Abstract: Objective To review the advances in research on the efficacy of Mudan granules in the prevention and treatment of diabetic microangiopathy based on the principle of “tonifying qi, activating blood, and unblocking meridians” in order to provide a reference for their clinical application. Methods Literature on Mudan granules was retrieved from such databases as CNKI and PubMed. The material basis, clinical applications, and mechanisms of action of Mudan granules in the prevention and treatment of diabetic microangiopathy were analyzed. Results Mudan granules contained multiple active compounds, including saponins, flavonoids, alkaloids, and phenolic acids. Through such mechanisms as regulating inflammatory pathways like TLR4/NF-κB and inhibiting fibrotic signals like TGF-β1/Smad, these granules could alleviate inflammation and oxidative stress, delay fibrosis, and improve insulin resistance and microcirculatory disturbances, with the properties of “the same treatment for different diseases” in diabetic microangiopathy. Current clinical studies mostly support the synergistic action of this drug when combined with Western medicine, along with a favorable safety profile. Conclusion Mudan granules have proved to be effective against diabetic microangiopathy. However, current research is facing such problems as insufficient high-quality evidence and poor understanding of the connection between the micro-level mechanisms and the connotation of “unblocking meridians” in TCM. More studies are needed to elucidate the modern biological basis of “tonifying qi, activating blood, and unblocking meridians” in order to popularize this formula in the comprehensive prevention and management of diabetic microangiopathy.

Key words: Mudan Granules, Diabetic Microangiopathy, Tonifying Qi, Activating Blood, and Unblocking Meridians, Diabetic Peripheral Neuropathy, Diabetic Nephropathy, Integrative Medicine