糖尿病足病理机制与治疗方法研究进展  

Advances in pathomechanisms and therapies fordiabetic foot

作　　者：张道英[1] 杨燕玲 黄浩[1] 陈垒 ZHANG Daoying;YANG Yanling;HUANG Hao;CHEN Lei(National Engineering Research Center for Modernization of Traditional Chinese Medicine-Hakka Medical Resources Branch,School of Pharmacy,Gannan Medical University,Ganzhou 341000,China)

机构地区：[1]赣南医学院药学院国家中药现代化工程技术研究中心客家中医药资源研究分中心,江西赣州341000

出　　处：《沈阳药科大学学报》2021年第6期636-642,共7页Journal of Shenyang Pharmaceutical University

基　　金：赣南医学院校级重点课题(ZD201912)。

摘　　要：目的总结糖尿病足溃疡(diabetic foot ulcer,DFUs)的分子学和遗传学基础以及临床所采用的治疗方法,以期为DFUs药物开发和临床治疗提供新思路。方法检索国内外相关文献56篇,并进行总结分析。结果糖尿病是以持续高血糖为基本生化特征的代谢性疾病,其中DFUs是其主要并发症之一,由神经、血管、免疫、代谢等内源性变化和感染、创伤、压力等外源性因素共同作用所致。在DFUs中,多个生理愈合过程均出现功能紊乱,包括生长因子生成,血管新生,白细胞吞噬,角质细胞和成纤维细胞增殖/迁移,胶原沉积,肉芽组织形成等等。临床治疗方法包括:药物改善微循环功能、人生长因子、高压氧疗法、负压疗法、伤口清创术、电击疗法等等。结论DFUs是一个复杂的病理过程,受多种分子和细胞以及表观遗传的调控。揭示其复杂的生理/病理机制将有利于开发建立新颖的治疗方法和药物。Objective To summarize the molecular and genetic basis underlying diabetic foot ulcer(DFUs)as well as the therapies used in clinical practice,and to provide new ideas for drug development and clinical management of DFUs.Methods A summary was made by searching 56 domestic and foreign literatures.Results Diabetes mellitus was a metabolic disease basically characterized by persistent hyperglycemia in biochemistry,with DFUs as one of its major complications,which was the result of a combination of endogenous alteration in nerves,blood vessels,immunity,metabolism and exogenous factors such as infection,trauma,and pressure.Dysfunctions in multiple physiological healing processes were caused by DFUs,including growth factor production,angiogenesis,leukocyte phagocytosis,keratinocyte and fibroblast proliferation/migration,collagen deposition,formation of granulation tissue etc.Clinically,the general managements for DFUs involved improvement in microvascular blood flow by drug intervention,human growth factors,hyperbaric oxygen therapy,negative pressure wound therapy,wound debridement and electric therapy etc.Conclusion DFUs is a complicated pathological process regulated by all kinds of molecules,cells and epigenetic inheritance.It is helpful for developing novel therapies and drugs for DFUs to reveal its complex physiological/pathological mechanisms.

关 键 词：糖尿病足溃疡 慢性难愈合伤口 病理机制 治疗方法 

分 类 号：R96[医药卫生—药理学]