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CASE REPORT article

Front. Endocrinol.

Sec. Clinical Diabetes

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1638086

This article is part of the Research TopicInnovative Therapeutic Strategies for Managing Diabetic Foot Ulcers and Mitigating Associated ComplicationsView all 8 articles

Integrated Traditional Chinese and Western Medicine in the Outpatient Management of Diabetic Foot Gangrene Complicating Uremia: A Case Report

Provisionally accepted
  • Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China

The final, formatted version of the article will be published soon.

Diabetic foot gangrene (DFG) in uremic patients presents profound management challenges due to immune dysfunction and impaired tissue repair. We report on a 65-year-old male patient with end-stage renal disease undergoing peritoneal dialysis, presenting with progressive right foot gangrene that was unresponsive to conventional treatment. Clinical evaluation indicated extensive gangrene affecting the first and second toes, elevated inflammatory markers (C-reactive protein at 95.57 mg/L and fibrinogen at 8.18 g/L), and cardiovascular compromise (brain natriuretic peptide at 4869 pg/mL). Lower limb computed tomography angiography confirmed severe atherosclerosis. An integrated protocol combining Yanghe Sijunzi Decoction with meticulous debridement and localized analgesia was implemented over 7 months (18 outpatient visits). This approach resulted in complete ulcer healing by October 2024, with the resolution of gangrene, an 87% reduction in CRP levels (to 12 mg/L), normalization of coagulation markers, and preservation of foot function-thus preventing amputation.Patient-reported outcomes, including pain scores and sleep duration gradually improved as healing advanced from 23 March 2024. The total treatment costs amounted to 25,000 CNY, with the patient's share being 5,000 CNY, demonstrating cost-efficiency. This case highlightsTraditional Chinese Medicine's potential as an immunomodulatory adjuvant in uremia-associated DFG, modulating inflammation and promoting tissue regeneration in high-risk patients.

Keywords: Diabetic Foot, Gangrene, Uremia, Traditional Chinese Medicine, Inflammation

Received: 10 Jun 2025; Accepted: 04 Aug 2025.

Copyright: © 2025 Hu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jian Chen, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China

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