Volume 39 Issue 4
Apr.  2023
Turn off MathJax
Article Contents
CHEN Xiao-ying, ZHOU Jing-wen, LI Tian-ci, LU Zi-yu, YE Fang. Exploration of the Complex Pathogenic Transformation Characteristics of Type 2 Diabetes Mellitus with Thyroid Nodules Comorbidity[J]. Journal of Nanjing University of traditional Chinese Medicine, 2023, 39(4): 301-305. doi: 10.14148/j.issn.1672-0482.2023.0301
Citation: CHEN Xiao-ying, ZHOU Jing-wen, LI Tian-ci, LU Zi-yu, YE Fang. Exploration of the Complex Pathogenic Transformation Characteristics of Type 2 Diabetes Mellitus with Thyroid Nodules Comorbidity[J]. Journal of Nanjing University of traditional Chinese Medicine, 2023, 39(4): 301-305. doi: 10.14148/j.issn.1672-0482.2023.0301

Exploration of the Complex Pathogenic Transformation Characteristics of Type 2 Diabetes Mellitus with Thyroid Nodules Comorbidity

doi: 10.14148/j.issn.1672-0482.2023.0301
  • Received Date: 2022-12-30
    Available Online: 2023-04-17
  • The comorbidity of type 2 diabetes mellitus(T2DM) with thyroid nodules(TN) is discussed, and the theoretical implications of the compound pathogenesis of phlegm, constraint, stasis and heat are explored. The study introduces the pathogenesis evolution of T2DM and TN in Chinese medicine, and discusses the evolutional characteristics of the compound pathogenesis of T2DM combined with TN. The pathological factors center around phlegm and stasis, which are compounded with constraint, dampness, dryness, heat, etc. The corresponding location of the disease is mainly in the liver and kidney, and is also closely related to the heart, spleen, and lung. The nature of the disease is based on yin deficiency. From the modern biological point of view, the evolution of the compound pathogenesis of T2DM combined with TN is presented as follows. Firstly, insulin resistance is related to the production of phlegm, dampness, and stasis. Secondly, glucolipid metabolism is related to the formation and transformation of phlegm, dampness, and stasis. Thirdly, the formation of chronic inflammation is related to the pathological state of deficiency-excess complex. Thus, the combination of reductionist biomedicine and the holistic view of Chinese medicine is expected to provide new ideas for the modernization of the homotherapy for heteropathy in Chinese medicine.

     

  • loading
  • [1]
    ZHANG HM, FENG QW, NIU YX, et al. Thyroid nodules in type 2 diabetes mellitus[J]. Curr Med Sci, 2019, 39(4): 576-581. doi: 10.1007/s11596-019-2076-5
    [2]
    WEISS CO, VARADHAN R, PUHAN MA, et al. Multimorbidity and evidence generation[J]. J Gen Intern Med, 2014, 29(4): 653-660. doi: 10.1007/s11606-013-2660-5
    [3]
    周仲瑛, 吴勉华, 周学平, 等. 温经典, 传师道, 重临床, 善感悟: 略论中医药理论传承与创新研究的思路与方法[J]. 南京中医药大学学报, 2019, 35(5): 503-506, 522. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=zr20190505&flag=1

    ZHOU ZY, WU MH, ZHOU XP, et al. Discuss on thought and method of inheritance and innovation of traditional Chinese medicine theory: Review of classics, inherit of Masters' experience, emphasis of clinic and elaborate thinking[J]. J Nanjing Univ Tradit Chin Med, 2019, 35(5): 503-506, 522. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=zr20190505&flag=1
    [4]
    叶放, 周学平, 周仲瑛. 复合病机转化论初探[J]. 中医杂志, 2010, 51(10): 869-871, 874. doi: 10.13288/j.11-2166/r.2010.10.005

    YE F, ZHOU XP, ZHOU ZY. Preliminary study on the transformation theory of compound pathogenesis[J]. J Tradit Chin Med, 2010, 51(10): 869-871, 874. doi: 10.13288/j.11-2166/r.2010.10.005
    [5]
    杜骥腾, 石岩, 杨宇峰. 消渴病因病机理论框架研究[J]. 辽宁中医杂志, 2018, 45(10): 2073-2075. doi: 10.13192/j.issn.1000-1719.2018.10.017

    DU JT, SHI Y, YANG YF. Study on theoretical framework of diabetes etiology and pathogenesis[J]. Liaoning J Tradit Chin Med, 2018, 45(10): 2073-2075. doi: 10.13192/j.issn.1000-1719.2018.10.017
    [6]
    赵林华, 姬航宇, 冀博文, 等. 葛根芩连汤治疗糖尿病理论探讨[J]. 中华中医药杂志, 2012, 27(2): 280-283. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201202008.htm

    ZHAO LH, JI HY, JI BW, et al. Exploration of Gegen Qinlian Decoction's effect on diabetes mellitus in theory[J]. China J Tradit Chin Med Pharm, 2012, 27(2): 280-283. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201202008.htm
    [7]
    叶天士. 临证指南医案[M]. 上海: 上海科学技术出版社, 1959: 235.

