the multi-pathway intervention strategies of TCM，offering novel insights into the prevention and treatment of diabetic macrovascular complications. Future research should further validate the regulatory of key targets and promote the clinical translation of integrated traditional Chinese and Western medicine approaches.