Volume 11,Issue 3
Traditional Chinese Medicine Dietary Therapy for Painful Diabetic Peripheral Neuropathy: Compatibility Principles and Mechanistic Rationale—A Narrative Review
Painful diabetic peripheral neuropathy (PDPN) is one of the most prevalent and refractory chronic complications of diabetes mellitus. Clinically, it is characterized by distal numbness, burning pain, stabbing pain, cold pain, and sensory disturbances, all of which substantially impair quality of life. Although there is no exact disease entity corresponding to PDPN in traditional Chinese medicine (TCM), the condition is generally interpreted within the categories of Xiaoke Bi syndrome, blood Bi, Bi syndrome, numbness, and pain syndrome, based on its diabetic background and manifestations of pain, numbness, and channel obstruction. According to TCM theory, the core pathogenesis of PDPN is defined by a deficiency in origin and excess in superficiality. Long-standing Xiaoke gradually consumes both Qi and Yin, leading to spleen-kidney deficiency, insufficiency of liver blood, and malnourishment of the extremities; meanwhile, phlegm turbidity, blood stasis, cold coagulation, and damp-heat obstruct the channels and collaterals, resulting in pain due to collateral blockage. TCM dietary therapy is grounded in the principle of medicine-food homology and emphasizes syndrome differentiation, mild nourishment, and long-term regulation. Its major therapeutic strategies include replenishing Qi and nourishing Yin, strengthening the spleen and tonifying the kidney, activating blood and unblocking the collaterals, and harmonizing the nutritive and defensive Qi. Recent studies on prescription patterns in diabetic peripheral neuropathy found that Astragali radix, Angelicae sinensis radix, Spatholobi caulis, Paeoniae radix alba, Chuanxiong rhizoma, and Achyranthis bidentatae radix are the main herbs. This shows the treatment idea of supplementing Qi, activating blood, and nourishing the collaterals. At the same time, network pharmacology studies suggest that these compatibility patterns may produce therapeutic effects through interactions among multiple components, targets, and pathways. This review summarizes the TCM pathogenesis of PDPN, the theoretical basis of TCM dietary therapy, representative dietary compatibility patterns, and the supportive evidence from network pharmacology, to provide a theoretical basis for the dietary management of PDPN within the TCM framework.
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