Research Progress on the Mechanism of Huangqi Guizhi Wuwu Decoction in Treating Diabetic Peripheral Neuropathy

Abstract

Diabetic peripheral neuropathy (DPN) is a common chronic complication of diabetes mellitus, characterized by high incidence and significant harm. Modern medicine primarily focuses on blood glucose control, neurotrophy, and antioxidation, but its efficacy is limited, and adverse reactions are numerous. In traditional Chinese medicine, DPN falls under the categories of “Arthralgia due to Blood Stasis” (Bi disease), “Arthralgia Syndrome” (Bi syndrome), and “Flaccidity Syndrome” (Wei syndrome). The core pathogenesis is Qi deficiency and blood stasis, with deficiency as the root and excess as the manifestation. Huangqi Guizhi Wuwu Decoction, originating from the Synopsis of the Golden Chamber (Jin Gui Yao Lue), is composed of Astragali Radix (Huangqi), Cinnamomi Ramulus (Guizhi), Paeoniae Radix Alba (Shaoyao), Zingiberis Rhizoma Recens (Shengjiang), and Jujubae Fructus (Dazao). Its functions are to supplement Qi and harmonize blood, warm the meridians and unblock collateral stasis, which aligns with the TCM pathogenesis of DPN. Modern research has confirmed that this formula acts through multiple targets and pathways, including anti-inflammation, immunomodulation, neurotrophic repair, and anti-oxidative stress. It can reduce inflammatory cytokine levels, improve nerve conduction velocity, and alleviate nerve injury. In clinical practice, when used alone or combined with Western medicines such as mecobalamin or epalrestat for treating DPN, it shows superior efficacy and higher safety compared to Western medicine alone. This article systematically reviews the TCM theory, pharmacological mechanisms, and clinical research progress of Huangqi Guizhi Wuwu Decoction in treating DPN, providing a theoretical basis and research ideas for the prevention and treatment of DPN with TCM.