Yan Li-Shan, Cheng Brian Chi-Yan, Zhang Shuo-Feng, Luo Gan, Zhang Chao, Wang Qing-Gao, Fu Xiu-Qiong, Wang Yi-Wei, Zhang Yi
School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, China.
College of Professional and Continuing Education, Hong Kong Polytechnic University, Hong Kong, China.
Front Pharmacol. 2021 Oct 21;12:748500. doi: 10.3389/fphar.2021.748500. eCollection 2021.
Diabetes mellitus (DM) and its complications pose a major public health threat which is approaching epidemic proportions globally. Current drug options may not provide good efficacy and even cause serious adverse effects. Seeking safe and effective agents for DM treatment has been an area of intensive interest. As a healing system originating in Tibet, Traditional Tibetan Medicine (TTM) has been widely used by Tibetan people for the prevention and treatment of DM and its complications for hundreds of years. Tibetan Materia Medica (TMM) including the flower of (Wall.) Meisn., Phyllanthi Fructus, Chebulae Fructus, Huidouba, and Berberidis Cortex are most frequently used and studied. These TMMs possess hypoglycemic, anti-insulin resistant, anti-glycation, lipid lowering, anti-inflammatory, and anti-oxidative effects. The underlying mechanisms of these actions may be related to their α-glucosidase inhibitory, insulin signaling promoting, PPARs-activating, gut microbiota modulation, islet β cell-preserving, and TNF-α signaling suppressive properties. This review presents a comprehensive overview of the mode and mechanisms of action of various active constituents, extracts, preparations, and formulas from TMM. The dynamic beneficial effects of the products prepared from TMM for the management of DM and its complications are summarized. These TMMs are valuable materia medica which have the potential to be developed as safe and effective anti-DM agents.
糖尿病（DM）及其并发症构成了重大的公共卫生威胁，在全球范围内正接近流行程度。目前的药物选择可能效果不佳，甚至会导致严重的不良反应。寻找安全有效的糖尿病治疗药物一直是一个备受关注的领域。作为起源于西藏的一种治疗体系，传统藏药（TTM）已被藏族人民广泛用于预防和治疗糖尿病及其并发症达数百年之久。最常使用和研究的藏药包括 （Wall.）Meisn.的花、余甘子、诃子、灰兜巴和黄柏。这些藏药具有降血糖、抗胰岛素抵抗、抗糖化、降脂、抗炎和抗氧化作用。这些作用的潜在机制可能与其α-葡萄糖苷酶抑制、胰岛素信号促进、过氧化物酶体增殖物激活受体（PPARs）激活、肠道微生物群调节、胰岛β细胞保护和肿瘤坏死因子-α（TNF-α）信号抑制特性有关。本综述全面概述了藏药中各种活性成分、提取物、制剂和配方的作用方式和机制。总结了藏药制备的产品对糖尿病及其并发症管理的动态有益作用。这些藏药是有价值的药材，有潜力被开发为安全有效的抗糖尿病药物。
