| 魏靖杰,张逸鲲,苗 斌.益气活血通络汤治疗 Wagner 1~ 3 级糖尿病足疗效分析[J].中国烧伤创疡杂志,2025,(1):22~26. |
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| 中文摘要: |
| 【摘要】 目的 分析探讨益气活血通络汤治疗 Wagner 1 ~ 3 级糖尿病足的临床疗效。 方法 选取2020年8月至2021年10月张掖市中医医院收治的 86 例 Wagner 1~ 3 级糖尿病足患者作为研究对象, 按照不同处理方法将其分为观察组 (43 例) 和对照组 (43 例), 在营养神经、改善微循环等治疗基础上, 观察组患者联合应用湿润烧伤膏与胰岛素外敷及益气活血通络汤口服, 对照组患者仅应用湿润烧伤膏与胰岛素外敷, 对比观察两组患者创面临床症状积分、神经传导速度、炎症因子水平、血管新生情况以及创面愈合时间。 结果 治疗 1 个月后, 观察组患者创面红、肿、痛及渗出积分均明显低于对照组 ( Z = - 2.085、- 3.755、- 4.703、- 4.520, P = 0.037、P<0.001、P<0.001、P<0.001), 正中神经感觉传导速度(SCV)及腓总神经SCV与运动传导速度 (MCV) 均明显快于对照组(Z=-3.695、-4.343、-5.927, P均<0.001),血清白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白 (CRP) 水平均明显低于对照组 (Z= -3.071、 -5.683、-6.285, P 均<0.001), 血清血管内皮生长因子 (VEGF)、碱性成纤维细胞生长因子 ( bFGF) 水平均明显高于对照组 (Z = -6.300、 -7.975, P 均<0.001)。观察组患者创面愈合时间为 28 (25, 30) d, 明显短于对照组患者的创面愈合时间 49 (44, 54) d (Z = -7.992,P<0.001)。 结论 在营养神经、改善微循环、湿润烧伤膏与胰岛素外敷等治疗的基础上, 给予 Wagner 1 ~ 3 级糖尿病足患者加服益气活血通络汤, 能够明显改善临床症状, 提升神经传导速度, 减轻炎症反应, 刺激血管新生,促进创面愈合。 |
| 英文摘要: |
| 【Abstract】 Objective To study the clinical efficacy of Yiqi Huoxue Tongluo Decoction in treating diabetic foot of Wagner grade 1 - 3. Methods 86 patients with diabetic foot of Wagner grade 1 - 3 admitted to Zhangye Hospital of Traditional Chinese Medicine from August 2020 to October 2021 were enrolled as research subjects, and were divided into the study group (n = 43) and the control group (n = 43) according to different treating methods. Patients in the study group received oral administration of Yiqi Huoxue Tongluo Decoction combined with external application of moist exposed burn ointment (MEBO) and insulin on the basis of conventional therapies such as neurotrophic and microcirculation improvement treatments, while patients in the control group only received MEBO and insulin external application along with conventional treatments. Clinical symptom scores, nerve conduction velocity, levels of inflammatory factors, angiogenesis, and wound healing times were compared between the two groups. Results After one month of treatment, scores of redness, swelling, pain, and exudation of patients in the study group were significantly lower than those in the control group (Z = -2.085,-3.755, -4.703 and - 4.520, P = 0.037, P < 0.001, P < 0.001, P < 0.001). Sensory conduction velocity ( SCV) of median nerve and SCV and motor conduction velocity (MCV) of common peroneal nerve of patients in the study group were significantly faster than those in the control group (Z= -3.695, -4.343 and -5.927, all P<0.001). Compared with the control group, serum levels of interleukin?6 ( IL?6), tumor necrosis factor?α ( TNF?α), and C-reactive protein (CRP) were significantly lower in the study group (Z= -3.071, -5.683 and -6.285, all P<0.001), while vascular endothelial growth factor (VEGF) and basic fibroblast growth factor ( bFGF) levels were significantly higher in the study group (Z =-6.300 and -7.975, both P<0.001). The wound healing time was 28 ( 25, 30) days in the study group, significantly shorter than the 49 (44, 54) days in the control group (Z= -7.992, P<0.001) .Conclusion On the basis of conventional therapies such as neurotrophic, microcirculation improvement treatments and external applications of MEBO and insulin, oral administration of Yiqi Huoxue Tongluo Decoction can significantly improve clinical symptoms, enhance nerve conduction velocity, reduce inflammatory response, stimulate angiogenesis, and promote wound healing in patients with diabetic foot of Wagner grade 1-3. |
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