2型糖尿病（T2DM）是以胰岛素抵抗为特征的代谢性疾病，是目前世界范围内最常见的慢性非传染性疾病之一。中医 认为，阳虚致消是T2DM的重要发病机制之一，也是胰岛素抵抗的核心病理基础。该文以阳虚致消理论为指导，通过查阅近 年来国内相关文献，梳理2型糖尿病胰岛素抵抗的西医发病机制与治疗、中医阳虚致消的理论与治疗应用、中医治疗胰岛素 抵抗的临床效用，分析阳虚致消理论在中医治疗T2DM胰岛素抵抗中的适用性。认为基于阳虚致消理论的中医治疗T2DM胰 岛素抵抗具有显著的效果和优势，既考虑了西医的科学性和规范性，又可以发挥中医治疗的整体观和个体化的优势，实现 了两种医学的优势互补和协同作用。中医治疗胰岛素抵抗能够通过多种途径和多个靶点改善胰岛素信号传导、胰岛素分泌 功能和其他相关代谢异常指标，进而改善机体健康状态。中医治疗胰岛素抵抗具有较好的安全性和耐受性，能够减少西药 治疗所致的不良反应。但中医治疗胰岛素抵抗也存在临床试验质量有待提高、作用机制有待深入探讨、创新性和前沿性有 待提升等问题。未来需进一步深入开展相关研究，以期为中医药在防治代谢性疾病方面发挥更大的作用提供科学依据。

Type 2 diabetes mellitus（T2DM）is a metabolic disease characterized by insulin resistance，and is one of the most common chronic non-communicable diseases worldwide. In the field of traditional Chinese medicine （TCM）， yang deficiency causing diabetes is one of the important pathogenetic mechanisms of T2DM and contributes to the core pathological basis of insulin resistance. Guided by the theory of yang deficiency causing diabetes，this paper reviewed the relevant domestic literature issued in recent years，sorted out western medical pathogenesis and treatment for insulin resistance in T2DM ，TCM theory of yang deficiency causing diabetes and its clinical application，and the clinical efficacy of TCM for the treatment of insulin resistance，and then explored the applicability of theory of yang deficiency causing diabetes for TCM treatment of insulin resistance in T2DM. It is concluded that TCM treatment for insulin resistance in T2DM based on the theory of yang deficiency causing diabetes has significant efficacy and advantages，for it realizes the integration of advantages of TCM and western medicine and achieves the synergistic actions through keeping the scientific nature and standardization of western medicine and by maintaining the advantages of holism and individualization of TCM treatment. TCM treatment for insulin resistance is effective on improving insulin signal transduction，insulin secretion function and other related metabolic abnormalities indicators through multiple pathways and targets，thus to improve the health status of the body. TCM treatment for insulin resistance exerts good safety and tolerance， and can reduce the incidence of adverse reactions caused by western medicine. However，the research on TCM treatment for insulin resistance still has the insufficiencies such as low quality of clinical trials， unclear therapeutic mechanism， and lack of innovation and pioneering. Further relevant research needs to be carried out in-depth，so as to provide a scientific basis for TCM to play a greater role in preventing and treating metabolic diseases.

R255.4

省部共建中医湿证国家重点实验室专项（编号：SZ2021ZZ08）