[Objective]To explore the application and mechanism of dredging therapy in treating diabetes mellitus and cerebral infarction(DACI).[Methods]A method integrating theoretical literature review with modern mechanistic research was adopted to systematically organize the perspectives on the brain from ancient Chinese medical books and physicians,as well as their discussions on the etiology and pathogenesis of DACI.This process served to summarize the traditional Chinese medicine therapeutic system for treating DACI.Furthermore,by combining modern experimental and clinical research,the pharmacological mechanisms and pathways of action of representative formulas and medicinals belonging to the dredging therapy were analyzed.[Results]The brain is the mansion of the primordial spirit,with"replenishment"and"patency"serving as its physiological foundation.The pathogenesis of DACI primarily involves persistent consumptive thirst that leads to deficiency of both Qi and Yin,intermingled phlegm and blood stasis,and blockage of the brain collaterals.The dredging therapy is its fundamental treatment principle,mainly comprising the"tonifying and unblocking method"which boosts Qi,activates blood,nourishes Yin and unblocks collaterals;and the"purging and unblocking method"which purges the Fu-organs to drain heat and expel turbid stasis.Tonifying-unblocking formulas such as Buyang Huanwu Decoction and Dihuang Yinzi which can regulate glucose and lipid metabolism,inhibit inflammation,and promote vascular and neural repair.Purging-unblocking formulas such as Xinglou Chengqi Decoction and Huanglian Wendan Decoction which can improve gut microbiota,modulate the gut-brain axis and alleviate systemic inflammatory responses.[Conclusion]The dredging therapy emphasizes the therapeutic principle of"removing obstruction to restore free flow"and combines unblocking with tonification,which aligns with the physiological characteristics of the brain.It exerts significant therapeutic effects by multi-target regulation of the metabolic and inflammatory microenvironment,as well as the neurovascular micro-environment in DACI.Future research should focus on refining syndrome-based classification of the dredging therapy,elucidating the material basis of herbal medicine efficacy,and advancing integrated Chinese-western treatment models to promote its precise and individualized application.

[Objective]To explore the application and mechanism of dredging therapy in treating diabetes mellitus and cerebral infarction(DACI).[Methods]A method integrating theoretical literature review with modern mechanistic research was adopted to systematically organize the perspectives on the brain from ancient Chinese medical books and physicians,as well as their discussions on the etiology and pathogenesis of DACI.This process served to summarize the traditional Chinese medicine therapeutic system for treating DACI.Furthermore,by combining modern experimental and clinical research,the pharmacological mechanisms and pathways of action of representative formulas and medicinals belonging to the dredging therapy were analyzed.[Results]The brain is the mansion of the primordial spirit,with"replenishment"and"patency"serving as its physiological foundation.The pathogenesis of DACI primarily involves persistent consumptive thirst that leads to deficiency of both Qi and Yin,intermingled phlegm and blood stasis,and blockage of the brain collaterals.The dredging therapy is its fundamental treatment principle,mainly comprising the"tonifying and unblocking method"which boosts Qi,activates blood,nourishes Yin and unblocks collaterals;and the"purging and unblocking method"which purges the Fu-organs to drain heat and expel turbid stasis.Tonifying-unblocking formulas such as Buyang Huanwu Decoction and Dihuang Yinzi which can regulate glucose and lipid metabolism,inhibit inflammation,and promote vascular and neural repair.Purging-unblocking formulas such as Xinglou Chengqi Decoction and Huanglian Wendan Decoction which can improve gut microbiota,modulate the gut-brain axis and alleviate systemic inflammatory responses.[Conclusion]The dredging therapy emphasizes the therapeutic principle of"removing obstruction to restore free flow"and combines unblocking with tonification,which aligns with the physiological characteristics of the brain.It exerts significant therapeutic effects by multi-target regulation of the metabolic and inflammatory microenvironment,as well as the neurovascular micro-environment in DACI.Future research should focus on refining syndrome-based classification of the dredging therapy,elucidating the material basis of herbal medicine efficacy,and advancing integrated Chinese-western treatment models to promote its precise and individualized application.