前列地尔联合甲钴胺治疗糖尿病足的临床效果观察

Observation of clinical effect by alprostadil combined with mecobalamine in the treatment of diabetic foot

目的探讨前列地尔联合甲钴胺治疗糖尿病足的临床效果。方法 80例糖尿病足患者,随机分为观察组和对照组,每组40例。两组患者均给予常规治疗,在此基础上观察组患者采用前列地尔联合甲钴胺静脉输液治疗,对照组只采取甲钴胺静脉输液治疗。观察比较两组患者的临床效果。结果对照组的总有效率75.00%低于观察组的97.50%(χ~2=8.54,P<0.05)。观察组治疗前足背动脉血流速度为(0.45±0.08)m/s·mm^2,治疗后为(0.75±0.16)m/s·mm^2;对照组治疗前为(0.44±0.07)m/s·mm^2,治疗后为(0.65±0.13)m/s·mm^2,两组治疗前的足背动脉血流速度比较差异无统计学意义(t=0.59,P=0.28>0.05);治疗后,两组的足背动脉血流速度较治疗前均有一定程度的好转,且观察组的好转情况明显优于对照组(P<0.01);观察组治疗前的腓浅神经感觉传导速度为(40.12±4.05)m/s,治疗后为(44.38±4.23)m/s;对照组治疗前为(39.98±4.12)m/s,治疗后为(42.21±3.84)m/s,两组治疗前的腓浅神经感觉传导速度比较差异无统计学意义(t=0.15,P=0.44>0.05);治疗后,两组的腓浅神经感觉传导速度较治疗前均有一定程度的好转,且观察组好转情况明显优于对照组(P<0.05)。结论前列地尔联合甲钴胺治疗糖尿病足可提高临床治疗效果,改善足背动脉血流速度以及腓浅神经感觉传导速度,促进糖尿病足的恢复,降低致残率及致死率,提高患者生活质量,值得临床推广应用。

Objective To investigate clinical effect by alprostadil combined with mecobalamine in the treatment of diabetic foot. Methods A total of 80 patients with diabetic foot were randomly divided into observation group and control group, with 40 cases in each group. Both groups received conventional therapy, while the observation group received additional alprostadil combined with mecobalamine through intravenous infusion for treatment, and the control group received mecobalamine alone through intravenous infusion. Clinical effect were observed and compared between the two groups. Results The control group had lower total effective rate as 75.00% than 97.50% in the observation group（χ~2=8.54, P〈0.05）. The observation group had dorsal pedal artery blood flow velocity as（0.45±0.08） m/s·mm^2 before treatment and（0.75±0.16） m/s·mm^2 after treatment. The control group had it as（0.44±0.07） m/s·mm^2 before treatment and（0.65±0.13） m/s·mm^2 after treatment. There was no statistically significant difference of dorsal pedal artery blood flow velocity before treatment between the two groups（t=0.59, P=0.28〉0.05）. After treatment, both groups had improved dorsal pedal artery blood flow velocity, while the observation group had better improvement than the control group（P〈0.01）. The observation group had superficial peroneal nerve sensory conduction velocity as（40.12±4.05） m/s before treatment and（44.38±4.23） m/s after treatment. The control group had it as（39.98±4.12） m/s before treatment and（42.21±3.84） m/s after treatment. There was no statistically significant difference of superficial peroneal nerve sensory conduction velocity before treatment between the two groups（t=0.15, P=0.44〉0.05）. After treatment, both groups had improved superficial peroneal nerve sensory conduction velocity, while the observation group had better improvement than the control group（P〈0.05）. Conclusion Combination of alprostadil and mecobalamine can improve clinical effect in the treatment of diabetic foot. This method improves dorsal pedal artery blood flow velocity and superficial peroneal nerve sensory conduction velocity, accelerates recovery of diabetic foot, reduce disability rate and mortality rate, and enhance quality of life in patients. It is worth clinical promotion and application.