从线粒体生物发生与自噬机制探讨益气活血法促进糖尿病足溃疡愈合的科学内涵OA

Based on the traditional Chinese medicine(TCM)pathogenesis of"Qi-deficiency and blood-stasis"in diabetic foot ulcer(DFU),this study elucidates the microscopic mechanism underlying DFU from the perspective of dysregulated coordination between mitochondrial biogenesis and mitophagy.We propose that qi-deficiency corresponds to insufficient functional mitochondria caused by impaired biogenesis,resulting in compromised oxidative phosphorylation and reduced ATP production,thereby generating a"low-renewal"wound milieu.Blood-stasis is defined as the failure to eliminate damaged mitochondria and toxic metabolites such as mtROS due to defective mitophagy,establishing a"high-stasis"chronic inflammatory microenvironment.These two processes mutually reinforce each other,forming a vicious cycle that impedes wound healing.Tonifying Qi enhances mitochondrial biogenesis,whereas activating blood resolves stasis by restoring mitophagy;their synergism disrupts the cycle of mitochondrial quality-control imbalance.This mechanism provides a scientific rationale for the TCM strategy of"tonifying qi and activating blood"in re-establishing mitochondrial homeostasis and promoting DFU repair,offering a novel theoretical basis for integrated Chinese-Western management of DFU.