木丹颗粒联合前列地尔注射液治疗糖尿病足的临床研究

Clinical study on Mudan Granules combined with Alprostadil Injection in treatment of diabetic foot

目的探讨木丹颗粒联合前列地尔注射液治疗糖尿病足的临床疗效。方法选取2015年7月—2016年7月在自贡市第四人民医院进行治疗的糖尿病足患者82例,根据治疗方案的差别分为对照组(41例)和治疗组(41例)。对照组静脉滴注前列地尔注射液,20μg加入生理盐水250 m L,1次/d。治疗组在对照组的基础上口服木丹颗粒,1袋/次,3次/d。两组患者均连续治疗4周。观察两组患者临床疗效,同时比较两组患者治疗前后临床症状评分、空腹血糖(FBG)和糖化血红蛋白(Hb A1c)水平、血清细胞因子及踝臂指数(ABI)和足趾皮肤温度变化。结果治疗后,对照组和治疗组总有效率分别为80.49%和95.12%,两组总有效率比较差异具有统计学意义(P<0.05)。两组临床症状评分均明显降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组的临床症状评分降低程度优于对照组,两组比较差异具有统计学意义(P<0.05)。两组高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)、晚期糖基化终末化产物(AEGs)均降低,而血管内皮生长因子(VEGF)、血小板源性生长因子(PDGF)水平均升高(P<0.05);且治疗组上述指标改善更显著(P<0.05)。两组ABI和足趾皮肤温度均升高,同组治疗前后差异有统计学意义(P<0.05);且治疗组升高程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论木丹颗粒联合前列地尔注射液治疗糖尿病足疗效显著,可明显改善患者临床症状,降低血清炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Mudan Granules combined with Alprostadil Injection in treatment of diabetic foot. Methods Patients （82 cases） with diabetic foot in the Fourth People＇s Hospital of Zigong from July 2015 to July 2016 were divided into control group （41 cases） and treatment group （41 cases） based on different treatments. Patients in the control group were iv administered with Alprostadil Injection, 20μg added into normal saline 250 mL, once daily. Patients in the treatment group werepo administered with Mudan Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and clinical symptoms score, FBG, HbAlc, serum inflammatory factors, ABI, and toe skin temperature in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.49% and 95.12%, respectively, and there were differences between two groups （P 〈 0.05）. After treatment, clinical symptoms scores in two groups was significantly decreased （P 〈 0.05）. And the decrease degree in the treatment group was significantly better than those in the control group （P 〈 0.05）. The levels of hs-CRP, IL-6, PCT, and AEGs in two groups were significantly decreased, while VEGF and PDGF increased （P 〈 0.05）. And the observational indexes in the treatment group were significantly better than those in the control group （P 〈 0.05）. ABI and toe skin temperature in two groups were significantly increased （P 〈 0.05）. And the increase degree of ABI and toe skin temperature in the treatment group wasmore significant than that in the control group （P 〈 0.05）. Conclusion Mudan Granules combined with Alprostadil Injection has a significant clinical effect in treatment of diabetic foot, can improve clinical symptoms and decrease serum inflammatory response, which has a certain clinical application value.