Exploring Mechanism of "Skin-gut Axis" in Diabetic Ulcer Based on Theory of "Gaozhuo" and Traditional Chinese Medicine Intervention Strategies

YE Du; YU Yunfeng; SU Siya; WANG Ying; YIN Yuman; CHU Shuzhou; ZHU Junping; YU Rong

doi:10.13422/j.cnki.syfjx.20260892

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Exploring Mechanism of "Skin-gut Axis" in Diabetic Ulcer Based on Theory of "Gaozhuo" and Traditional Chinese Medicine Intervention Strategies

更新时间：2026-07-01

- Exploring Mechanism of "Skin-gut Axis" in Diabetic Ulcer Based on Theory of "Gaozhuo" and Traditional Chinese Medicine Intervention Strategies
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 32, Issue 15, Pages: 238-244(2026)
- 作者机构：
  
  湖南中医药大学中医学院，长沙 410208
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20260892
  CLC： R242;R587.2;R255.4
- Received：30 October 2025，
  
  Revised：2026-01-08，
  
  Accepted：12 February 2026，
  
  Online First：02 March 2026，
  
  Published：05 August 2026
- 稿件说明：
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叶杜,俞赟丰,苏思雅等.基于膏浊理论探析“皮-肠轴”在糖尿病溃疡作用机制及中药干预策略[J].中国实验方剂学杂志,2026,32(15):238-244.

YE Du,YU Yunfeng,SU Siya,et al.Exploring Mechanism of "Skin-gut Axis" in Diabetic Ulcer Based on Theory of "Gaozhuo" and Traditional Chinese Medicine Intervention Strategies[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(15):238-244.
叶杜,俞赟丰,苏思雅等.基于膏浊理论探析“皮-肠轴”在糖尿病溃疡作用机制及中药干预策略[J].中国实验方剂学杂志,2026,32(15):238-244. DOI： 10.13422/j.cnki.syfjx.20260892.

YE Du,YU Yunfeng,SU Siya,et al.Exploring Mechanism of "Skin-gut Axis" in Diabetic Ulcer Based on Theory of "Gaozhuo" and Traditional Chinese Medicine Intervention Strategies[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(15):238-244. DOI： 10.13422/j.cnki.syfjx.20260892.

摘要

糖尿病溃疡（DU）作为糖尿病严重的慢性并发症，具有迁延难愈、复发率高等特点，严重影响患者生存质量并造成沉重社会经济负担。该文基于中医“膏浊理论”，结合现代医学“皮-肠轴”学说，系统探讨DU的中医病机演变规律及其与微生态失衡之间的内在联系，进一步提出中药干预的潜在策略。中医学认为，脾失健运致水谷精微不归正化，酿生“膏浊”，内蕴脏腑，下注肠腑，扰乱肠道微生态；膏浊郁而化热，外泛皮腠，阻滞络脉，形成“脾-肠-皮”病理传导链，最终导致皮肤屏障功能障碍与创面修复延迟。现代研究表明，DU患者存在显著的肠道与皮肤菌群失调，系统性炎症反应及免疫功能紊乱构成其难愈机制的关键环节。中药复方及其活性成分可通过多靶点、多途径调节肠道菌群结构、增强肠黏膜屏障、抑制炎症反应，进而经“皮-肠轴”改善皮肤微环境，促进溃疡愈合。这些干预策略与中医“健脾化浊、祛瘀通络”治法高度契合，体现了从脾胃论治、以菌群为靶点的整体调节优势。该文通过整合“膏浊理论”与“皮-肠轴”机制，构建了DU防治的中西医结合理论框架，以期为临床实践与后续研究提供新视角与思路。

Abstract

Diabetic ulcer （DU）， a severe chronic complication of diabetes， is characterized by delayed healing and high recurrence rates， significantly impairing patients' quality of life and imposing a substantial socioeconomic burden. Based on the traditional Chinese medicine （TCM） theory of "Gaozhuo" and combined with the modern medical concept of the "skin-gut axis"， this study systematically explored the evolutionary pathophysiology of DU and its intrinsic relationship with microecological imbalance， and proposed potential TCM intervention strategies. According to TCM principles， spleen dysfunction in transportation led to the abnormal metabolism of nutrients， resulting in the pathological formation of Gaozhuo. Gaozhuo accumulated internally， descended to the intestines， and disrupted the gut microbiota. Over time， Gaozhuo stagnated， transformed into heat， spread externally to the striated layer， and blocked collaterals， forming a "spleen-gut-skin" pathological chain that ultimately impaired skin barrier function and delayed wound healing. Modern research demonstrated significant dysbiosis in both gut and skin microbiota in DU patients， with systemic inflammation and immune dysregulation identified as key contributors to the refractory nature of DU. TCM compounds and their active components can modulate the gut microbiota structure， enhance intestinal barrier integrity， and suppress inflammatory responses through multi-target and multi-pathway mechanisms. These effects further improved the skin microenvironment and promote ulcer healing via the skin-gut axis. Such intervention strategies aligned closely with the TCM therapeutic approach of "invigorating spleen， resolving turbidity， removing stasis， and unblocking collaterals"， highlighting the holistic regulatory advantage of treating from the perspective of the spleen-stomach system while targeting the microbiota. By integrating the theory of Gaozhuo with the skin-gut axis mechanism， this study constructed a theoretical framework combining Chinese and western medicine for DU prevention and treatment， offering novel perspectives and directions for clinical practice and future research.

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references

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