小剂量胰岛素和重组人粒细胞-巨噬细胞集落刺激因子治疗糖尿病足难愈性创面的临床疗效

Clinical efficacy of low-dose insulin and recombinant human granulocyte-macrophage colony-stimulating factor % (rhGMCSF) for diabetic foot refractory wounds

目的通过比较不同药物对糖尿病足难愈性创面的治疗,探讨治疗糖尿病足难愈性创面的有效方法。方法 112例糖尿病足患者根据治疗方式不同分为常规治疗组(常规组)、小剂量胰岛素组(胰岛素组)、rh GM-CSF组和小剂量胰岛素+rh GM-CSF组(联合组),分别观察每组患者治疗后3,15,26,40,51 d的创面愈合情况和愈合率。结果联合组愈合时间较其他三组明显缩短,各组间差异具有统计学意义(P<0.05)。各实验组创面愈合率均高于常规组,以联合组为最高,各实验组与常规组相比,组间差异具有统计学意义(P<0.05),胰岛素组与rh GM-CSF组间比较差异不具有统计学意义(P>0.05)。结论小剂量胰岛素联合人类重组粒细胞-巨噬细胞集落刺激因子(rh GM-CSF)的使用,能够更好地治疗糖尿病足难愈性创面。

Objective To explore an effective method for diabetic foot refractory wounds. Methods A total of 112 diabetic patients were divided into four groups： conventional treatment group（ control group）,low-dose insulin group（ insulin group）,recombinant human granulocyte-macrophage colony-stimulating factor（ rh GM-CSF） group and low-dose insulin ＋ rh GM-CSF group（ combination group）. The healing status and the healing rate of wound were observed at day 3,15,26,40,51. Results The wound healing time in combination group was the shortest（ P 〈 0. 05）. The healing rates in insulin group,rh GM-CSF group and combination group were higher than in control group（ P 〈 0. 05）,with the highest in combination group. The healing rate was not significantly different between insulin group and combination group（ P 〉 0. 05）. Conclusion Combination treatment of the low-dose insulin and rh GM-CSF has a better therapeutic effect on diabetic foot refractory wounds.