Supplementary Material for: Chronic Diabetic Foot Ulcer treated with Homoeopathy as adjuvant in an Integrative Management Model: An Evidence-based case report

Abstract: Introduction: Diabetic foot ulcers (DFUs), among the most severe complications associated with diabetes, impose a substantial economic and public health burden due to their significant prevalence (15–25%). In India, the escalating incidence of DFUs has markedly increased the frequency of lower-limb amputations. This case seeks to examine the potential wound healing efficacy of homeopathic medicines as part of an integrative approach to DFU management, demonstrated through evidence-based case reports. Case presentation: Patient presenting with DFUs classified as Wagner grade 2 and with a 12-year history of diabetes were managed using individualized homeopathic treatment. Alongside homeopathic intervention, patients continued their prescribed oral hypoglycemic agents for glycemic control and adhered to routine wound-dressing protocols. DFU was monitored until complete healing using the Leg Ulcer Measurement Tool (LUMT). Neuropathic involvement was evaluated via the 10g monofilament tactile test, while the Modified Naranjo Criteria for Homeopathy Inventory (MONARCH) tool was employed to determine the probability of a causal relationship between the observed clinical improvement and the homeopathic treatment. Within 12 weeks, the DFU demonstrated notable healing, reflected in a significant reduction in LUMT scores. The MONARCH tool assessment yielded a score of +8, strongly suggesting a causal link between the observed therapeutic outcomes and the homeopathic intervention. The homeopathic remedies administered were found to contribute effectively to the patient’s recovery. Conclusion: Adjuvant Homeopathic treatment appeared to play a supportive role in expediting the healing process of DFUs within a clinically acceptable timeframe.

摘要
引言：糖尿病足溃疡（Diabetic foot ulcers, DFUs）是糖尿病最严重的并发症之一，因其15%~25%的高患病率，给公共卫生与经济带来沉重负担。在印度，糖尿病足溃疡发病率的持续上升显著增加了下肢截肢的发生频率。本案例旨在通过循证病例报告，探讨顺势疗法药物作为糖尿病足溃疡整合管理方案的潜在伤口愈合功效。

病例介绍：1例罹患12年糖尿病病史、被归类为Wagner 2级糖尿病足溃疡的患者，接受了个体化顺势疗法治疗。在接受顺势疗法干预的同时，患者继续遵医嘱服用口服降糖药物以控制血糖，并严格遵循常规伤口换药流程。研究采用腿部溃疡测量工具（Leg Ulcer Measurement Tool, LUMT）对糖尿病足溃疡进行全程监测，直至其完全愈合。通过10g单丝触觉测试评估患者的神经病变情况，并使用改良纳兰霍顺势疗法标准量表（Modified Naranjo Criteria for Homeopathy Inventory, MONARCH）来判定临床症状改善与顺势疗法之间的因果关联概率。

结果：在12周内，该患者的糖尿病足溃疡出现显著愈合，表现为LUMT评分大幅降低。MONARCH量表评分为+8，强烈提示本次临床治疗效果与顺势疗法干预存在明确因果关联。所用顺势疗法药物被证实对患者的康复起到了有效促进作用。

结论：辅助性顺势疗法似乎在临床可接受的时间范围内，对加速糖尿病足溃疡的愈合进程发挥了支持性作用。