Abstract: Background　In recent years，diabetic foot has become an important cause of disability and death among diabetic patients. With the advancement of the times and technology，modern medicine and traditional Chinese medicine have gradually deepened their understanding and research on diabetic foot，further improving the treatment methods for diabetic foot. To a certain extent，this can relieve the pain of patients and improve their quality of life. Objective　The mechanism of action of Simiao Yongan Decoction in the treatment of diabetic foot was explored by combining metabolomics with network pharmacology. Methods　Diabetic foot patients who were hospitalized in the Burn Department，Vascular Surgery Department of Heilongjiang Provincial Hospital and the Vascular Surgery Department of Nangang Campus from July 2023 to August 2024 were selected as the research subjects. A total of 60 patients with heat-toxin intense diabetic foot who met the criteria were included in this study. They were randomly divided into debridement group，Western medicine group，traditional Chinese medicine group and combined Chinese and Western medicine group，with 15 cases in each group. Another 15 normal people were included as the control group.Firstly，databases and software such as TCMSP，GeneCards，OMIM，and TTD were used to search for the pharmacodynamic basis，target sites and metabolic pathways of Simiao Yongan Decoction on diabetic foot. The serum metabolomics and network pharmacology of Simiao Yongan Decoction were integrated for research to verify the possible active ingredients and metabolic pathways of Simiao Yongan Decoction in the intervention of diabetic foot. Results　The main active ingredients of Simiao Yongan Decoction for treating diabetic foot are luteolin，quercetin and acanthopanthin，etc. Diabetic foot may be treated by regulating pathways such as mitogen-activated protein kinase signaling pathway，tumor necrosis factor signaling pathway，phosphatidyacyl alcohol signaling pathway，HIF-1 signaling pathway，and Toll-like receptor signaling pathway through targets such as AKT1，TNF，HSP90AA1，MAPK8，and STAT3. Among them，the phospholipacyl alcohol signaling pathway is consistent with the research results of the serum metabolomics of Simiao Yongan Decoction. Conclusion　The phosphatidylinositol signaling pathway may be the one through which Simiao Yongan Decoction interferes with the metabolism of diabetic foot.

Key words: Diabetic foot, Simiao Yongan Decoction, Metabolomics, Network pharmacology, Metabolic pathway, Phosphatidyl inositol

摘要： 背景　近些年来，糖尿病足成为糖尿病患者致残致死的重要原因。随着时代和科技的进步，现代医学及中医学对于糖尿病足的认识及研究逐渐深入，进一步提高了糖尿病足的治疗手段，在一定程度上可以缓解患者痛楚，改善了患者的生活质量。目的　运用代谢组学与网络药理学相结合的方法探讨四妙勇安汤治疗糖尿病足的作用机制。方法　选取2023年7月—2024年8月于黑龙江省医院烧伤科、血管外科、南岗院区血管外科住院的糖尿病足患者为研究对象。本研究共纳入符合标准热毒炽盛型糖尿病足患者60例。随机分成清创组、西药组、中药组、中西联用组，各组15例，另纳入15例正常人作为对照组。首先，运用TCMSP、GeneCards、OMIM、TTD等数据库和软件，寻找四妙勇安汤对糖尿病足的药效学基础、作用靶点及代谢通路。并将四妙勇安汤的血清代谢组学与网络药理学进行整合研究，验证四妙勇安汤干预糖尿病足的可能的有效成分及代谢通路。结果　四妙勇安汤治疗糖尿病足的主要活性成分为木犀草素、槲皮素和刺芒柄花素等；可能通过AKT1、TNF、HSP90AA1、MAPK8、STAT3等靶点，调控丝裂原活化蛋白激酶信号通路、肿瘤坏死因子信号通路、磷脂酰基醇信号通路、HIF-1信号通路、Toll样受体信号通路等途径治疗糖尿病足，其中磷脂酰基醇信号通路与四妙勇安汤血清代谢组学的研究结果一致。结论　磷脂酰肌醇信号通路可能是四妙勇安汤干预糖尿病足的代谢通路。

关键词: 糖尿病足, 四妙勇安汤, 代谢组学, 网络药理学, 代谢通路, 磷脂酰肌醇