Review Article

Advances in Topical Chinese Herbal Medicine Formulas for Treating Diabetic Foot Ulcers

DOI:

10.3791/69239

February 27th, 2026

In This Article

Summary

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This article reviews the use of topical Chinese herbal medicine (CHM) for diabetic foot ulcers, highlighting current clinical challenges, recent evidence, therapeutic mechanisms, and the potential role of CHM as an integrative strategy to enhance wound healing and reduce complications.

Abstract

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The prevalence of diabetic foot ulcers (DFU), one of the most common complications of diabetes mellitus (DM), varies significantly across different countries, but remains high globally. The presence of DFU is associated with escalated healthcare expenditures, compromised physical functioning, and diminished quality of life, with a 5-year mortality rate 2.5 times higher than diabetes patients without foot ulcers. Common therapeutic strategies for DFU include glycemic control, eradication of infections, alleviation of pressure on the ulcers, and facilitation of wound healing. CHM, a fundamental element of Traditional Chinese Medicine, has gained widespread recognition in both oral and topical applications for the management of chronic wounds, owing to its functions of detoxification, promotion of blood circulation, removal of blood stasis, and enhancement of wound healing, as outlined in Chinese Medicine theories. Therefore, it is imperative to conduct a comprehensive literature review on the utilization of topical CHM for treating DFU in order to provide evidence-based guidance for clinical practice.

Introduction

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Diabetes mellitus (DM) has become one of the most pressing global health challenges, affecting an estimated 537 million adults in 2021, with projections suggesting this number will reach around 783 million by 20451. As the most commonly recognized complication of diabetes2, the prevalence of DFU varies significantly across different countries, but a commonality exists in that the prevalence of DFU remains high. The prevalence in African countries typically ranges from 10% to 30%, while in certain high-income regions, it accounts for 1% to 17%1. The presence of DFU is associated with escalated heal....

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Review and Perspective

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Pathophysiology of DFU
DFU is characterized by a disruption of the epidermis and at least partial involvement of the dermis in individuals with diabetes. Its development is attributed to multifactorial causes, including peripheral artery disease (PAD), diabetic peripheral sensory, motor, and autonomic neuropathy13.

Peripheral neuropathy
Peripheral neuropathy (PN) most commonly presents as symmetric polyneuropathy with pain or paresthesia, though up to 50% of cases may be asymptomatic14. It involves sensory, motor, and autonomic deficits

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Conclusions

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The topical application of traditional CHM shows promising therapeutic potential in diabetic wound management, yet its clinical translation remains constrained by limited evidence quality and a lack of standardization. Most existing studies suffer from small sample sizes, inadequate controls, and heterogeneous formulations, making it difficult to draw firm conclusions regarding efficacy and safety. Standardization challenges -- including inconsistent raw material quality, variability in active compound concentrations, an.......

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Disclosures

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The authors declare that they have no competing interests.

Acknowledgements

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Not applicable

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References

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  1. Singh, J., Sangwan, R. K., Mudgal, S. K., Huda, R. K. Empowering diabetes care: Patient practices and the role of mobile health - A qualitative exploration. Dialog Health. 7, 100231(2025).
  2. Armstrong, D. G., Boulton, A. J. M., Bus, S. A. Diabetic Foot Ulcers and Their Rec....

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Tags

Diabetic Foot UlcersChinese Herbal MedicineTopical Herbal FormulasWound HealingBlood CirculationChronic Wound ManagementTraditional Chinese MedicineGlycemic ControlInfection EradicationBlood Stasis Removal

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