奚氏清消方及祛腐清筋术治疗糖尿病足筋疽重症90例临床观察

Xishi Qingxiao Fang and therapy of dispelling putridity and clearing sinew for treating severe diabetic foot sinew gangrene in 90 cases

目的观察奚氏清消方及祛腐清筋术治疗糖尿病足筋疽重症的临床疗效。方法用奚氏清消方及祛腐清筋术治疗糖尿病足筋疽重症90例。观察临床疗效;观察治疗前后生化指标变化,包括空腹血糖(FBG)、餐后2h血糖(PBG)、C肽(C-PR)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、白细胞(WBC)、C-反应蛋白(CRP)、血沉(ESR)、红细胞(RBC)、血红蛋白(Hb)、白蛋白(ALB);观察治疗前后创面的个数、面积、深度;同时观察患者不良反应。结果 90例中临床痊愈29例,占32.22%;显效35例,占38.89%;改善23例,占25.56%;恶化(截肢)3例,占3.33%。无死亡病例,保肢成功率为96.67%。FBG,PBG,HbA1c,HOMA-IR,WBC,CRP,ERS治疗后与治疗前比较明显下降,RBC,Hb,ALB治疗后与治疗前比较明显上升,差异有统计学意义(P<0.05)。创面个数、创面面积、创面深度数值治疗后与治疗前比较明显减少,差异有统计学意义(P<0.05)。未见明显的不良反应。结论运用奚氏清消方及祛腐清筋术治疗糖尿病足筋疽重症具有较好的临床疗效。

Objective To observe the curative effect of Xishi Qingxiao Fang and therapy of dispelling putridity and clearing sinew on severe diabetic foot sinew gangrene. Methods Xishi Qingxiao Fang and therapy of dispelling putridity and clearing sinew were used for treating 90 patients, and the curative effect was observed. The biochemical indexes, including fasting plasma glucose （FPG）, 2-hour postprandial plasma glucose （2-h PBG）, C-peptide （C-PR）, fasting insulin （FINS）, glycated hemoglobin （HbAlc）, homeostasis model assessment of insulin resistance （HOMA-IR）, white blood ceils （WBC）, sensitivity C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, red blood cells （RBC）, hemoglobin （Hb） and albumin （ALB）, number, area and depth of wounds, and adverse reactions were observed before and after treatment. Results Among 90 cases, there were 29 cured （32.22%）, 35 with remarkable curative effect （38.89%）, 23 relived （25.56%） and 3 grew worse （amputation, 3.33%）. There was no death case. The success rate for salvaging limbs was 96.67%. FBG, PBG, HbAlc, HOMA-IR, WBC, CRP and ERS decreased significantly, and RBC, Hb and ALB increased significantly after treatment （P〈0.05）. The number, area and depth of wounds decreased significantly after treatment （P〈0.05）. There were no adverse reactions observed. Conclusion Xishi Qingxiao Fang and therapy of dispelling putridity and clearing sinew have a good curative effect on severe diabetic foot sinew gangrene.