广州中医药大学学报2026，Vol.43Issue(1)：72-78,7.DOI:10.13359/j.cnki.gzxbtcm.2026.01.011
基于Nrf2/HO-1/NLRP3信号通路探讨益气解毒生肌方治疗难治性糖尿病足湿热毒盛证的作用机制
Exploring the Mechanism of Yiqi Jiedu Shengji Formula in Treating Refractory Diabetic Foot with Damp-Heat Toxin Excess Syndrome Based on the Nrf2/HO-1/NLRP3 Signaling Pathway
摘要
Abstract
Objective To investigate the mechanism of Yiqi Jiedu Shengji Formula in treating refractory diabetic foot with damp-heat toxin excess syndrome based on the nuclear factor E2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)/NOD-like receptor protein 3(NLRP3)signaling pathway.Methods Eighty patients with refractory diabetic foot of damp-heat toxin excess type admitted to Haikou Traditional Chinese Medicine Hospital between February 2021 and February 2023 were selected.They were randomly divided into a control group and an observation group using a random number table method,with 40 patients in each group.The control group received conventional western medical treatment,while the observation group received Yiqi Jiedu Shengji Formula in addition to the conventional treatment.The treatment course was 4 weeks,followed by a 6-month follow-up.The wound closure index at different time points,TCM syndrome scores,and serum levels of interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),advanced glycation end products(AGEs),Nrf2,HO-1,and NLRP3 were observed before and after treatment.Clinical efficacy and recurrence rates were compared between the two groups.Results(1)Regarding efficacy,after 4 weeks of treatment,the total effective rate was 95.00%(38/40)in the observation group and 77.50%(31/40)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy in the observation group was significantly superior to that in the control group(P＜0.05).(2)Regarding the wound closure index,intragroup comparisons at different time points in both groups showed that the index was increased with the treatment time:after 4 weeks of treatment>after 3 weeks>after 2 weeks>after 1 week(P＜0.05).Intergroup comparisons revealed that the wound closure index in the observation group was greater than that in the control group at 1 to 4 weeks after treatment(P＜0.05).(3)Regarding TCM syndrome scores,after treatment,scores for wound pain,peri-wound burning sensation,thirst,yellow urine,dry stool,and ulceration decreased compared to before treatment in both groups(P＜0.05).The reduction in all TCM syndrome scores in the observation group was significantly greater than that in the control group(P＜0.01).(4)Regarding laboratory indicators,after treatment,serum levels of IL-6,TNF-α,AGEs,and NLRP3 decreased compared to before treatment in both groups(P＜0.05),while serum levels of Nrf2 and HO-1 increased(P＜0.05).The reductions in serum IL-6,TNF-α,AGEs,and NLRP3 levels and the increases in serum Nrf2 and HO-1 levels in the observation group were significantly greater than those in the control group(P＜0.05 or P＜0.01).(5)Regarding recurrence,during the 6-month follow-up,the recurrence rate was 6.45%(2/31)in the observation group,significantly lower than the 29.63%(8/27)in the control group,with a statistically significant difference between the groups(P＜0.05).Conclusion The combination of Yiqi Jiedu Shengji Formula with conventional western medical treatment is effective for patients with refractory diabetic foot of damp-heat toxin excess type.It can effectively alleviate clinical symptoms,accelerate wound closure,and reduce the recurrence rate.Its mechanism may be related to downregulating IL-6,TNF-α,AGEs,and NLRP3 levels,upregulating Nrf2 and HO-1 levels,and thereby mitigating oxidative stress and inflammatory responses via the Nrf2/HO-1/NLRP3 signaling pathway.关键词
Nrf2/HO-1/NLRP3信号通路/益气解毒生肌方/难治性糖尿病足/湿热毒盛证/创面闭合指数/氧化应激/炎症反应/复发率Key words
Nrf2/HO-1/NLRP3 signaling pathway/Yiqi Jiedu Shengji Formula/refractory diabetic foot/damp-heat toxin excess syndrome/wound closure index/oxidative stress/inflammatory response/recurrence rate分类
医药卫生引用本文复制引用
邓兰英,郑靓,林少兰,银罗熙,洪德济,王春燕,范良..基于Nrf2/HO-1/NLRP3信号通路探讨益气解毒生肌方治疗难治性糖尿病足湿热毒盛证的作用机制[J].广州中医药大学学报,2026,43(1):72-78,7.基金项目
海南省卫生健康行业科研项目(编号:20A200076) （编号:20A200076）
