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Journal of Traditional Chinese Medicine >

2026 , Vol. 46 >Issue 2: 427 - 438

DOI: https://doi.org/10.19852/j.cnki.jtcm.2026.02.015

Original Articles

Effect of Huiyang Shengji unguent (回阳生肌膏) on the NOD-like receptor family pyrin domain containing protein 3/caspase1/ gasdermin D pathway and lymphatic angiogenesis in patients with diabetic foot ulcer

  • YU Fangning ,
  • LIN Li ,
  • TANG Xiao ,
  • HE Xiujuan ,
  • ZHANG Bo ,
  • CHEN Yukun ,
  • MA Yizhao ,
  • LIU Zeyu ,
  • YE Jinsheng ,
  • XU Xuying
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  • 1 Department of Vascular Surgery, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing 100010, China
    2 Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100020, China
    3 Research Laboratory for the Theory and Application of Wound Healing, Beijing Institute of Traditional Chinese Medicine, Beijing 100010, China
    4 Department of General Surgery of Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing 100010, China

YU Fangning and LIN Li are co-first authors and contributed equally to this work

XU Xuying, Department of Vascular Surgery, Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing 100010, China. xxy7341@163.com; Telephone: +86-10-87906642

Received date: 2025-01-11

  Accepted date: 2025-06-05

  Online published: 2026-04-04

Supported by

National Natural Science Foundation of China: Mechanism Study of Huiyang Shengji Ointment in Inducing Acute Inflammation in Chronic Diabetic Foot Ulcers and Promoting Wound Healing Based on the Signal Transducer and Activator of Transcription 3/Forkhead Box Protein M1 Pathway(Grant numbers 82174388)

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Abstract

OBJECTIVE: To investigate the mechanism of Huiyang Shengji unguent (回阳生肌膏, HYSJ) for improving inflammation and promoting wound healing in patients with diabetic foot.

METHODS: The primary components of the HYSJ unguent were analyzed using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). A total of 20 patients with a diabetic foot wound were divided randomly into either a HYSJ treatment group (10 cases) or control group (10 cases). The HYSJ group was treated for 14 d with Hui Yang Shengji unguent, while the control group was treated for 14 d with basic fibroblast growth factor unguent. Central granulation tissue and wound secretions were collected before treatment and on the 7th and 14th day, respectively. The proteins prospero homeobox protein 1 (PROX-1), lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) and vascular endothelial growth factor receptor 3 (VEGFR-3) associated with lymphatic angiogenesis were detected by immunohistochemistry, the levels of inflammatory cytokines in wound exudates including interleukin-1β (IL-1β), interleukin-18 (IL-18), and vascular endothelial growth factor C (VEGF-C) were measured using enzyme-linked immunosorbent assay, while the protein levels of NOD-like receptor family, pyrin domain containing protein 3 (NLRP3), caspase-1, gasdermin D, and N-terminal gasdermin D were measured using immunoimprinting.

RESULTS: UPLC-MS/MS analysis revealed that the high-abundance peak compounds in HYSJ unguent included coclaurine, glucoraphanin, citric acid, gallic acid, L-glutamine, and gentianose. Following treatment, there was a significant reduction in IL-1β and IL-18 levels in the HYSJ group's wound exudates on day 14 compared to pre-treatment values (P < 0.05). Conversely, VEGF-C levels showed a significant increase from pre-treatment levels (P < 0.05). In addition, the expression of PROX-1, LYVE-1 and VEGFR-3 in wound tissue increased significantly after 14 d of treatment when compared to pre-treatment levels (P < 0.05). Taken together, the results of these analyses provide insights into the dynamic changes of these factors in wound healing processes. On the 7th and 14th day of treatment, the expression levels of IL-β and IL-18 in wound secretions and NLRP3, caspase-1, gasdermin D, and N-terminal gasdermin D in wound tissue were significantly lower in the HYSJ group than those measured in the control group (P < 0.05). At the same time, the expressions of VEGF-C, PROX-1, and LYVE-1 in wound secretions in the HYSJ group were significantly higher than those in the control group (P < 0.05).

CONCLUSIONS: The mechanism of HYSJ to promote wound healing of the Yinsyndrome in patients with diabetic foot may involve inhibition of cell necrosis mediated by the NLRP3/caspase-1/gasdermin D pathway, promotion of lymphangiogenesis, and establishment of a “protective field” for wound healing.

Key words： diabetic foot; pyroptosis; inflammation; lymphatic vessel; Hui Yang Shengji unguent

Cite this article

YU Fangning , LIN Li , TANG Xiao , HE Xiujuan , ZHANG Bo , CHEN Yukun , MA Yizhao , LIU Zeyu , YE Jinsheng , XU Xuying . Effect of Huiyang Shengji unguent (回阳生肌膏) on the NOD-like receptor family pyrin domain containing protein 3/caspase1/ gasdermin D pathway and lymphatic angiogenesis in patients with diabetic foot ulcer[J]. Journal of Traditional Chinese Medicine, 2026 , 46(2) : 427 -438 . DOI: 10.19852/j.cnki.jtcm.2026.02.015

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