胰岛素联合丹红注射液对糖尿病足患者足背血流动力学、血清炎症标记物和内皮功能的影响

Effects of insulin combined with Danhong injection on foot dorsal hemodynamics,markers of serum inflammation and endothelial function in patients with diabetic foot

目的探讨胰岛素联合丹红注射液对糖尿病足患者的足背血流动力学、血清炎症标记物和内皮功能的影响。方法选取于2015年2月—2016年2月在绍兴市立医院治疗的糖尿病足溃疡患者108例,按照入院的先后顺序,结合随机对照表将患者分为观察组和对照组,每组各54例。对照组患者给予胰岛素控制血糖和抗感染等治疗,同时采用胰岛素、山莨菪碱和生理盐水混合液外敷于患处。观察组在对照组基础上外敷丹红,并静脉滴注丹红注射液,疗程为4周,1次/d。观察2组患者治疗后的足背动脉血流动力学、血清炎症标记物、血管内皮功能、溃疡面积和不良反应等指标。结果经治疗后,观察组的血管内径和血流量明显大于对照组(P<0.01),峰值流速显著低于对照组(P<0.01),且肿瘤坏死因子(TNF-α)、白介素细胞-6(IL-6)、血管内皮素(ET)和血管性血友病因子(v WF)的水平明显低于对照组,差异有统计学意义(P<0.01),观察组溃疡面积明显低于对照组,差异有统计学意义(P<0.01),2组患者均未见明显不良反应。结论胰岛素联合丹红注射液对糖尿病足患者的足背血流动力学、血清炎症标记物和内皮功能指标有一定程度的影响,可能对治疗糖尿病足有一定的临床应用价值,在今后的工作中,可扩大样本量,结合其他指标进行更深入的研究。

Objective To explore the effect of insulin combined with Danhong injection on foot dorsal hemodynamics, markers of serum inflammation and endothelial function in patients with diabetic foot. Methods From February, 2015 to February, 2016, 108 patients with diabetic foot ulcers were selected in the hospital, according to the order of admission and random control table, the patients were divided into the observation group and the control group, with 54 cases in each group. The control group was treated with insulin to control blood sugar and anti infection; meanwhile, insulin, anisodamine and normal saline were applied to the affected part. The observation group was treated with Danhong on the basis of the control group and intravenous drip of Danhong injection. The course of treatment was 4 week, 1 time a day. The hemodynamics of the dorsalis pedis artery, serum inflammatory markers, endothelial function, ulcer area and side effects were observed in the two groups. Results After treatment, the vascular diameter and blood flow in the observation group were significantly greater than those in the control group （ P 〈 0.01 ） , and the peak flow velocity was significantly lower than that in the control group （P 〈 0.01 ） ; the levels of TNF-α and IL-6, ET and vWF in the observation group were significantly lower than those in the control group, and the difference between the two groups was statistically significant （P 〈 0.01 ）. The ulcer area in the observation group was significantly lower than that in the control group, and the difference was statistically significant （P 〈 0.01 ）. Neither group had significant adverse reactions. Conclusion The combination of insulin and Danhong injection has some effect on foot dorsal hemodynamics, markers of serum inflammation and endothelial function in patients with diabetic foot, which may be of certain clinical value for the treatment of diabetic foot. In the future work, it should be expanded in the sample size and combined with other indicators to carry out a more indepth study.