Topical Huangbai liniment (Tazi therapy) was an effective and safe adjunctive therapy for short-term infection resolution in patients with diabetic foot ulcers and mild MDRO infection, but no evidence emerged for improved ulcer healing within 2 weeks.
Infection resolution was more frequent with Huangbai liniment than with silver dressing in diabetic foot ulcers with mild MDRO infection.
Mixed-level logistic regression showed HB treatment was associated with higher odds of infection resolution.
Topical HB facilitated MDRO conversion, a secondary outcome.
HB did not improve ulcer healing completion or ulcer size reduction within the 2-week treatment period.
No adverse effects were reported with topical HB.
The trial was a multicenter, open-label randomized controlled trial in China comparing Tazi therapy with HB to silver dressing, with both groups receiving the same basic diabetic foot treatment.
This study tested whether Huangbai liniment, a standardized herbal product applied to the skin, could help clear infections in diabetic foot ulcers infected with multidrug-resistant bacteria. These infections are hard to treat, raise amputation risk, and long use of broad-spectrum antibiotics can worsen resistance. Researchers at several centers in China compared two weeks of the herbal liniment with silver dressings in 154 patients with mild infections; 137 were analyzed. All patients received the same standard diabetic foot care. Infection cleared in about 47% of patients using the liniment versus about 21% using silver dressings. After statistical adjustment, the liniment group had roughly 4.8 times the odds of infection resolution. The researchers also reported better conversion away from drug-resistant organisms and no adverse effects. However, the liniment did not improve full ulcer healing or shrink ulcers more than silver dressings during the two weeks. The trial was open-label (patients and clinicians knew the treatment) and short. This research suggests the liniment may help with short-term infection control as an add-on treatment, but longer studies are needed to learn whether it improves wound healing.
Wang N, Wang G, Zhou M, Zhang K, Zhou T, Wang X, et al.. (2026). Efficacy of Huangbai liniment for diabetic foot ulcers with multidrug-resistant organism infection: a randomized controlled multicenter trial.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1926211