基于筋之血化现象分段探索糖尿病足肌腱坏死创面修复的要点

Segmented exploration on essentials of necrotic wound repair of tendons in diabetic foot based on vascularization of tendon

糖尿病足肌腱坏死创面在中医药综合疗法干预下趋于好转时,局部往往表现为血络充盈,通过微小络脉的渗入促进基底部肉芽生长,并以络脉长入的方式使其与肌腱、筋膜连为一体,进而包裹滋养之,最终使得创面愈合,此即筋之血化现象。此现象的出现,在很大程度上提示了治疗的正确性。而促进筋之血化的实现,分为筋之血润、筋之血生、筋之血被三个阶段。具体需要在不同的阶段通过积极调节全身气血,促进侧枝循环建立,化腐再生法辨证应用,改善局部引流等不同方式完成对创面局部环境的良性改善,此即糖尿病足肌腱坏死创面修复的要点。

When the necrotic wound on tendons of diabetic foot tended to be recovered under the intervention of the comprehensive therapy of TCM, the engorged network of blood vessels was manifested in local scope. The permeating tiny collaterals could promote the granulation growth on basilar part. With the growth of collateral vessels, the granulation could wrap up the tendon and fascia, and these vessels could nourish it, thus ultimately the wound healing was finished, which is namely the vascularization of Jin （tendon）. This phenomenon has largely improved the validity of treatment. Implementation of the vascularization of Jin include three stages： moist the vascularization of Jin, originate the vascularization of Jin, and cover the vascularization of Jin.Yet the implementation of the vascularization of Jin are required to be carried out by ways like actively adjusting Qi and blood of the whole body, promoting the lateral branch circulation, the dialectic application of Huafuzaisheng method and improving local drainage etc. in different segments, thus leading to the benign improvement of wound in local scope, the above of which are the essentials of necrotic wound repair on tendons of diabetic foot.