中药熏洗结合西医常规疗法治疗老年前期糖尿病足临床研究

Clinical study on treatment of diabetic foot by traditional Chinese medicine fumigation combined with conventional therapy

目的 评价中药熏洗结合西医常规疗法治疗老年前期糖尿病足的疗效。方法 将符合入选标准的90例2型糖尿病患者，采用随机数字表法分为2组，每组45例。在西医常规治疗基础上，治疗组结合中药熏洗，对照组结合温水熏洗。2组均治疗4周。分别于治疗前后对患者中医症状、体征进行评分，并以彩色多普勒测量患肢腘动脉、股总动脉、胫后和足背动脉峰值流速，评价临床疗效。结果 治疗组总有效率为73.3%（33/45）、对照组为53.3%（24/45），2组比较差异有统计学意义（χ2=3.876，P=0.049）。治疗后，治疗组患肢股总动脉[（58.38±12.53）cm/s比（51.94±11.62）cm/s，t=2.528]、腘动脉[（43.87±9.46）cm/s比（39.87±8.28）cm/s，t=2.134]、胫后动脉[（35.72±8.29）cm/s比（30.89±8.51）cm/s，t=2.725]、足背动脉[（26.82±8.10）cm/s比（22.87±7.39）cm/s，t=2.413]峰值流速均高于对照组（P＜0.05）；治疗组主症积分[（2.0±1.5）分比（4.1±2.1）分，t=5.419]、次症积分[（3.1±1.8）分比（5.1±2.3）分，t=4.692]、舌苔脉象积分[（1.8±0.8）分比（2.4±0.6）分，t=4.277]均低于对照组（P＜0.01）。结论 中药熏洗可有效改善老年前期糖尿病足患者下肢血流状态和临床症状。

Objective To evaluate the curative effect of traditional Chinese medicine fumigation combined with conventional therapy for the diabetic foot. Methods A total of 90 patients with type 2 diabetes who were treated in the hospital from March 2015 to August 2017 were enrolled in this study. On the basis of conventional treatment, the treatment group received the traditional Chinese medicine fumigation, while the control group received warm water fumigation. The total limb popliteal artery, femoral artery, posterior tibial artery and dorsalis pedis artery and a score of symptoms and signs were compared between two groups after 4 weeks. Results The total effective rate of the treatment group was 73.3% （33/45）, while the control group was 53.3% （24/45）, and the difference was statistically significant （χ2=3.876, P=0.049）. After treatment, total limb femoral artery （58.38 ± 12.53 cm/s vs. 51.94 ± 11.62 cm/s, t=2.528）, popliteal artery （43.87 ± 9.46 cm/s vs. 39.87 ± 8.28 cm/s, t=2.134）, posterior tibial artery （35.72 ± 8.29 cm/s vs. 30.89 ± 8.51 cm/s, t=2.725）, dorsalis pedis artery （26.82 ± 8.10 cm/s vs. 22.87 ± 7.39 cm/s, t=2.413） of the treatment group were significantly higher than those of the control group （P〈0.05）. The main symptom score （2.0 ± 1.5 vs. 4.1 ± 2.1, t=5.419）, sub syndrome score （3.1 ± 1.8 vs. 5.1 ± 2.3, t=4.692）, tongue and pulse condition score （1.8 ± 0.8 vs. 2.4 ± 0.6, t=4.277） of the treatment group were significantly lower than those of the control group （P〈0.01）. Conclusions The traditional Chinese medicine fumigation combined with conventional therapy could improve the lower extremity blood flow status in diabetic foot patients and clinical symptoms.