解毒洗药灌注联合负压封闭引流术干预糖尿病足溃疡的临床效果研究

Clinical Research on Epidermal Growth Factor and Tumor Necrosis Factor-αof Diabetic Foot Ulcer by Combining Jieduxiyao Instillation with Vacuum Sealing Drainage

目的:观察解毒洗药灌注联合负压封闭引流术促进糖尿病足溃疡(DFU)创面愈合的效果及其对创面组织表皮生长因子(EGF)、肿瘤坏死因子-α(TNF-α)的影响。方法:选取DFU患者60例,随机分为对照组和观察组各30例,对照组采用生理盐水灌注联合负压封闭引流术(VSD),观察组使用解毒洗药灌注联合负压封闭引流术(VSD),疗程为14 d。观察两组患者临床疗效,统计治疗前后创面组织中EGF、TNF-α含量及创面证候积分。结果:观察组临床有效率为63.33%,对照组为56.67%,差异无统计学意义;观察组的创面愈合速度、创面愈合率明显高于对照组,创面证候积分明显低于对照组,差异有统计学意义(P<0.05)。去VSD后(去除护创材料),与对照组比较,观察组EGF含量增加,TNF-α含量降低,差异均有统计学意义(P<0.05)。结论:解毒洗药灌注联合负压封闭引流术具有较好的促进DFu愈合的效果,其作用机制与解毒洗药提高创面组织EGF含量、降低TNF-α含量、降低创面证候积分有关。

Objective To study the effect of Jieduxiyao instillation combined with vacuum sealing drainage in promoting wound healing of diabetic foot ulcer and its effect on epidermal growth factor(EGF)and tumor necrosis factor-α(TNF-α)in wound tissue.Methods Sixty patients with diabetic foot ulcers were selected and randomly divided into control group and observation group with 30 cases each.The control group was treated with saline instillation combined with vacuum sealing drainage(VSD),and the observation group was used with Jieduxiyao instillation combined with VSD,which the course of treatment is 14 days.The clinical efficacy of the two groups of patients after treatment were observed.The contents of EGF and TNF-αin the wound tissue before and after treatment,and the scores of wound syndromes were counted.Results The clinical effective rate of the observation group was 63.33%,and that of the control group was 56.67%.The wound healing speed and wound healing rate of the observation group were significantly higher than those of the control group(P<0.05).The wound syndrome scores of the observation group were significantly lower than those of the control group(P<0.05).After removal of VSD(removal of wound care materials),the contents of EGF and TNF-αin wound tissue of the observation group were significantly different from those of the control group(P<0.05).Conclusion Jieduxiyao instillation combined with vacuum sealing drainage has a better effect of promoting the healing of diabetic foot ulcers.The mechanism of action is related to that Jieduxiyao could increase the content of EGF in the wound tissue,reduce the content of TNF-αand reduce the wound syndrome scores.