    YE TS. Case Records as a Guide to Clinical Practice[M]. Shanghai: Shanghai scientific and technical publishers, 1959: 235.
    [8]
    柳宝诒. 温热逢源[M]. 北京: 人民卫生出版社, 1959: 79.

    LIU BD. Encountering the Sources of Warm-Heat Diseases[M]. Beijing: People's medical publishing house, 1959: 79.
    [9]
    周仲瑛. 论瘀热[J]. 南京中医药大学学报, 2006, 22(5): 273-276, 331. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=200605125&flag=1

    ZHOU ZY. On stagnated heat[J]. J Nanjing Univ Tradit Chin Med, 2006, 22(5): 273-276, 331. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=200605125&flag=1
    [10]
    周仲瑛. 糖尿病杂谈[J]. 江西中医药, 2001, 32(2): 15-16. https://www.cnki.com.cn/Article/CJFDTOTAL-JXZY200102008.htm

    ZHOU ZY. Talking about diabetes mellitus[J]. Jiangxi J Tradit Chin Med, 2001, 32(2): 15-16. https://www.cnki.com.cn/Article/CJFDTOTAL-JXZY200102008.htm
    [11]
    陈实功. 外科正宗[M]. 天津: 天津科学技术出版社, 1993: 135.

    CHEN SG. Orthodox Lineage of External Medicine[M]. Tianjin: Tianjin science and technology publisher, 1993: 135.
    [12]
    王桂彬, 姜晓晨, 刘福栋, 等. 甲状腺结节中医辨治浅析[J]. 环球中医药, 2021, 14(9): 1630-1633. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY202109022.htm

    WANG GB, JIANG XC, LIU FD, et al. Analysis on TCM differentiation and treatment of thyroid nodules[J]. Glob Tradit Chin Med, 2021, 14(9): 1630-1633. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY202109022.htm
    [13]
    严用和. 重订严氏济生方[M]. 北京: 人民卫生出版社, 1980: 99.

    YAN YH. Redefining Yan's Formulas to Aid the Living[M]. Beijing: People's medical publishing house, 1980: 99.
    [14]
    王盼盼, 叶放. 国医大师周仲瑛教授辨治良性甲状腺结节经验[J]. 四川中医, 2021, 39(5): 12-14. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202105005.htm

    WANG PP, YE F. Professor ZHOU zhongying's experience of differentiating and treating benign thyroid nodules[J]. J Sichuan Tradit Chin Med, 2021, 39(5): 12-14. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202105005.htm
    [15]
    叶放, 周学平, 程海波, 等. 基于整体观理解和创新中医病机辨证新理论[J]. 南京中医药大学学报, 2017, 33(5): 436-439. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=ZR2017_0502&flag=1

    YE F, ZHOU XP, CHENG HB, et al. Understanding and innovation of new theory of TCM syndrome differentiation based on holism[J]. J Nanjing Univ Tradit Chin Med, 2017, 33(5): 436-439. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=ZR2017_0502&flag=1
    [16]
    黄帝内经素问[M]. 北京: 人民卫生出版社, 1963.

    The Yellow Emperor's Inner Classic: Basic Questions[M]. Beijing: People's medical publishing house, 1963.
    [17]
    周仲瑛, 周学平, 郭立中, 等. 中医病机辨证新体系的构建及临床应用[J]. 江苏中医药, 2019, 51(2): 1-4. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY201902002.htm

    ZHOU ZY, ZHOU XP, GUO LZ, et al. The construction and clinical application of new system of TCM pathogenesis differentiation[J]. Jiangsu J Tradit Chin Med, 2019, 51(2): 1-4. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY201902002.htm
    [18]
    晁梁. 周仲瑛教授从"三热"论治糖尿病的学术思想研究[D]. 南京: 南京中医药大学, 2007.

    CHAO L. Academic research on professor Zhou zhongying treating diabetes mellitus with tripe-heat[D]. Nanjing: Nanjing University of Chinese Medicine, 2007.
    [19]
    黄元御. 四圣心源[M]. 北京: 中国医药科技出版社, 2020: 44.

