糖尿病足疗效评价指标的现代文献研究

The literature research on therapeutic evaluation method of diabetic foot

探讨糖尿病足疗效评价指标的分布规律,明确目前用于糖尿病足疗效评价的症状、体征、检查指标。经过文献检索,纳入糖尿病足临床研究文献106篇,研究糖尿病足的疗效评价方法,对用于疗效评价的症状、体征、检查指标进行频次分析。结果显示,目前尚缺乏全面评价糖尿病疗效的量化标准。临床疗效评价常用的局部非溃疡症状指标主要有患肢疼痛、患肢麻木、患肢冷感、间歇性跛行和静息痛,溃疡相关指标有溃疡面积减小或愈合、新鲜肉芽增多和分泌物减少,体征指标有患肢皮温改善、患肢皮色改善、动脉搏动改善和患肢水肿改善,检查指标有踝肱比、血流动力学、血液流变学和血糖生化。用于糖尿病足的临床疗效观察指标与用于诊断的指标有区别,应结合临床实际特点,研究出一套适合于本病的、包含多维度指标的、具有中医特色的疗效评价体系。

The purpose of this study was to explore the distributed law of efficacy evaluation indexes in diabetic foot and to be clear on items of symptom, sign and examination for efficacy evaluation of diabetic foot. 106 documents were researched. Therapeutic evaluation methods of diabetic foot were studied. The items for therapeutic evaluation were analyzed in frequency. The results showed that there was no therapeutic evaluation standard of diabetic foot. The main symptoms for clinical observation of efficacy included pain, numbness, creeping chilling, intermittent claudication and rest pain soreness; ulcer related items included size of ulcer, growth of granulation and dose of secretion; signs mainly involved skin temperature, skin color, arteriopalmus and edema change in affected extremity; while examination mainly involved anklebrachial Index, hemodynamics, hemorheologic indexes and blood sugar indexes. Therefore, there are differences between the indexes of clinical efficacy observation and items of diagnosis for diabetic foot. Combined with clinical features, a system of efficacy evaluation that is suitable for diabetic foot should be studied, which could be applied to evaluate the efficacy of different syndromes with TCM characteristics.