【目的】 观察外用十敛散联合内服舒脉胶囊对糖尿病足溃疡（DFU）大鼠的治疗作用及机制。【方法】 将足溃疡造模成功的 雄性大鼠 8只设为对照组。将 DFU造模成功的雄性大鼠 24只随机分为 DFU组、舒脉组、十敛散合舒脉组，每组 8只。对应 干预后，比较各组大鼠的创面愈合率，创面组织病理学变化，血清中炎症因子白细胞介素（IL）-6、IL-1β和血管内皮生长因 子（VEGF）水平，创面组织松弛素（Relaxin）、爱帕琳肽（Apelin）、磷脂酰肌醇3-激酶（PI3K）、蛋白激酶B（AKT）、VEGF蛋白 表达水平，PI3K、AKT、Relaxin和Apelin mRNA表达水平。【结果】 与对照组比较，DFU组创面愈合率，血清、创面VEGF水 平，创面Relaxin水平，创面AKT蛋白、mRNA水平均显著降低 （P < 0.05），血清IL-6、IL-1β水平，创面Apelin水平，PI3K 蛋白、mRNA表达水平均显著升高 （P < 0.05），镜下可见创面肉芽组织及新生的毛细血管减少，炎性细胞浸润增多。与DFU 组比较，舒脉组和十敛散合舒脉组创面愈合率，血清、创面 VEGF水平，创面 Relaxin、Apelin水平，创面 PI3K和 AKT的蛋 白及mRNA表达水平均显著升高 （P < 0.05），血清IL-6、IL-1β水平均显著降低 （P < 0.05），镜下可见创面肉芽组织及新生 的毛细血管增多，炎性细胞浸润减少。与舒脉组比较，十敛散合舒脉组创面愈合率，创面VEGF水平，创面Relaxin、Apelin 水平，创面 PI3K和 AKT的蛋白及 mRNA 水平均显著升高 （P < 0.05），血清 IL-6、IL-1β水平均显著降低 （P < 0.05），镜下 可见创面肉芽组织及新生的毛细血管增多，炎性细胞浸润减少。【结论】 外用十敛散联合内服舒脉胶囊可促进糖尿病足溃疡 大鼠创面愈合，其机制与激活PI3K/AKT/Relaxin/Apelin信号通路有关。

Objective To observe the therapeutic effect and mechanism of external application with Shilian Powder combined with oral administration of Shumai Capsules for the treatment of rats with diabetic foot ulcer （DFU）. Methods Eight male rats with successfully modeled foot ulcer（DF）were used as the control group. While 24 male rats with successfully modeled DFU were randomly divided into DFU group，Shumai Capsules group and Shilian Powder combined with Shumai Capsules group， with eight rats in each group. After the corresponding interventions，we determined the wound healing rate，histopathological changes of wound，levels of inflammatory factors such as interleukin（IL）- 6，IL-1β and vascular endothelial growth factor（VEGF）in serum，levels of Apelin and Relaxin，and protein expressions of phosphatidylinositol 3-kinase（PI3K），protein kinase B（AKT） and VEGF in wound tissue，as well as mRNA expressions of PI3K，AKT，Relaxin and Apelin. Results Compared with the control group, the DFU group showed a significant decrease in wound healing rate, VEGF level in serum and wound, wound Relaxin level, protein and mRNA levels of wound AKT (P < 0.05), and a significant increase in serum IL -6 and IL-1β levels, wound Apelin level, wound PI3K protein and mRNA levels(P < 0.05), and the reduced wound granulation tissue and formation of new capillaries and increased inflammatory cell infiltration were seen under the microscope. Compared with the DFU group, the wound healing rate, VEGF level in serum and wound, wound Relaxin and Apelin levels, protein and mRNA levels of wound PI3K and AKT in the Shumai Capsules group and Shilian Powder combined with Shumai Capsules group were significantly increased (P < 0.05), and serum IL-6 and IL-1β levels were significantly decreased (P < 0.05), and the increased wound granulation tissue and formation of new capillaries and reduced inflammatory cell infiltration were seen under the microscope. Compared with the Shumai Capsules group, the wound healing rate, wound VEGF level, wound Relaxin and Apelin levels, protein and mRNA levels of wound PI3K and AKT in Shilian Powder combined with Shumai Capsules group were significantly increased (P<0.05), and the serum IL-6 and IL-1β levels were significantly decreased (P < 0.05), and the increased wound granulation tissue and formation of new capillaries and reduced inflammatory cell infiltration were seen under the microscope. Conclusion External application with Shilian Powder combined with oral administration of Shumai Capsules can promote the wound healing in rats with DFU，its mechanism is related to the activation of PI3K/AKT/Relaxin/Apelin signaling pathway.

R285.5

广东省第二中医院中医特色重点医院建设工程项目（编号：602023069）；广州市科技计划项目（编号：201904010194）