中医药治疗糖尿病足溃疡研究述评

李友山; 杨博华

doi:10.16025/j.1674-1307.2025.05.001

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中医药治疗糖尿病足溃疡研究述评

专题——糖尿病足溃疡的中医药诊疗 | 更新时间：2025-07-07

- 中医药治疗糖尿病足溃疡研究述评
- A review of the treatment of diabetic foot ulcers with traditional Chinese medicine
- 北京中医药 2025年44卷第5期页码：536-541
- 作者机构：
  
  1.北京中医药大学东直门医院周围血管科二区，北京 101121
  2.北京中医药大学东直门医院周围血管科一区，北京 100700
- 作者简介：
  
  李友山，男，46岁，博士，主任医师，博士生导师。研究方向：中医药治疗周围血管疾病、难愈性溃疡、下肢深静脉血栓相关疾病。
  杨博华，E-mail：yangb5191@sina.com
- 基金信息：
- DOI：10.16025/j.1674-1307.2025.05.001
  中图分类号：
- 收稿日期：2025-04-18，
  
  纸质出版日期：2025-05-25
- 稿件说明：
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李友山，杨博华.中医药治疗糖尿病足溃疡研究述评［J］.北京中医药，2025，44（5）：536-541.

LI Youshan,YANG Bohua.A review of the treatment of diabetic foot ulcers with traditional Chinese medicine[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(05):536-541.
李友山，杨博华.中医药治疗糖尿病足溃疡研究述评［J］.北京中医药，2025，44（5）：536-541. DOI： 10.16025/j.1674-1307.2025.05.001.

LI Youshan,YANG Bohua.A review of the treatment of diabetic foot ulcers with traditional Chinese medicine[J]. Beijing Journal of Traditional Chinese Medicine,2025,44(05):536-541. DOI： 10.16025/j.1674-1307.2025.05.001.

摘要

糖尿病足溃疡作为糖尿病最严重的慢性并发症之一，病理机制复杂，涉及慢性炎症及免疫微环境失衡、血管生成障碍等多因素相互作用。尽管现代医学在清创、抗感染等方面取得进展，但高复发率与致残率仍为临床难题。中医药基于“脱疽”“筋疽”理论，提出“虚、瘀、毒”核心病机，通过益气化瘀、扶正托毒等治法显著改善创面微循环，调控巨噬细胞极化，抑制NOD样受体蛋白3炎性小体活化及清除生物膜等多靶点机制，促进血管生成与组织修复。本文系统梳理中医古籍理论与现代研究进展，揭示糖尿病足溃疡中医药发病机制，并通过调节慢性炎症、纠正免疫失衡及改善血管生成障碍的协同作用，为中西医结合诊疗提供理论依据。然而，当前研究仍面临中医病机理论未统一、复方作用机制研究深度不足及临床疗效评价缺乏标准化等问题。未来需整合系统生物学与人工智能技术，构建“证候-病理-分子网络”动态模型，推动中医药精准化与国际化发展，实现从基础研究到临床转化的完整链条。

Abstract

Diabetic foot ulcer， as one of the most severe chronic complications of diabetes， has a complex pathogenesis involving the interplay of multiple factors such as chronic inflammation， immune microenvironment imbalance， and angiogenesis disorder. Although modern medicine has made progress in debridement and anti-infection treatments， the high recurrence and disability rates remain clinical challenges. Traditional Chinese medicine （TCM）， based on the theories of "digital gangrene" and "sinew abscess"， proposes the core pathogenesis as "deficiency， stasis， and toxicity". Through therapeutic methods such as invigorating

to resolve stasis and supporting the healthy

to expel toxins， TCM significantly improves local microcirculation， regulates macrophage polarization， inhibits activation of the NLRP3 inflammasome， and clears biofilms via multi-target mechanisms， thereby promoting angiogenesis and tissue repair. This article systematically reviews the classical TCM theories and recent research advances， revealing the TCM pathogenesis of diabetic foot ulcer and its synergistic effects in regulating chronic inflammation， correcting immune imbalance， and improving ang

iogenesis disorder， providing a theoretical basis for integrated TCM and Western medicine diagnosis and treatment. However， current research still faces issues including the lack of a unified TCM pathogenesis theory， insufficient depth in compound mechanism studies， and absence of standardized clinical efficacy evaluation. Future research should integrate systems biology and artificial intelligence technologies to construct a dynamic "syndrome–pathology–molecular network" model， promoting precision and internationalization of TCM development and achieving a complete chain from basic research to clinical translation.

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references

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