前列地尔联合甲钴胺治疗Wagner 1～3级2型糖尿病足的临床疗效观察

The clinical effect of Alprostadil combined with Mecobalamin on Wanger 1～3 level of type 2 diabetic foot

目的观察前列地尔联合甲钴胺治疗Wagner 1～3级2型糖尿病足的临床疗效。方法将52例Wagner 1～3级糖尿病足患者随机分为治疗组和对照组各26例。两组患者均予常规治疗。治疗组在常规治疗基础上采用前列地尔注射液10μg加人0.9%生理盐水250 ml静脉滴注,同时联用甲钴胺0.5 mg加入0.9%生理盐水100 ml静脉滴注;对照组采用甲钴胺0.5 mg加入0.9%生理盐水100 ml静脉滴注。疗程4周。结果治疗组治愈17例,有效7例,无效1例,恶化1例;对照组治愈8例,有效9例,无效7例,恶化2例。两组疗效比较差异有统计学意义（P〈0.05）。治疗组疼痛、肿胀、跛行症状较治疗前改善（P〈0.05）,且疼痛及跛行症状改善优于对照组（P〈0.05）。治疗组腘动脉及足背动脉峰流速明显高于治疗前,且明显优于对照组（P〈0.05）。两组患者未见明显不良反应。结论在常规治疗基础上,采用前列地尔联合甲钴胺治疗可明显改善肢体血液供应,减轻疼痛、肿胀、跛行症状,是治疗Wagner 1～3级2型糖尿病足安全有效的方法。

Objective To evaluate the effects of Alprostadil combined with Meeobalamin on Wanger 1 ～ 3 level of type 2 Diabetic foot（DF）. Methods Fifty-two patients with Wanger 1 -3 level of type 2 DF were randomly divided into the treatment group （n = 26 ） and the control group （n = 26 ）. The treatment group received Alprostadil in- jection（ 10μg ＋250 ml NS, ivgtt） and Mecobalamin injection（0. 5 mg ＋ 100 ml NS, ivgtt） , and the control group received Mecobalamin injection（0. 5 mg ＋ 100 ml NS, ivgtt）. Both of the two groups were treated for 4 weeks and their clinical outcomes were evaluated. Results The baseline information was similar between the two groups （P 〉 0. 05 ）. Seventeen cases were cured, 7 cases improved, 1 ease invalid and 1 case deteriorated in the treatment group. Eight eases were cured, 9 cases improved, 7 cases invalid and 2 cases deteriorated in the control group. There was significant difference in the clinical total curative effect between the two groups （P 〈 0. 05 ）. Compared with the same symptoms in the control group, the symptoms of claudication, swelling, pain and hemodynamics were improved in the treatnlent group after the treatment, and the treatment group were markedly better than the control group in improving the symptoms of claudication, pain and hemodynamics. The peak flow rate of popliteal and dorsal pedal arteries was significantly quicker after the treatment than that before the treatment in the treatment group, which was superior to that in the control group （P 〈 0. 05）. No severe adverse reactions were found in the two groups. Conclusion Alpros- tadil combined with Mecobalamin can significantly improve the limb blood supply, alleviate the symptoms of pain, swelling and claudication, which is an effective and safe therapy for Wanger 1 ～ 3 level of type 2 DF.