中药熏蒸联合西药治疗糖尿病足临床研究

Clinical Study on Chinese Herbal Fumigation Combined with Western Medicine for Diabetic Foot

目的:观察中药熏蒸联合西药治疗糖尿病足的临床疗效。方法:采用数字奇偶法将72例糖尿病足患者分为治疗组与对照组各36例。对照组给予西药治疗,治疗组在对照组基础上联用中药熏蒸治疗。比较2组治疗前后中医证候评分、溃疡下肢血流速度、溃疡面积及创面渗液基质金属蛋白酶-2 (MMP-2)、血管内皮生长因子(VEGF)水平;比较2组溃疡愈合时间、临床疗效及不良反应发生情况。结果:治疗组临床总有效率高于对照组(P<0.05),溃疡愈合时间短于对照组(P<0.05)。治疗后,2组溃疡下肢胫前动脉、胫后动脉、股浅动脉及腘动脉血流速度、创面渗液VEGF水平较治疗前增加(P<0.05),中医证候评分、溃疡面积及创面渗液MMP-2水平减少(P<0.05),且治疗组治疗后溃疡下肢血流速度、创面渗液VEGF水平高于对照组(P<0.05),中医证候评分、溃疡面积及创面渗液MMP-2水平低于对照组(P<0.05)。治疗组不良反应发生率低于对照组(P<0.05)。结论:中药熏蒸联合西药治疗糖尿病足疗效确切,能够有效促进患者溃疡面愈合,改善患者下肢血流速度及血管病变,安全性较高。

Objective: To observe the clinical effect of Chinese herbal fumigation combined with western medicine for diabetic foot. Methods:A total of 72 cases of patients with diabetic foot were divided into the treatment group and the control group according to the odd-even number grouping method,with36 cases in each group. The control group was treated with western medicine,and the treatment group was additionally treated with Chinese herbal fumigation based on the treatment of the control group.Traditional Chinese medicine(TCM) syndrome scores,blood flow velocity of anterior tibial artery,posterior tibial artery,superficial femoral artery and popliteal artery and ulcer area of the lower limbs with ulcer,and levels of matrix metalloproteinase-2(MMP-2) and vascular endothelial growth factor(VEGF) in wound effusion before and after treatment were compared between the two groups. The healing time of ulcer,the clinical effects and the incidence of adverse reactions were compared between the two groups. Results:The total effective rate in the treatment group was higher than that in the control group(P<0.05),and the healing time of ulcer was shorter than that in the control group(P<0.05). After treatment,the blood flow velocity of anterior tibial artery,posterior tibial artery,superficial femoral artery and popliteal artery in the lower limbs with ulcer and the VEGF levels in wound effusion in the two groups were increased when compared with those before treatment(P<0.05), and TCM syndrome scores, ulcer area and levels of MMP-2 in wound effusion in the two groups were decreased(P<0.05);the blood flow velocity of lower limbs with ulcer and the VEGF level in wound effusion in the treatment group were higher than those in the control group,and the TCM syndrome score,ulcer area and MMP-2 level in wound effusion were lower than those in the control group(P<0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05). Conclusion: Chinese herbal fumigation combined with western medicine for diabetic foot has a definite curative effect,and can effectively promote the healing of ulcer surface and improve the blood flow velocity and vascular lesions of lower limbs with high safety.