反向式体外反搏治疗糖尿病足疗效研究

Study on the therapeutic effect of reverse extracorporeal counterstroke in diabetic foot

目的探索反向式体外反搏辅助治疗糖尿病足的疗效及安全性。方法选择2015年2月~2016年12月于山东省泰安市第四人民医院内分泌科就诊的0~2级糖尿病足患者42例,随机分为常规治疗组和体外反搏组,分别给予常规药物治疗或加用体外反搏辅助药物治疗8周,监测足背动脉的直径、踝肱指数、腓总神经感觉神经传导速度,并记录体外反搏治疗过程中发生的不良反应。结果重复测量方差分析示,体外反搏组与常规治疗组足背动脉直径分组主效应有统计学意义(F=91.071,P<0.001),体外反搏组与常规治疗组相比踝肱指数分组主效应有统计学意义(F=6.827,P=0.036)。体外反搏组与常规治疗组相比腓总神经的传导速度分组主效应有统计学意义(F=4.782,P=0.015)。体外反搏组出现不良反应者(2/21)与常规治疗组(0/21)相比无统计学意义(P=0.052)。结论反向式体外反搏辅助治疗糖尿病足可改善足背动脉直径、增强腓总神经感觉神经传导速度且治疗后不良反应未增加。

Objective To explore the curative effect and safety of reverse extracorporeal counterstroke in treating diabetic foot. Methods Forty-two patients with type 0-2 diabetic foot from February 2015 to December 2016 were randomly divided into conventional treatment group and external counterpulsation group, were given routine drug treatment or combined with external counterpulsation auxiliary drug treatment for 8 weeks. The diameter of the dorsalis pedis artery, the ankle brachial index and the sensory nerve conduction velocity of the common peroneal nerve was monitored, and the adverse reactions that occurred during counterpulsation treatment were recorded. Results Analysis of variance showed that main effect of dorsal artery diameter in the external counterpulsation group and routine treatment group was statistically significant （F=91.071, P〈0.001）; main effect of ankle brachial index in the external counterpulsation group and the conventional treatment group was statistically significant （F=6.827, P=6.827）; main effect of the sensory nerve conduction velocity of the common peroneal nerve in the external counterpulsation group and the conventional treatment group was statistically significant （F=4.782, P=0.015）. There was no difference of adverse reactions between the external counterpulsation group （2/21） and the conventional treatment group （0/21, P=0.052）. Conclusions The antipodiatrial antiboating adjuvant treatment of diabetic foot can improve the diameter of the dorsal artery, increase the nerve conduction speed of the total nerve and not increase the adverse reaction after treatment.