    HUANG YY. The Indication of Classics by Four Medical Sages[M]. Beijing: China pharmaceutical science and technology publisher, 2020: 44.
    [20]
    董晓敏, 洪海鸥, 张洪, 等. 甲状腺及乳腺良性疾病和子宫肌瘤的关联性分析[J]. 中国临床保健杂志, 2019, 22(5): 627-630. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ201905014.htm

    DONG XM, HONG HO, ZHANG H, et al. Correlation among the prevalence of benign diseases of thyroid, breast and uterine fibroids[J]. Chin J Clin Healthc, 2019, 22(5): 627-630. https://www.cnki.com.cn/Article/CJFDTOTAL-LZBJ201905014.htm
    [21]
    范雪, 唐钰姣, 巴妍·谢开, 等. 健康体检人群超声检查乳腺结节与甲状腺结节发病率的相关性[J]. 影像研究与医学应用, 2020, 4(12): 129-131. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY202012085.htm

    FAN X, TANG YJ, BAYAN XK, et al. Correlation between ultrasound examination of breast nodules and incidence of thyroid nodules in healthy people[J]. J Imaging Res Med Appl, 2020, 4(12): 129-131. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYY202012085.htm
    [22]
    徐英, 李志学, 马艳, 等. 1990-2019年中国成年人归因于2型糖尿病的癌症疾病负担研究[J]. 中国肿瘤, 2022, 31(12): 959-966.

    XU Y, LI ZX, MA Y, et al. Cancer disease burden attributable to type 2 diabetes mellitus among adults in China, 1990-2019[J]. China Cancer, 2022, 31(12): 959-966.
    [23]
    张世安, 叶放. 周仲瑛教授从肾虚肝旺病机论治疑难杂病探讨[J]. 南京中医药大学学报, 2015, 31(2): 104-107. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=20150202&flag=1

    ZHANG SA, YE F. Discussion on professor Zhou zhongying's treating of complicated diseases from the pathogenesis of kidney deficiency and liver hyperactivity[J]. J Nanjing Univ Tradit Chin Med, 2015, 31(2): 104-107. http://xbs.njucm.edu.cn/jnutcmns/ch/reader/view_abstract.aspx?file_no=20150202&flag=1
    [24]
    张秉成. 成方便读[M]. 上海: 科技卫生出版社, 1958: 111.

    ZHANG BC. Convenient Reader on Established Formulas[M]. Shanghai: Science and health publishing house, 1958: 111.
    [25]
    赵成程, 刘孙强, 郑旭琴. 二甲双胍通过调控糖代谢抑制甲状腺结节的研究进展[J]. 南京医科大学学报(自然科学版), 2022, 42(5): 740-745. https://www.cnki.com.cn/Article/CJFDTOTAL-NJYK202205023.htm

    ZHAO CC, LIU SQ, ZHENG XQ. Progress in the study of metformin inhibiting thyroid nodules by regulating glucose metabolism[J]. J Nanjing Med Univ Nat Sci, 2022, 42(5): 740-745. https://www.cnki.com.cn/Article/CJFDTOTAL-NJYK202205023.htm
    [26]
    MARAVILLA DOMINGUEZ MA, ZERMENO GONZALEZ ML, ZAVALETA MUNIZ ER, et al. Inflammation and atherogenic markers in patients with type 2 diabetes mellitus[J]. Clin Investig Arterioscler, 2022, 34(3): 105-112.
    [27]
    FENG F, HAN HQ, WU SQ, et al. Crosstalk between abnormal TSHR signaling activation and PTEN/PI3K in the dedifferentiation of thyroid cancer cells[J]. Front Oncol, 2021, 11: 718578.
    [28]
    刘蕊蕊, 岳仁宋, 杨茂艺, 等. 从"痰脂膏浊-土壤变质"论胰岛素抵抗的中医实质[J]. 中医杂志, 2018, 59(19): 1699-1701. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201819020.htm

    LIU RR, YUE RS, YANG MY, et al. Discussion on the essence of traditional Chinese medicine for insulin resistance from the "phlegm, fat, turbid vs earth deterioration"[J]. J Tradit Chin Med, 2018, 59(19): 1699-1701. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201819020.htm
    [29]
    苏庆民, 王琦. 肥胖人痰湿型体质血脂、血糖、胰岛素及红细胞Na+-K+-ATP酶活性的检测[J]. 中国中医基础医学杂志, 1995, 1(2): 39-41. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC201705019.htm

    SU QM, WANG Q. Detection of blood lipid, blood glucose, insulin and erythrocyte Na+-K+-ATPase activity in obese people with phlegm-dampness constitution[J]. China J Basic Med Tradit Chin Med, 1995, 1(2): 39-41. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC201705019.htm
    [30]
    俞亚琴, 王彬. 从血瘀角度探讨Ⅱ型糖尿病胰岛素抵抗[J]. 浙江中医杂志, 2002, 37(4): 175-176. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZZ200204026.htm

