基于中医辨证分型应用中药外用制剂促进糖尿病足溃疡愈合的临床研究

Clinical Study on Diabetes Foot Ulcer Treated with External Application of Traditional Chinese Medicine Based on the Differentiation of Symptoms

目的:探讨基于中医辨证分型应用中药外用制剂促进糖尿病足溃疡愈合的疗效。方法:选取2019年7月至2022年7月住院的糖尿病足患者,随机分为治疗组和对照组。治疗组根据中医三期辨证分型,采用清创换药+相应中药外用制剂,对照组采用单纯清创换药的方法。对比观察两组患者在临床综合疗效、患肢疼痛视觉模拟量表(VAS)评分、创面愈合时间等结果的差异。结果:纳入符合标准的病例90例,其中治疗组及对照组各45例,两组病例基本资料及病情差异无统计学意义(P>0.05)。临床综合疗效方面:治疗组治愈13例,显效25例,有效3例,无效4例,总有效率为91%;对照组治愈5例,显效20例,有效2例,无效18例,总有效率为60%,两组疗效比较差异有统计学意义(P<0.05)。两组患者在治疗后2周、1个月及3个月时VAS评分均较前改善,治疗组VAS评分由治疗前的(6.31±1.01)分降至治疗后2周的(3.11±1.09)分、1个月时的(1.49±0.81)分和3个月时的(0.51±0.84)分,对照组疼痛评分由治疗前的(6.47±1.18)分降至2周后的(4.18±1.45)分、1个月时的(2.58±0.89)分及3个月时的(2.00±1.38)分,两组之间差异有统计学意义(P<0.05)。治疗组创面愈合时间方面明显优于对照组,差异有统计学意义(P<0.05),但治疗组组内不同分型的VAS评分及创面愈合时间差异无统计学意义(P>0.05)。结论:根据中医三期辨证分型来合理应用中药外用制剂可促进糖尿病足溃疡愈合。

Objective:To explore the curative efficacy of external application of Chinese medicine on promoting the healing of diabetes foot ulcer based on the differentiation of symptoms and signs of traditional Chinese medicine(TCM).Methods:Patients diagnosed with diabetes foot from July 2019 to July 2022 were randomly collected and divided into treatment group and control group.The treatment group was treated with debridement and external used Chinese medicine according to the three-stage differentiation of traditional Chinese medicine,while the control group was treated with simple debridement.Clinical comprehensive efficacy,visual analogue scale(VAS)score of limb pain and wound healing time were compared between the two groups.Results:90 cases were included,comprised 45 cases in the treatment group and 45 cases in the control group.There was no significant statistical difference between the two groups in the basic line.In terms of clinical comprehensive efficacy,for the treatment group,13 cases were cured,25 cases were markedly effective,3 cases were effective,and 4 cases were ineffective,with the total effective rate of 91%;in the control group,5 cases were cured,20 cases were markedly effective,2 cases were effective,and 18 cases were ineffective,the total effective rate was 60%.There was significant difference between the two groups(P<0.05).The VAS score of the two groups was improved at 2 weeks,1 month and 3 months after treatment.The VAS score of the treatment group decreased from(6.31±1.01)points before treatment to(3.11±1.09)points at 2 weeks and(1.49±0.81)points at 1 month and(0.51±0.84)points at 3 months after treatment.The pain score of the control group decreased from(6.47±1.18)points before treatment to(4.18±1.45)points at 2 weeks and(2.58±0.89)points at 1 month and(2.00±1.38)points at 3 months after treatment.However,there was significant difference between the two groups(P<0.05).The wound healing time of the treatment group was significantly shorter than the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in VAS and wound healing time of different types between the treatment groups(P>0.05).Conclusion:Rational application of TCM external preparations according to TCM syndrome differentiation can promote the healing of diabetes foot ulcers.