温针灸联合NPWT技术对糖尿病足患者血清VEGF、IGF-1、IL-6、CRP影响观察

Effect of warm acupuncture combined with NPWT technique on serum VEGF,IGF-1,IL-6 and CRP in patients with diabetic foot

目的:证实温针灸联合NPWT技术是治疗糖尿病足简单、有效的新方法。方法:收集确诊糖尿病足溃疡患者60例(Wagner分级2～4级),随机分为三组:常规换药组、NPWT组、温针灸联合NPWT组,每组各20例。分别治疗8周,选取第1,2,4,8周四个时间点,比较治疗前后溃疡大小、深度及组织学改变、溃疡愈合时间、平均住院时间、平均住院费用、有效率的差异,ELISA法检测治疗前后患者血清中VEGF、IGF-1、IL-6、CRP等指标变化。结果:使用温针灸联合NPWT技术的方案治疗糖尿病足患者,治疗第2周溃疡面即明显缩小,伤口愈合进程也明显快于其他两组治疗方案的患者,差异有统计学意义(P <0. 01);伤口愈合快,住院时间短,住院花费低,有效率高,差异有统计学意义(P <0. 05);血清指标的检测结果则表明,温针灸+NPWT治疗后,血清中VEGF、IGF-1水平明显上升,血清中IL-6、CRP水平明显下降。结论:温针灸联合NPWT技术方法简单,效果显著,易在临床及基层医院推广与普及,可以为糖尿病足治疗提供一种新的治疗手段。

Objective It is confirmed that warming needle moxibustion combined with NPWT is a simple and effective new method for treating diabetic foot.Method Sixty patients with WC's diagnosed diabetic foot ulcer(Wagner grade 2~4)were randomly divided into three groups:conventional dressing group,NPWT group,warm acupuncture combined with NPWT group,20 cases in each group.After 8 weeks of treatment,the time,depth and histological changes,ulcer healing time,average hospitalization time,average hospitalization cost,and effective difference were compared before and after treatment at the first,second,fourth,and eighth weeks.The serum levels of VEGF,IGF-1,IL-6 and CRP were measured before and after treatment.Results The patients with diabetic foot were treated with warm acupuncture combined with NPWT technique.The ulcer surface was significantly reduced in the second week of treatment,and the wound healing process was also significantly faster than the other two groups(P<0.01).The wound healed quickly and was hospitalized.The time was short,the hospitalization cost was low,and the effective rate was high(P<0.05).The results of serum index showed that the levels of VEGF and IGF-1 in serum increased significantly after serum acupuncture plus NPWT treatment,and the levels of IL-6 and CRP in serum were detected.Significant decline.Conclusion Warm acupuncture combined with NPWT is simple and effective,and it is easy to promote and popularize in clinical and primary hospitals.It can provide a new treatment for diabetic foot treatment.