五味消毒饮联合“煨脓长肉法”治疗糖尿病足后病原菌分布及药物敏感性分析

Distribution and Drug Sensitivity Analysis on Pathogenic Bacteria of Using Wuwei Xiaodu Drink Combined with “Simmering Pus and Growing Meat Method” in the Treatment of Diabetic Foot

目的:对五味消毒饮联合"煨脓长肉法"治疗糖尿病足后病原菌分布及药物敏感性进行分析。方法:选择2017年12月~2018年12月青岛市南区人民医院收治的糖尿病足溃疡患者550例作为实验对象,以信封法将患者分为对照组和观察组,各275例,在整个治疗期间均接受抗生素(邦达)联合五味消毒饮进行治疗,其中观察组患者在此基础上接受生肌玉红膏+万灵膏进行治疗。实验采集患者的溃疡处的分泌物进行培养和药敏检测和对比,以此来观察病原菌分布情况和抗菌药物敏感性。结果:(1)观察组患者的治疗有效率明显高于对照组,差异有统计学意义(P<0.05);(2)在入院时,研究组275例患者的溃疡分泌物培养后获得303株阳性样本,对照组275例患者的溃疡分泌物培养后获得324株阳性样本;在治疗后,研究组275例患者的溃疡分泌物培养后获得291株阳性样本,对照组275例患者的溃疡分泌物培养后获得316株阳性样本;(3)药敏观察显示观察组在加用"煨脓长肉法"后,革兰阳性菌(以金黄色葡萄球菌、粪肠球菌为主)在多种抗生素敏感性上均优于对照组,在左氧氟沙星、四环素、万古霉素、阿莫西林克拉维酸钾、氨苄西林舒巴坦上优势明显,形成较大差异(P<0.05);观察组革兰阴性菌(以大肠埃希菌、肺炎克雷伯菌为主)革兰阴性菌在多种抗生素敏感性上同样均优于对照组,在阿米卡星、氨苄西林、头孢他啶、庆大霉素、美罗培南、哌拉西林他唑巴坦钠上优势明显,形成较大差异(P<0.05)。结论:在对糖尿病足溃疡患者进行治疗时,以"煨脓长肉法"进行相关治疗后,患者的病症情况能够得到控制,其能够改善伤口的环境,促进肉芽生长,有效率会明显提高,从细菌菌谱和耐药性进行分析,"煨脓长肉法"能够控制菌群的生长,提升菌群对抗生素的敏感性具有极高的应用价值。

Objective: To analyze the distribution of pathogenic bacteria and drug sensitivity of using Wuwei Xiaodu Drink combined with "simmer pus and long meat method" in the treatment of diabetic foot.Methods: 550 patients with diabetic foot ulcer admitted to the South District People’s Hospital of Qingdao City from December 2017 to December 2018 were selected as the experimental subjects.The patients were divided into a controlled group and an observation group by envelope method, with 275 cases in each group.During the whole treatment period, all patients were treated with antibiotics(Bangda) combined with Wuwei Xiaodu Drink, and the patients in the observation group were treated with Shengji Yuhong Ointment and Wanling Ointment on the basis of the controlled group.In order to observe the distribution of pathogens and antimicrobial susceptibility, the secretion of patients with ulcer was collected for culture and drug sensitivity detection and comparison.Results:(1) The effective rate of the observation group was significantly higher than that of the controlled group, the difference was statistically significant(P<0.05).(2) On admission, 303 positive samples were obtained from 275 patients in the study group, and 324 positive samples were obtained from 275 patients in the controlled group;after treatment, 291 positive samples were obtained from 275 patients in the study group and 275 patients in the controlled group.After secretion culture, 316 positive samples were obtained;(3) Drug sensitivity observation showed that the Gram-positive bacteria(mainly Staphylococcus aureus and Enterococcus faecalis) in the observation group were better than those in the controlled group in a variety of antibiotic sensitivity after adding "simmer pus and long meat method".The advantages of levofloxacin, tetracycline, vancomycin, amoxicillin clavulanate potassium and ampicillin sulbactam were obvious in the observation group.The Gram-negative bacteria(mainly Escherichia coli and Klebsiella pneumoniae) in the observation group were also better than those in the controlled group in a variety of antibiotic sensitivity, and the advantages of amikacin, ampicillin, ceftazidime, gentamicin, meropenem, piperacillin tazobactam sodium were obvious in the observation group(P<0.05).Conclusion: In the treatment of diabetic foot ulcer, the method of "simmering pus and growing flesh" is the most effective method in the treatment of diabetic foot ulcer.After the relevant treatment, the patient’s condition can be controlled, which can improve the wound environment, promote the growth of granulation, and the effective rate will be significantly improved.From the analysis of bacterial spectrum and drug resistance, "simmering pus and growing meat method" can control the growth of bacteria and improve the sensitivity of bacteria to antibiotics, which has high application value.