胰岛素加康复新液贴敷治疗糖尿病足的临床效果分析

Clinical effect analysis of insulin and Kangfuxin solution on diabetic foot

目的分析胰岛素加康复新液贴敷治疗糖尿病足的临床效果。方法74例糖尿病足患者,采用随机数字表法分为试验组和参照组,每组37例。两组患者均行胰岛素干预,参照组患者给予常规换药,试验组患者给予康复新液贴敷治疗。比较两组患者治疗前后血糖指标(空腹血糖、餐后2 h血糖、餐后最高血糖)、血液流变学指标[全血低切粘度(BVL)、全血高切粘度(BVH)、血浆粘度(PV)]、D-二聚体(D-D)、足背动脉血流动力学指标[血管内径、血流量、阻力指数(RI)、搏动指数(PI)]。结果治疗后,两组患者空腹血糖、餐后2 h血糖、餐后最高血糖水平均低于本组治疗前,且试验组患者空腹血糖(4.81±0.42)mmol/L、餐后2 h血糖(7.12±1.30)mmol/L、餐后最高血糖(10.17±1.28)mmol/L均低于参照组的(6.10±0.49)、(8.11±1.27)、(12.58±1.34)mmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者BVH、BVL、PV、D-D水平均低于本组治疗前,且试验组患者BVH(6.02±0.74)mPa·s、BVL(10.47±1.45)mPa·s、PV(1.66±0.08)mPa·s、D-D(0.92±0.13)μg/ml均低于参照组的(6.63±0.58)mPa·s、(11.90±1.35)mPa·s、(1.72±0.13)mPa·s、(1.10±0.14)μg/ml,差异具有统计学意义(P<0.05)。治疗后,两组患者血管内径、血流量、RI、PI均大于本组治疗前,且试验组患者血管内径(2.20±0.09)mm、血流量(1.07±0.10)ml/s、RI(0.74±0.06)、PI(3.39±0.32)大于参照组的(1.95±0.07)mm、(0.94±0.07)ml/s、(0.68±0.03)、(3.01±0.24),差异具有统计学意义(P<0.05)。结论糖尿病足治疗中,在常规使用胰岛素的基础上联合康复新液贴敷,有利于改善局部血液流动状态,改善血糖指标,加快创面愈合速度。

Objective To analyze the clinical effect of insulin and Kangfuxin solution on diabetic foot.Methods A total of 74 cases of diabetic foot patients were divided into experimental group and reference group according to the random numerical table,with 37 cases in each group.Both groups received insulin intervention,the reference group was given routine dressing change,and the experimental group was given Kangfuxin solution.Both groups were compared in terms of blood glucose indexes(fasting blood glucose,2 h postprandial blood glucose,postprandial maximum blood glucose),hemorheology indexes[blood viscosity at low shear rate(BVL),blood viscosity at high shear rate(BVH),plasma viscosity(PV)],D-dimer(D-D),dorsalis arteriae hemodynamics indexes[vessel diameter,blood flow,resistance index(RI),pulse index(PI)]before and after treatment.Results After treatment,the fasting blood glucose,2 h postprandial blood glucose and maximum postprandial blood glucose levels in both groups were lower than those before treatment in this group;in the experimental group,the fasting blood glucose was(4.81±0.42)mmol/L,the 2 h postprandial blood glucose was(7.12±1.30)mmol/L,and the postprandial maximum blood glucose was(10.17±1.28)mmol/L,which were lower than those of(6.10±0.49),(8.11±1.27)and(12.58±1.34)mmol/L in the reference group;the differences were statistically significant(P<0.05).After treatment,the levels of BVH,BVL,PV and D-D in both groups were lower than those before treatment in this group;the experimental group had BVH of(6.02±0.74)mPa·s,BVL of(10.47±1.45)mPa·s,PV of(1.66±0.08)mPa·s,and D-D of(0.92±0.13)μg/ml,which were lower than those of(6.63±0.58)mPa·s,(11.90±1.35)mPa·s,(1.72±0.13)mPa·s,and(1.10±0.14)μg/ml in the control group;the differences were statistically significant(P<0.05).After treatment,the vessel diameter,blood flow,RI and PI in both groups were higher than those before treatment in this group;in the experimental group,the vessel diameter was(2.20±0.09)mm,the blood flow was(1.07±0.10)ml/s,RI was(0.74±0.06)and PI was(3.39±0.32),which were higher than those of(1.95±0.07)mm,(0.94±0.07)ml/s,(0.68±0.03)and(3.01±0.24)in the reference group;the differences were statistically significant(P<0.05).Conclusion In the treatment of diabetic foot,the combination of routine use of insulin and Kangfuxin solution can improve the local blood flow,improve the blood glucose index and accelerate the speed of wound healing.