清法治疗糖尿病足筋疽重症281例效果分析

Analysis of Effect of Qing Method on 281 Cases of Severe Diabetic Sinew Gangrene Foot

目的:回顾性分析用奚氏清法治疗糖尿病足筋疽重症的临床疗效及安全性。方法:选取2017年1月—2021年10月上海市中西医结合医院脉管科收治的重症糖尿病足筋疽患者281例,采用奚氏清法治疗,分析其临床疗效及安全性;对比治疗前后生化指标变化,包括空腹血糖(FBG)、餐后2 h血糖(PBG)、C肽(C-PR)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、白细胞(WBC)、C-反应蛋白(CRP)、红细胞沉降率(ESR)、降钙素原(PCT)、白细胞介素6((IL-6)、红细胞(RBC)、血红蛋白(Hb)、白蛋白(ALB);观察治疗前后创面的个数、面积、深度;同时观察患者不良反应。结果:281例中痊愈89例,占31.67%;显效150例,占46.26%,改善50例,占17.79%,恶化(截肢)11例,占3.91%,死亡1例,占0.36%,保肢成功率为95.73%。治疗后,患者的FBG、PBG、HbA1c、HOMA-IR与治疗前比较明显下降,差异有统计学意义(P<0.05)。治疗前后C-PR、FINS比较差异无统计学意义(P>0.05)。患者的WBC、CRP、ESR、PCT、IL-6与治疗前比较明显下降,差异有统计学意义(P<0.05)。患者的RBC、Hb、ALB与治疗前比较明显升高,差异有统计学意义(P<0.05)。患者的创面个数减少、创面面积缩小、创面深度减少,差异有统计学意义(P<0.01)。且未见明显的不良反应。结论:运用奚氏清法治疗糖尿病足筋疽重症有明确临床疗效及安全性。

Objective To retrospective analysis the curative effect and security of Xishi Qing method on severe diabetic sinew gangrene foot.Methods The Xishi Qing method was used for treating 281 patients,which aims to retrospectively analyze the curative effect and security of the creating.The biochemical indexes,including fasting plasma glucose(FPG),2-hour postprandial plasma glucose(2h PBG),C-peptide(C-PR),fasting insulin(FINS),glycated hemoglobin(HbA1c),homeostasis model assessment of insulin resistance(HOMA-IR),white blood cells(WBC),sensitivity C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),calcitonin ogen(PCT),interleukin 6(IL-6),red blood cells(RBC),hemoglobin(Hb)and albumin(ALB),number,area and depth of wounds and adverse reactions were observed before and after treatment.Results Among 281 cases,there were 89 cured(account for 31.67%),150 with remarkable curative effect(account for 46.26%),50 relieved(account for 17.79%)and 11 grew worse(amputation,account for 3.91%),1 death occurred(account for 0.36%).The success rate for salvaging limbs was 95.73%.The FBG,PBG,HbA1c,HOMA-IR,WBC,CRP,ESR,PCT and IL-6 decreased significantly(P<0.05).The RBC,Hb and ALB increased significantly after treatment(P<0.05).The number,area and depth of wounds decreased significantly after treatment(P<0.01).There were no adverse reactions observed.Conclusion Xishi Qing method has good curative effect and security on severe diabetic sinew gangrene foot.