基于"脾络理论"探析细胞外基质重塑在糖尿病认知功能障碍中的发病机制及辨治思路OA

Diabetes-associated cognitive decline,a common central nervous system complication of type 2 diabetes mellitus,is clinically characterized by memory impairment,executive dysfunction,and decreased information processing speed,which impairs the quality of life and self-management ability of patients.In traditional Chinese medicine,the spleen collaterals are regarded as the hub for spleen-qi essence distribution.Spleen collateral injury,spleen yin deficiency,blood stasis in the brain collateral,and spleen-impairing-idea are the core pathogenesis of diabetes-associated cognitive decline.The extracellular matrix is a key component of the neuronal microenvironment.Its remodeling can lead to decreased synaptic plasticity in the hippocampus and mitochondrial dysfunction,thereby participating in diabetes-associated cognitive decline occurrence and development.Based on the"spleen collateral theory,"this article systematically explains the pathogenesis of Diabetes-associated cognitive decline from the dual perspectives of the pathogenesis of spleen collateral injury,spleen yin deficiency,blood stasis in the brain collateral,and spleen-impairing-idea in traditional Chinese medicine and the pathological mechanism of extracellular matrix remodeling-mitochondrial dysfunction-impaired synaptic plasticity-neuronal microenvironment disorder in modern medicine.It also proposes the principle of nourishing spleen yin,activating spleen essence,regulating spleen collateral,and dredging brain collateral for preventing and treating diabetes-associated cognitive decline,providing a theoretical basis for the basic research and clinical practice of the scientific connotation of the spleen zangxiang theory.