四妙勇安汤联合纳米银抗菌凝胶治疗糖尿病足临床研究

Clinical study of SimiaoYongan Decoction combined with nano silver external antibacterial gel on diabetic foot

目的观察四妙勇安汤联合纳米银抗菌凝胶治疗糖尿病足(DF)的临床疗效。方法将80例DF患者按照随机数字表法分为2组。对照组40例予纳米银抗菌凝胶创面换药治疗,治疗组40例在对照组治疗基础上加四妙勇安汤,2组均2周为1个疗程,共治疗2个疗程后统计疗效。比较2组治疗前后血液流变学指标[血浆黏度、全血黏度(200)、全血黏度(100)、全血黏度(50)、全血黏度(5)、全血黏度(1)]、外周血炎症相关因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10、C反应蛋白(CRP)]水平及跛行距离。结果治疗后,2组血浆黏度、全血黏度(200)、全血黏度(100)、全血黏度(50)、全血黏度(5)、全血黏度(1)均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后,2组血清TNF-α、IL-6、CRP水平均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。2组治疗后IL-10水平均较本组治疗前升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗后,2组跛行距离均较本组治疗前增加(P<0.05),且治疗组高于对照组(P<0.05)。治疗组总有效率为87.5%(35/40),对照组总有效率为62.5%(25/40),治疗组总有效率高于对照组(P<0.05)。结论四妙勇安汤联合纳米银抗菌凝胶治疗DF疗效确切,其机制可能与抑制炎症和改善血液流变有关。

Objective To observe the clinical effectof SimiaoYongan Decoction combined with nano silver antibacterial gel to treat diabetic foot(DF).Methods A total of 80 patients with DF were taken as the research objects.They were randomly allocated to the two groups,on basis of nano silver topical antibacterial gel for wound dressing(the control group,n=40),the treatment group(n=40)was additionally given SimiaoYongan Decoction.The treatment continued for 2 courses(1 course for 2 weeks),the aim was to compare hemorheology indexes(plasma viscosity,whole blood viscosity[WBV][200],WBV[100],WBV[50],WBV[5],WBV[1]),peripheral blood inflammation-related factors including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-10,C-reactive protein(CRP)levels and walking distance in intermittent claudication.Results After treatment,the hemorheology indexes in the two groups were lower than those before treatment(P<0.05),and which were lower in the treatment group than the control group(P<0.05).Reduced serum TNF-α,IL-6,CRP levels and elevated IL-10 were found in both groups than those before treatment(P<0.05),and different were statistically between groups(P<0.05).The walking distance in intermittent claudication in the two groups was increased when compared with that before treatment(P<0.05),and the treatment group was higher than the control group(P<0.05).The total effective rate in the treatment group was higher than that in the control group(87.5%[35/40]vs 62.5%[25/40],P<0.05).Conclusion For patients with DF,SimiaoYongan Decoction combined with nano silver antibacterial gel has a good therapeutic effect.The mechanism may be related to inhibiting inflammation and improving hemorheology.