糖尿病足溃疡（DFU）是糖尿病并发症之一的糖尿病足的主要表现，具有高发病率、高致残率、高复发率等特点。临床 上糖尿病足溃疡主要可归属于中医的“脱疽”范畴。黄淑玲教授认为，糖尿病足溃疡的病机多为消渴日久，肾水枯涸，痰 瘀阻络，又因正气不足而逢外邪侵袭，湿热毒蕴所致。根据病程进展，可将其分为热毒血壅证、热结阴伤证、脾虚痰瘀证、 气血亏虚兼络脉瘀阻证、肝肾阴虚兼瘀血阻滞证5个证型。治疗DFU基于扶正以祛邪的原则，拟定清热解毒活血、清热养阴 活血、健脾化痰通络、补益气血化瘀、滋补肝肾通瘀等治法。并总结了“早发现、早干预糖尿病高危足”“延缓神经病变、 血管病变的进展，积极治疗足癣”“有效治疗糖尿病足溃疡，降低截肢率”的糖尿病足溃疡三级防治方案。防治措施采用中 西医结合、内外兼治的疗法，中医治疗重视在中药内服基础上，结合紫珠叶洗剂持续湿敷创面，取得较好的疗效。

Diabetic foot ulcers（DFU）are the primary manifestations of diabetic foot，and the diabetic foot is one of the complications of diabetes mellitus. DFU present the characteristics of high morbidity，high disability rate and high recurrence rate. Clinically，DFU can be classified into the category of finger-toe gangrene in traditional Chinese medicine（TCM）. In the view of Professor Huang Shuling，DFU develop from diabetes after a long time， and are caused by insufficiency of kidney yin together with phlegm and blood stasis blocking collaterals，which results in the internal retention of damp-heat and toxins under the conditions of insufficiency of healthy qi and attack of external pathogens. According to the progression of DFU，DFU can be differentiated as five syndromes， namely heat-toxin and blood stasis accumulation syndrome， heat retention impairing yin syndrome， spleen deficiency and phlegm-stasis syndrome，qi and blood deficiency complicated by blood-stasis obstructing collaterals syndrome， and liver-kidney yin deficiency complicated by blood-stasis obstruction syndrome. Following the therapeutic principle of supporting healthy qi to eliminate pathogens，Professor Huang formulated the therapies for DFU， i. e.， clearing heat and removing toxins and activating blood， clearing heat and nourishing yin and activating blood， invigorating spleen and resolving phlegm and unblocking collaterals， tonifying qi-blood and removing blood stasis，and nourishing liver-kidney and unblocking blood stasis. Moreover，three-level prevention and treatment strategies for DFU were put forward by Professor Huang. The strategies include early diagnosis and early treatment of high-risk diabetic foot，delaying the progression of peripheral neuropathy and vascular disease of diabetes mellitus and treating tinea pedis positively，and effectively treating DFU to reduce amputation rate. The preventive and therapeutic strategies for DFU cover the therapies of integrated Chinese and western medicine，and therapies of simultaneous internal and external treatment. In treating DFU with TCM therapy， Professor Huang addressed the importance of combined use of Zizhuye Lotion for wet compressing on the wound continuously based on oral administration of Chinese medicine，which achieves a stronger therapeutic effect.

R259.872

东莞市社会发展科技项目（编号：20231800919372）