松花粉联合三黄汤加减外用治疗糖尿病足溃疡验案1则

A Case Report on Treating Diabetic Foot Ulcer with Pine Pollen Combined with Modified Sanhuang Decoction for External Use

摘要: 糖尿病作为全球性公共卫生问题，严重危害人类健康，而糖尿病足溃疡是糖尿病患者致残与死亡的关键因素之一。如何促进糖尿病足溃疡创面愈合为临床难点之一。中医典籍《黄帝内经》所载“脱痈”，即是对此病最早的医学认识。笔者导师认为，糖尿病所致足部慢性创面，局部可见寒、热、痰、瘀等实邪结聚，然其本质为本虚标实之证，气虚血瘀、脉络痹阻为其病机关键。基于上述病机认识，导师强调在整体扶正内治之外，应结合溃疡创面的局部情况，合理运用外治法以祛邪敛疮。因此，临床施治局部予以中药外洗清热解毒的同时可予松花粉外用以收湿敛疮。现分享遵循此思路诊治的验案1例。

Abstract: Diabetes mellitus, as a global public health issue, poses a severe threat to human health, with diabetic foot ulcers being one of the key factors contributing to disability and mortality in diabetic patients. Promoting the healing of diabetic foot ulcer wounds remains one of the clinical challenges. The earliest medical recognition of this condition is documented in the classical Chinese medical text “Huangdi Neijing” (Yellow Emperor’s Inner Canon), where it is described as “tuo yong” (abscess rupture). Throughout history, physicians have held diverse views on its etiology, pathogenesis, and treatment strategies. The author’s mentor posits that chronic foot wounds caused by diabetes involve the accumulation of pathogenic factors such as cold, heat, phlegm, and blood stasis, but fundamentally manifest as a syndrome of “deficiency root with excess manifestation,” with qi deficiency, blood stasis, and collaterals obstruction being the key pathogenic mechanisms. Based on this understanding, the mentor emphasizes that, in addition to systemic treatment to reinforce healthy qi, local treatments should be appropriately applied to eliminate pathogens and promote wound healing. Therefore, in clinical practice, while using herbal washes to clear heat and detoxify the affected area, pine pollen can be applied topically to absorb dampness and promote wound healing. This article presents a case study following this therapeutic approach.