糖尿病足溃疡中西医治疗进展

Advances in Chinese and Western Medicine for Diabetic Foot Ulcers

糖尿病足溃疡是慢性糖尿病常见的并发症之一,因其日益增长的发病率与病死率,治疗尤为重要,主要包括基础治疗和标准治疗。基础治疗重点在于对患者进行疾病教育,注意日常的血糖调控等。标准治疗主要是应用药物对创面进行抗感染治疗、清创治疗、局部减压治疗以及应用敷料进行治疗等。由于糖尿病足发病机制复杂,影响因素众多,导致一些患者在接受西医规范化治疗后疗效果仍不明显,因此应综合多学科知识与技术对糖尿病足溃疡患者进行全面治疗。中医治疗包括内治法与外治法,两种方法常联合应用,内外同调,加强疗效。中医内治法主要通过收集患者四诊资料,进行辨证论治,根据患者不同证型选用相应的中药方剂进行个体化治疗;中医外治法包括中药外敷、足浴、熏蒸、溻渍、针灸等,根据患者溃疡创面大小、患者状态及患者偏好选择不同的干预方式进行治疗,每种外治法又可选择不同的中药复方或穴位。中医疗法在临床应用中较为多变,覆盖患病类型广泛,效果显著。临床治疗实践中应结合多样化中西医疗法,取长补短,在治疗上取得良好疗效。文章查阅总结近年国内外发表关于糖尿病足溃疡治疗的文献,总结中西医在糖尿病足溃疡方面的治疗方法与手段,以期为临床选择提供参考。

Diabetic foot ulcer is one of the most common complications of chronic diabetes.Due to its increasing morbidity and mortality,treatment is particularly important,including basic treatment and standard treatment.Basic treatment focuses on disease education and daily blood sugar regulation.The standard treatment is mainly anti-infection treatment,debridement treatment,local decompression treatment and dressing treatment.However,due to the complex pathogenesis of diabetic foot and numerous influencing factors,the therapeutic effect of some patients is still not obvious after receiving standardized treatment of western medicine.Therefore,comprehensive treatment of diabetic foot ulcer patients should be conducted by integrating multidisciplinary knowledge and technology.Traditional Chinese medicine treatment includes internal treatment and external treatment,the two methods are often used in combination,the internal and external harmonization of patients,strengthen the curative effect.The internal treatment of traditional Chinese medicine mainly collects the four-diagnosis data of patients,carries out syndrome differentiation and treatment,and selects the corresponding Chinese medicine prescriptions according to the different syndrome types of patients for individual treatment;The external treatment methods of traditional Chinese medicine include external application of traditional Chinese medicine,foot bath,fumigation,moxibustion,etc.Different intervention methods are selected for treatment according to the size of the ulcer wound,the state of the patient and the preference of the patient.Different traditional Chinese medicine compounds or acupoints can be selected for each external treatment method.Therefore,traditional Chinese medicine therapy in clinical application is more changeable,covering a wide range of disease types,the effect is remarkable.In clinical treatment practice,a variety of traditional Chinese and western medicine should be combined to learn from each other and achieve good therapeutic effect.This article reviewed and summarized the literature on the treatment of diabetic foot ulcer published at home and abroad in recent years,and summarized the treatment methods and means of Chinese and western medicine in diabetic foot ulcer,in order to provide reference for clinical selection.