解毒活血类中药治疗糖尿病溃疡的作用机制研究进展  

Research progress on mechanism of toxin‑resolving and blood‑quickening traditional Chinese medicine in treating diabetic ulcer

作　　者：魏晓涛 王彩虹 田慧卿 宋渊源 谢婧 刘涛 何志军[1] 李非[1] 陈杰[1] 何波 马岁录 WEI Xiaotao;WANG Caihong;TIAN Huiqing;SONG Yuanyuan;XIE Jing;LIU Tao;HE Zhijun;LI Fei;CHEN Jie;HE Bo;MA Suilu(Gansu Provincial Hospital of TCM,Lanzhou,Gansu 730000,China;Gansu University of Chinese Medicine,Lanzhou,Gansu 730000,China;Nanyang Hospital of Traditional Chinese Medicine,Nanyang,Henan 473000,China;Xi'an Hospital of Traditional Chinese Medicine,Xi'an,Shaanxi 710000,China)

机构地区：[1]甘肃省中医院,甘肃兰州730000 [2]甘肃中医药大学,甘肃兰州730000 [3]南阳市中医院,河南南阳473000 [4]西安市中医院,陕西西安710000

出　　处：《上海中医药杂志》2025年第5期87-94,共8页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82460942,81660802);中共甘肃省委组织部省级青年人才项目(甘组通字〔2024〕4号);甘肃省重点研发计划项目(21YF5FA021);甘肃省自然科学基金项目(22JR5RA620,25JRRA275);甘肃省中医药管理局高水平重点课题(GZKZ-2024-3);甘肃省卫健委甘肃省卫生健康行业科研项目(GSWSKY2024-65,GSWSKY2024-15);兰州市人才创新创业专项(2019-RC-63)。

摘　　要：糖尿病溃疡(DU)是糖尿病患者常见且严重的并发症,常见于足部,尤其是足底和趾间。其主要发病原因是长期高血糖导致的神经和血管损伤,并使伤口难以愈合。西药在DU治疗中虽有重要作用,但存在药物耐药性、高治疗成本和副作用等问题。中医药以其整体调理和个体化治疗的特点在DU治疗中展现了独特优势,尤其是解毒活血类中药。解毒活血类中药具有独特的治疗特点,主要用于治疗因血液瘀滞、毒素积聚引起的各种疾病,可促进体内的毒素排出,改善血液循环,调节机体免疫和炎症反应。其治疗DU的作用机制主要包括减少炎症因子的产生、减轻氧化应激、促进血管生成、调控细胞自噬,以及调控核丝裂原活化蛋白激酶(MAPK)、沉默信息调节因子2相关酶1(SIRT1)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)等相关信号通路。主要综述了中药有效成分防治DU作用机制的研究进展,旨在为进一步研究中药有效成分在DU防治中的应用价值提供参考和依据。Diabetic ulcer(DU)is a common and serious complication in diabetic patients,which is common in the foot,especially between the sole and toe.The main cause is nerve and vascular injury caused by long-term hyperglycemia,and the wound is difficult to heal.Although Western medicine plays an important role in the treatment of DU,but there are problems such as drug resistance,high treatment cost and side effects.Traditional Chinese medicine has shown unique advantages in the treatment of DU with its characteristics of overall conditioning and individualized treatment,especially toxin-resolving and blood-quickening traditional Chinese medicine.Toxin-resolving and blood-quickening traditional Chinese medicine has unique therapeutic characteristics.It is mainly used to treat various diseases caused by blood stasis and toxin accumulation.It can promote the excretion of toxins in the body,improve blood circulation,and regulate the body's immune and inflammatory responses.The mechanism of action of toxin-resolving and blood-quickening traditional Chinese medicine in the prevention and treatment of DU mainly includes reducing the production of inflammatory factors,reducing oxidative stress,promoting angiogenesis,regulating autophagy,and regulating nuclear mitogen-activated protein kinase(MAPK),silent information regulator 2-related enzyme 1(SIRT1),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and other related signaling pathways.This paper mainly reviews the research progress on the mechanism of action of effective components of traditional Chinese medicine in the prevention and treatment of DU,aiming to provide reference and basis for further research on the application value of effective components of traditional Chinese medicine in the prevention and treatment of DU.

关 键 词：糖尿病足 溃疡 炎症因子 氧化应激 血管新生 自噬 信号通路 中药研究 

分 类 号：R285[医药卫生—中药学]