化瘀解毒法对早期老年糖尿病足患者炎性因子的影响研究

Effect of the Huayu Jiedu therapy on the inflammatory cytokines of early old age diabetic foot

目的:观察活血化瘀、清热解毒法对早期老年糖尿病足患者炎性因子的影响。方法:选取山东中医药大学附属医院老年病科住院及门诊老年糖尿病足患者150例,随机分为治疗组100例,对照组50例,治疗组分为阿司匹林+中药高剂量组50例,阿司匹林+中药低剂量组50例。三组都给予糖尿病基础治疗同时,治疗组给予西药阿司匹林联合活血化瘀、清热解毒中药治疗,中药高剂量组:鸡血藤30g,丹参20g,三七粉(冲服)6g,水蛭6g,蒲公英24g,金银花24g,中药低剂量组:鸡血藤15g,丹参10g,三七粉(冲服)3g,水蛭3g,蒲公英12g,金银花12g。低剂量组剂量减半。对照组给予西药阿司匹林治疗。治疗前后观察患者C-反应蛋白(CRP)、血浆纤维蛋白原(FIB)、肿瘤坏死因子α(TNF-α)、每20min微栓子个数各项指标。结果:治疗组治疗4周后与治疗前相比明显降低C-反应蛋白、血浆纤维蛋白原、肿瘤坏死因子α等各炎性指标水平,减少血管内微栓子个数,统计学处理具有显著性差异,P<0.05。但对照组治疗前后对C-反应蛋白、血浆纤维蛋白原、肿瘤坏死因子α的影响,差异无显著性,P>0.05。治疗组明显优于对照组,P<0.05,具有显著性差异。结论:西药阿司匹林联合化瘀解毒中药对降低早期老年糖尿病足患者炎性因子水平及微栓子形成比单纯应用西药治疗具有显著疗效。

Objective： To observe the effect of the Huoxue Huayu therapy（ 活血化瘀法） and Qingre Jiedu therapy（ 清热解毒法） on the inflammatory cytokines of early old age diabetic foot. Methods： 150 cases of senile diabetic foot inpatients and outpatients in the geriatric department of Affiliated Hospital of Shandong University of Traditional Chinese Medicine were selected and randomly divided into the treatment group（100 cases） and the control group（50 cases）. The treatment group was consisted of 50 cases of aspirin plus TCM medicine high-dose group and 50 cases of aspirin plus TCM medicine low-dose group. Three groups were given the basic treatment of diabetes mellitus. The treatment group was given western medicine aspirin and TCM medicine treatment. The control group was given western medicine aspirin. Before and after treatment, the indexes of C-reactive protein（CRP）, fibrinogen（FIB）, tumor necrosis factor alpha（TNF-α） and the number of micro-emboli in every 20 minutes were observed. Results： After 4 weeks of treatment, the levels of C-reactive protein, plasma fibrinogen and tumor necrosis factor alpha in the treatment group were significantly decreased and the number of intravascular micro-emboli was decreased after treatment of 4 weeks, there was a significant difference between two groups, P〈0.05. The effect of C-reactive protein, plasma fibrinogen and tumor necrosis factor alpha in the control group before and after treatment was not significantly different, P〉0.05. The treatment group was statistically significantly better than the control group, and there were significant differences, P〈0.05. Conclusion： Aspirin and the Huayu Jiedu therapy（ 化瘀解毒法） could reduce the inflammatory cytokine levels and micro-embolization of early diabetic foot patients, it had a more significant effect than the simple application of western medicine.