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2型糖尿病(T2DM)是一种以高血糖为特征的慢性代谢性疾病,主要是由于胰岛素分泌不足而导致的空腹血糖升高[1]。冠状动脉粥样硬化性心脏病(CHD,简称冠心病)是一种常见的心血管疾病,主要是由于冠状动脉的粥样性硬化引起的血管阻塞或管腔狭窄,从而导致心肌缺血或缺氧性坏死,进而影响心脏功能[2]。近年来,T2DM的患病人数不断增加。据相关不完全统计,预计到2045年,全球T2DM患病人数将增加至7.83亿,已成为全球关注的重要人类问题之一[3]。目前,我国60岁以上的老年人中T2DM患病率超过20%,其中心血管疾病是最常见的并发症,而CHD则是T2DM患者最常见的致残或致死原因[4, 5]。有研究表明,T2DM患者发生心血管疾病的概率是非T2DM人群的2~4倍,葡萄糖耐受量受损是影响CHD进展的重要因素[6]。由此可见,T2DM与CHD相互影响,相互促进。
中药复方制剂麝香保心丸源于宋代《太平惠民和剂局方》中治疗“寒闭证”的经典名方苏合香丸,由戴瑞鸿教授在1972年改良而来。麝香保心丸已在临床应用40余年,方中麝香通窍温阳、活血化瘀为君药;苏合香辟秽通窍、人参扶正益气为臣药;牛黄开窍醒神、肉桂助阳通脉、蟾酥开窍止痛为佐药;冰片开窍醒神为使药。全方寒温并用、通补兼施、益气强心,主要用于治疗气滞血瘀所致的胸痹,症见心前区疼痛固定不移,心肌缺血所致的心绞痛、心肌梗死等[7-9]。目前临床上将麝香保心丸与基础西药中的降糖药联合应用,表现出比单用降糖药更好的血糖调节效果[10],还可以降低患者血清胆固醇水平[11],显著降低心血管事件发生率[12]。但目前关于麝香保心丸“异病同治”T2DM和CHD共同作用机制的研究相对不足。本研究旨在通过运用网络药理学方法,探索麝香保心丸“异病同治”T2DM和CHD的共同作用机制,为今后的研究和应用提供理论依据。
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