中西药治疗糖尿病下肢动脉粥样硬化性病变研究进展

Research Progress on Integrated Traditional Chinese and Western Medicine Therapy for Diabetic Lower Extremity Atherosclerotic Disease

摘要: 糖尿病下肢动脉粥样硬化性病变(Diabetic Lower Extremity Atherosclerotic Disease, DLEAD)作为糖尿病最严重的血管并发症之一，其典型临床特征包括下肢组织灌注不足引发的缺血性疼痛、运动诱发的间歇性跛行，病情进展可导致组织坏死形成坏疽，最终可能面临截肢风险。现代医学主要采用降糖、调脂、抗血小板及血管重建等治疗手段，而中医药则通过多靶点、多途径调节糖脂代谢、改善微循环、抗炎抗氧化等机制发挥协同作用。近年来，中西医结合治疗DLEAD显示出独特优势，可提高疗效并减少不良反应。本文系统综述DLEAD的发病机制、中西医治疗策略及联合应用的研究进展，以期为临床实践提供参考。

Abstract: Diabetic Lower Extremity Atherosclerotic Disease (DLEAD), one of the most severe vascular complications of diabetes, is clinically characterized by ischemic pain due to inadequate lower limb tissue perfusion, exercise-induced intermittent claudication, and progressive tissue necrosis leading to gangrene, which may ultimately necessitate amputation. Modern medicine primarily employs treatments such as glucose-lowering, lipid regulation, antiplatelet therapy, and vascular reconstruction, while traditional Chinese medicine (TCM) exerts synergistic effects through multi-target and multi-pathway mechanisms, including modulation of glucose and lipid metabolism, improvement of microcirculation, and anti-inflammatory and antioxidant actions. In recent years, integrated Chinese and Western medicine has demonstrated unique advantages in treating DLEAD, enhancing therapeutic efficacy while reducing adverse effects. This article systematically reviews the pathogenesis of DLEAD, treatment strategies in both Western and Chinese medicine, and advances in their combined application, aiming to provide insights for clinical practice.