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植物疗法在糖尿病足溃疡中的应用:一种促进有效伤口愈合的有前景的策略。

Phytotherapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing.

机构信息

Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of High Education, Manipal, Karnataka, India.

Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

J Am Nutr Assoc. 2023 Mar-Apr;42(3):295-310. doi: 10.1080/07315724.2022.2034069. Epub 2022 Apr 25.

Abstract

Despite the advancement in wound care, the effective therapy of chronic diabetic ulcers continues to be a challenge. Wound healing is a highly controlled process, which involves a sequence of complex overlapping steps. This healing pathway comprises of hemostasis, inflammation, proliferative, and remodeling phases. Recent evidence suggests that phytomedicines can prevent or repair different kinds of destructive cellular damage, including chronic wounds. Several phytochemicals such as polyphenols, alkaloids, flavonoids, terpenoids, and glycosides have pleiotropic effects, including stimulation of fibroblast proliferation, the main step in wound healing. Besides, the mechanism involves induction of collagen synthesis, migration, and reepithelization and their antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory actions. Similarly, the use of phytochemicals alone or as an adjuvant with standard therapy has demonstrated promising results in managing complications in the diabetic foot. For instance, the extract of Carica papaya has been shown antioxidant, antimicrobial, and anti-inflammatory, and immunomodulatory effects, which, together with proteolytic enzymatic activity, contributes to its wound healing property. It is generally believed that phytotherapy has no or minimal toxicity than synthetic therapeutic agents, favoring its use in diabetic foot ulcer management. The current review highlights the selected phytochemicals and their sources; and potential application in diabetic foot ulcer management.Key teaching points and nutritional relevanceCurrently, phytochemicals have been shown wide potential in disease. management including alleviating clinical manifestations, preventing degenerative disease, and curing illness.Increased evidence of phytochemical as anti-infective and anti-inflammatory suggests its role in the management of diabetic foot ulcer(DFU).Potential benefit along with minimal adverse effect favors its application as adjuvant therapy.Further research is needed to standardize its dose and formulation to enhance its clinical application in DFU management.

摘要

尽管伤口护理技术不断进步,但慢性糖尿病溃疡的有效治疗仍然是一个挑战。伤口愈合是一个高度受控的过程,涉及一系列复杂的重叠步骤。这个愈合途径包括止血、炎症、增殖和重塑阶段。最近的证据表明,植物药可以预防或修复包括慢性伤口在内的各种破坏性细胞损伤。几种植物化学物质,如多酚、生物碱、类黄酮、萜类化合物和糖苷,具有多种作用,包括刺激成纤维细胞增殖,这是伤口愈合的主要步骤。此外,其机制还包括诱导胶原合成、迁移和再上皮化,以及它们的抗菌、抗氧化、抗炎和免疫调节作用。同样,单独使用植物化学物质或作为标准治疗的辅助剂,已在糖尿病足并发症的管理中显示出有希望的结果。例如,木瓜提取物具有抗氧化、抗菌、抗炎和免疫调节作用,以及蛋白水解酶活性,这有助于其伤口愈合特性。人们普遍认为,植物疗法的毒性比合成治疗剂低或没有,这有利于其在糖尿病足溃疡管理中的应用。目前的综述强调了选定的植物化学物质及其来源;以及在糖尿病足溃疡管理中的潜在应用。

主要教学要点和营养相关性

目前,植物化学物质已显示出在疾病管理方面的广泛潜力,包括缓解临床表现、预防退行性疾病和治愈疾病。

越来越多的植物化学物质具有抗感染和抗炎作用的证据表明,其在糖尿病足溃疡(DFU)管理中的作用。

潜在的益处和最小的不良反应有利于将其作为辅助治疗应用。

需要进一步研究来规范其剂量和配方,以增强其在 DFU 管理中的临床应用。

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