自体富血小板凝胶联合黄芪汤加减治疗糖尿病足溃疡的可行性研究

Feasibility study of autologous platelet rich gel combined with Huangqi Decoction in treating diabetic foot ulcers

目的:探讨自体富血小板凝胶联合黄芪汤加减治疗在糖尿病足溃疡中的应用价值。方法:选取上海市第六人民医院2016年1月~2019年1月收治的糖尿病足溃疡患者84例,根据随机数字表法分成对照组(n=42)、观察组(n=42)。对照组采用自体富血小板凝胶治疗,观察组采用自体富血小板凝胶联合黄芪汤加减治疗。比较两组治疗效果,分别在治疗前、治疗3个月后采血检测两组血液流变学指标,包括高切全血粘度、低切全血粘度、血浆粘度、红细胞比积、红细胞沉降率,并检测两组足背动脉踝肱指数、胫后动脉踝肱指数的变化,记录两组不良反应情况。结果:观察组总有效率为95.24%,显著高于对照组的80.95%。两组治疗后高切全血粘度、低切全血粘度、血浆粘度、红细胞比积、红细胞沉降率均低于治疗前,且观察组显著低于对照组。两组治疗后足背动脉、胫后动脉踝肱指数均高于治疗前,且观察组显著高于对照组。两组腹泻、皮疹、食欲下降、恶心发生率比较无显著差异。结论:与单用自体富血小板凝胶相比,采用自体富血小板凝胶联合黄芪汤加减治疗,能进一步改善糖尿病足溃疡患者的血液流变学与足背动脉、胫后动脉踝肱指数,不良反应少,总体疗效可靠。

Objective To explore the application value of autologous platelet rich gel combined with Huangqi Decoction in treating diabetic foot ulcers.Methods 84 patients with diabetic foot ulcer admitted to Shanghai Sixth People’s Hospital from January 2016 to January 2019 were divided into control group(n=42)and observation group(n=42)according to random number table method.The control group was treated with autologous platelet rich gel,while the observation group was treated with autologous platelet rich gel combined with Huangqi decoction.The therapeutic effects of the two groups were compared.Blood samples were collected before treatment and 3 months after treatment to test the hemorheological indexes of the two groups,including high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate.The changes of ankle brachial index of dorsal pedal artery and ankle brachial index of posterior tibial artery were detected,and the adverse reactions of the two groups were recorded.Results The total effective rate was 95.24%in the observation group,which was significantly higher than 80.95%in the control group.After treatment,the high shear whole blood viscosity,low shear whole blood viscosity,plasma viscosity,hematocrit and erythrocyte sedimentation rate of the two groups were lower than those before treatment,and the observation group was significantly lower than that of the control group.The ankle brachial index of dorsal pedal artery and posterior tibial artery in the two groups after treatment was higher than that before treatment,and the observation group was significantly higher than that in the control group.There was no significant difference in the incidence of diarrhea,rash,loss of appetite and nausea between the two groups.Conclusion Compared with single platelet rich gel,autologous platelet rich gel combined with Huangqi decoction can further improve hemorheology and ankle brachial index of the dorsalis pedis artery and posterior tibial artery.