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

Corresponding author: Chen Lilan, jsfs2006@163.com

DOI: 10.12201/bmr.202605.00107

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  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

  Submit time: 29 May 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2026-04-22	10.12201/bmr.202605.00107V1	Download

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