中西医治疗糖尿病足研究进展

Research Progress of Diabetic Foot Treatment by Chinese and Western Medicine

摘要: 糖尿病足作为糖尿病最具破坏性的慢性并发症之一，其治疗体系的革新始终是医学界关注的重点。在病理机制深入解析与技术迭代的推动下，中西医分别形成了特色鲜明的治疗路径：中医遵循“辨证–分期–施治”的诊疗逻辑，通过八纲辨证对患者进行个体化分型，并综合运用内服方剂、外敷膏药，结合中药熏洗、针灸通络等多元化干预手段，在改善微循环与调节全身机能方面凸显优势；西医则以精准清创为核心，结合负压封闭引流、抗生素骨水泥填充、穿支皮瓣移植等外科技术，在控制感染、修复组织缺损等关键环节展现快速疗效。值得注意的是，两类疗法正呈现互补融合趋势——中医的低成本、高依从性与西医的靶向性、时效性相结合，显著提高了溃疡愈合率并降低截肢风险。本文系统梳理糖尿病足治疗领域的关键突破，为构建个体化综合治疗方案提供循证依据。

Abstract: Diabetic foot, as one of the most destructive chronic complications of diabetes, has always been a focal point in the medical community regarding the innovation of its treatment system. Driven by the in-depth elucidation of pathological mechanisms and the iteration of techniques, both traditional Chinese medicine (TCM) and Western medicine have developed distinct treatment pathways. TCM follows the diagnostic and therapeutic logic of “pattern identification-staging-treatment.” It employs the theory of the Eight Principles to individualize patient classification and integrates a variety of interventions, including oral herbal formulas, topical plasters, herbal fumigation and washing, and acupuncture for meridian unblocking. These approaches highlight the advantages of improving microcirculation and regulating overall bodily functions. In contrast, Western medicine employs precise and accurate treatment of diabetic foot to improve microcirculation and regulate systemic functions. Western medicine utilizes precise trauma as a core principle, integrating negative pressure closed drainage, antibiotic bone cement filling, perforated flap transplantation, and other surgical techniques. This approach demonstrates rapid efficacy in controlling infections, repairing tissue defects, and addressing other critical aspects. It is noteworthy that a trend of complementary integration is observed between the two therapeutic modalities. The low cost and high compliance of Chinese medicine, when combined with the targeting and timeliness of Western medicine, have been shown to significantly increase the healing rate of ulcers and reduce the risk of amputation. This paper systematically reviews the major breakthroughs in the field of diabetic foot treatment, providing an evidence-based foundation for the development of personalized, comprehensive treatment plans.