    YU YQ, WANG B. Discussion on insulin resistance of type Ⅱ diabetes mellitus from the perspective of blood stasis[J]. Zhejiang J Tradit Chin Med, 2002, 37(4): 175-176. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJZZ200204026.htm
    [31]
    HEIDARI Z, MASHHADI MA, NOSRATZEHI S. Insulin resistance in patients with benign thyroid nodules[J]. Arch Iran Med, 2015, 18(9): 572-576.
    [32]
    李健, 王珩, 毕兵, 等. 血糖波动对2型糖尿病患者凝血功能的影响[J]. 中国老年学杂志, 2015, 35(18): 5139-5141. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201518044.htm

    LI J, WANG H, BI B, et al. Effect of blood sugar fluctuation on coagulation function in patients with type 2 diabetes mellitus[J]. Chin J Gerontol, 2015, 35(18): 5139-5141. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201518044.htm
    [33]
    YAMADA T, SATO A, NISHIMORI T, et al. Importance of hypercoagulability over hyperglycemia for vascular complication in type 2 diabetes[J]. Diabetes Res Clin Pract, 2000, 49(1): 23-31.
    [34]
    任爽, 刘妍彤, 张杰. 痰湿现代医学本质述析[J]. 中国中医基础医学杂志, 2021, 27(9): 1515-1518. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202109041.htm

    REN S, LIU YT, ZHANG J. Discussion on the modern medical nature of phlegm dampness[J]. J Basic Chin Med, 2021, 27(9): 1515-1518. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202109041.htm
    [35]
    HOTAMISLIGIL GS, PERALDI P, BUDAVARI A, et al. IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-alpha- and obesity-induced insulin resistance[J]. Science, 1996, 271(5249): 665-668.
    [36]
    HU FB, MEIGS JB, LI TY, et al. Inflammatory markers and risk of developing type 2 diabetes in women[J]. Diabetes, 2004, 53(3): 693-700.
    [37]
    LIU XZ, WANG JM, JI YX, et al. Monocyte-to-high-density lipoprotein cholesterol ratio is associated with the presence and size of thyroid nodule irrespective of the gender[J]. Lipids Health Dis, 2020, 19(1): 36.
    [38]
    张红敏, 谢春光, 陈世伟. 动脉粥样硬化、2型糖尿病等疾病发病学说中低度炎症的中医病理探讨[J]. 中医杂志, 2005, 46(2): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ200502000.htm

    ZHANG HM, XIE CG, CHEN SW. Study on TCM pathology of inflammation of low degree in attack theory of atherosclerosis, type Ⅱ diabetes and other diseases[J]. J Tradit Chin Med, 2005, 46(2): 83-85. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ200502000.htm
    [39]
    FAHEY E, DOYLE SL. IL-1 family cytokine regulation of vascular permeability and angiogenesis[J]. Front Immunol, 2019, 10: 1426.
    [40]
    朱震宏, 蒋晓真, 顾哲. 2型糖尿病大血管病变与血糖波动和炎症因子相关分析[J]. 实用糖尿病杂志, 2012, 8(2): 55-56. https://www.cnki.com.cn/Article/CJFDTOTAL-LNSY201202040.htm

    ZHU ZH, JIANG XZ, GU Z. Correlation analysis of macroangiopathy with blood glucose fluctuation and inflammatory factors in type 2 diabetes mellitus[J]. J Pract Diabetol, 2012, 8(2): 55-56. https://www.cnki.com.cn/Article/CJFDTOTAL-LNSY201202040.htm
    [41]
    张黎洋, 唐红. 糖尿病伴脂代谢异常患者的中医证型与炎症细胞因子的相关性研究[J]. 世界中西医结合杂志, 2022, 17(5): 954-958. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202205022.htm

    ZHANG LY, TANG H. Correlation between TCM syndromes and inflammatory cytokines in patients with diabetes and abnormal lipid metabolism[J]. World J Integr Tradit West Med, 2022, 17(5): 954-958. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202205022.htm
    [42]
    徐健强, 赵国军, 王燕, 等. 阿托伐他汀的抗炎作用及其机制的研究进展[J]. 中国动脉硬化杂志, 2016, 24(4): 419-423. https://www.cnki.com.cn/Article/CJFDTOTAL-KDYZ201604021.htm

    XU JQ, ZHAO GJ, WANG Y, et al. Advance in the anti-inflammatory effect and mechanism of atorvastatin[J]. Chin J Arterioscler, 2016, 24(4): 419-423. https://www.cnki.com.cn/Article/CJFDTOTAL-KDYZ201604021.htm
    [43]
    刘霁堂, 冯承飞. 钱学森中医现代化思想探究[J]. 科技管理研究, 2015, 35(22): 253-257. https://www.cnki.com.cn/Article/CJFDTOTAL-KJGL201522045.htm

    LIU JT, FENG CF. Study on Qian Xuesen's Chinese medicine modernization thought[J]. Sci Technol Manag Res, 2015, 35(22): 253-257. https://www.cnki.com.cn/Article/CJFDTOTAL-KJGL201522045.htm
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (426) PDF downloads(46) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return