通讯作者: 陈丽兰, jsfs2006@163.com

DOI：10.12201/bmr.202605.00107

Prevention and Treatment of Diabetic Foot Based on the Spleen-Stomach and Gut Microbiota Axis

• 摘要：糖尿病足是糖尿病的严重慢性并发症,具有高致残率、高复发率。肠道菌群失调通过诱导代谢性内毒素血症、短链脂肪酸缺乏、胆汁酸代谢紊乱等途径,介导全身慢性低度炎症与胰岛素抵抗,是糖尿病足发生发展的重要推手。中医学认为,脾胃为后天之本、气血生化之源,“脾主四肢”“脾主肌肉”的理论奠定了从脾胃论治糖尿病足的基础。本文提出“脾胃-肠道菌群”轴的概念,系统梳理脾胃功能与肠道菌群稳态在生理功能、病理演变上的高度同构性,阐释“脾不散精、浊邪困脾”与菌群失调、“浊毒入血、痹阻脉络”与内毒素血症之间的病机对应关系,并从治未病的维度,提出健脾升清、化浊解毒、通调肠腑等防治策略。以期为糖尿病足的中医药防治提供新的理论视角与临床思路。

  关键词： 脾胃; 肠道菌群; 糖尿病足; 浊毒; 防治思路; 中医药

   

  Abstract: Diabetic foot is a severe chronic complication of diabetes mellitus, characterized by high rates of disability and recurrence. Gut microbiota dysbiosis mediates systemic chronic low-grade inflammation and insulin resistance through pathways including metabolic endotoxemia, short-chain fatty acid deficiency, and bile acid metabolism disorders, serving as a critical driver in the initiation and progression of diabetic foot. Traditional Chinese medicine posits that the spleen and stomach constitute the foundation of acquired constitution and the source of qi and blood biochemistry. The theories of the spleen governing the four limbs and the spleen dominating the muscles establish the basis for treating diabetic foot from the perspective of the spleen and stomach. This paper proposes the concept of the spleen-stomach and gut microbiota axis, systematically elucidating the profound structural isomorphism between spleen-stomach function and gut microbiota homeostasis in terms of physiological functions and pathological evolution. It interprets the pathogenic correspondence between spleen failing to distribute essence and turbid pathogen distressing the spleen and gut microbiota dysbiosis, as well as between turbid toxin entering the blood and obstructing collaterals and endotoxemia. Furthermore, from the perspective of preventive treatment of disease, it proposes prevention and treatment strategies including invigorating the spleen and ascending lucidity, resolving turbidity and detoxifying, and unblocking the fu-organs. This aims to provide new theoretical perspectives and clinical insights for the prevention and treatment of diabetic foot with traditional Chinese medicine.

  Key words: Spleen and stomach; Gut microbiota; Diabetic foot; Turbid toxin; Prevention and treatment strategies; Traditional Chinese medicine

  提交时间：2026-05-29

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-04-22	10.12201/bmr.202605.00107V1	下载

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