步行联合Buerger运动在O级糖尿病足治疗中的应用研究

Application of walking combined with Buerger exercise in patients with grade 0 diabetic foot

目的探讨步行联合Buerger运动在0级糖尿病足治疗中的应用价值。方法将80例0级糖碌病足患者按入院先后顺序随机分成观察组和对照组各40例，对照组采用步行运动进行训练，观察组采用步行联合Buerger运动进行训练。通过12个月的训练，观察两组的神经病变自觉症状量表（TSS）、踝肱指数（ABI）和足背动脉平均血流速度（dDAMV）的变化。结果两组的临床自感症状明显减少（观察组：显效15例，有效19例；对照组：显效5例，有效23例），观察组的有效率高于对照组（观察组85％；对照组70％）（χ^2=7．831，P〈0．05）；两组的ABI比值较治疗前增加，观察组的ABI比值高于对照组[观察组（0．889±0．113）；对照组（0．842±0．124），t=1．772，P〈0．05]；两组的DAWV较治疗前增加，观察组的DAWV高于对照组[观察组（6．772±0．435）cm／s；对照组（6．543±0．552）cm／s]（t=2．061，P〈0．05）。结论步行联合Buerger运动有利于改善0级糖尿病足患者的下肢的侧支循环血流速度和血流量，同时改善患者的周围神经病变的自觉症状。

Objective To study the application of walking combined with Buerger exercise in the treatment of grade 0 diabetic foot. Methods Eighty patients with grade 0 diabetic foot were randomly divided into observation group and control group. The control group was trained by walking exercise. The observation group was trained by walking combined with Buerger exercise through 12 months of training. The changes of self- sensory symptoms, ABI and DAWV were observed. Results The self - sensory symptoms of the two groups were significantly decreased （ observation group ： markedly effective 15 cases, effective 19 cases ; control group： markedly effective 5 cases, effective 23 cases）. The effective rate of the observation group was higher than that of the control group（85% vs. 70% ,χ^2 = 7. 831 ,P 〈 0. 05 ）. The ABI ratio of the two groups were higher than those before treatment; and the ABI ratio of the observation group was higher than that of the control group[ （0.889 ±0. 113） vs. （0. 842±0. 124） ,t = 1. 772 P 〈 0. 05 ]. The ratio of DAWV in the observation group was higher than that in the control group[ （6. 772 ± 0. 435 ）cm/s vs. （ 6. 543±0. 552 ） cm/s, t = 2. 061, P 〈 0.05 ]. Conclusion Walking combined with Buerger exercise can improve the blood flow velocity and blood flow of the collateral circulation of the lower limbs of patients with grade 0 diabetic foot, and improve the self - sensory symptoms of peripheral neuropathy.