Integrated Treatment Utilizing Both Chinese and Western Medicine for Refractory Diabetic Foot Ulcers
Summary: This case report describes a 57-year-old man with a 20-year diabetes history and Wagner grade IV diabetic foot ulcer (DFU) that progressed to near-amputation despite standard Western care. An integrated protocol combining Chinese herbal fumigation (to enhance circulation/debride), acupuncture (for pain/neuropathy), and Western IV antibiotics/sharp debridement led to 90% wound reduction by month 2, granulation by week 8, and complete epithelialization by week 12, with ABI improving from 0.6 to 0.9 and no recurrence at 6 months. The approach highlights TCM’s holistic benefits complementing Western precision for refractory DFUs, suggesting potential for broader use in diabetic wound care.
Key Highlights:
- Patient: 57M, BMI 25.4, HbA1c 8.9%; 10×8 cm ulcer with exposed bone, foul odor, severe pain (VAS 8).
- Treatment: Herbal fumigation (Angelica sinensis, etc.) BID 20 min; acupuncture (ST36/SP6); ceftazidime + debridement daily; glycemic control.
- Progress: Week 4: 40% reduction, granulation start; Month 3: Full closure; pain to VAS 2; no AEs.
- Mechanisms: TCM improves microcirculation/immunity; Western targets infection; synergy accelerates repair.
- Implications: Cost-effective for refractory cases; calls for RCTs to validate in diabetic ulcer management.
Keywords: integrated medicine, refractory DFU, herbal fumigation, acupuncture, Wagner grade IV