穴位注射结合四妙勇安汤辅助治疗糖尿病足溃疡临床效果观察

Clinical observation of acupoint injection combined with Simiao Yongan decoction in treatment of diabetic foot ulcer

目的:探讨穴位注射维生素B1结合四妙勇安汤辅助治疗糖尿病足溃疡(DFU)的临床疗效。方法:选取2021年10月-2023年2月我院收治的湿热毒盛型DFU患者96例,随机分为观察组与对照组各48例,对照组给予西医常规治疗,观察组在对照组基础上给予穴位注射结合四妙勇安汤治疗。观察两组患者治疗前后的临床疗效、中医证候评分、踝肱指数及创面情况(创面面积、创面深度),血清炎症指标(超敏C反应蛋白、白细胞介素-1、肿瘤坏死因子-α)、超声检查指标(足背动脉的血流速度、血管内径、阻力指数),血管内皮功能(血管内皮生长因子及血清碱性成纤维细胞生长因子)及复发率。结果:治疗后观察组总有效率为91.67%,显著高于对照组的77.08%(P <0.05);治疗后两组中医证候评分、血清炎症指标、创面面积、创面深度均较治疗前降低,且观察组低于对照组(P <0.05);两组治疗后血清血管内皮生长因子、血清碱性成纤维细胞生长因子水平、踝肱指数及各超声检查指标均较治疗前升高,且观察组高于对照组(P<0.05);观察组复发率10.42%低于对照组的27.08%(P<0.05)。结论:穴位注射维生素B1结合四妙勇安汤辅助治疗湿热毒盛型DFU患者临床疗效显著。

Objective To explore the clinical effect of acupoint injection combined with Simiao Yongan decoction in the treatment of damp-heat toxic-excess diabetic foot ulcer.Methods A total of 96 patients from October 2021 to February 2023 with damp-heat and dust-summing type diabetic foot ulcer were selected from our hospital and divided into the observation group and the control group according to random number table method,48 cases in each group,the control group was given conventional Western medicine treatment,and the observation group was given acupoint injection combined with Simiao Yongan decoction on the basis of the control group.Clinical efficacy,TCM syndrome score,ankle-brachial index and wound condition(wound area and depth),serum inflammatory indexes(hypersensitive C-reactive protein,interleukin-1,tumor necrosis factor-α),ultrasonic indexes(blood flow velocity,vascular diameter and resistance index of dorsal foot artery)of the 2 groups were observed before and after treatment.Vascular endothelial function(vascular endothelial growth factor and serum basic fibroblast growth factor)and recurrence rate.Results After treatment,observation group total effective rate was 91.67%significantly higher than that of control group 77.08%(P<0.05).TCM syndrome score,serum inflammatory index,wound area and wound depth of both groups were lower than before treatment,and observation group was lower than control group(P<0.05).the levels of serum vascular endothelial growth factor,serum basic fibroblast growth factor,anklebrachial index and ultrasonic indexes in 2 groups were higher than before treatment,and the observation group was higher than the control group(P<0.05).The recurrence rate of observation group was 10.42%lower than that of control group 27.08%(P<0.05).Conclusion Acupoint injection of vitamin B1 combined with Simiao Yongan decoction assisted treatment of damp-heat toxic excessive type diabetic foot ulcer patients with significant clinical effect.