高压氧联合硫辛酸治疗糖尿病足疗效分析

Analysis of the Therapeutic Effect of Hyperbaric Oxygen Combined with Thioctic Acid in Treating Diabetic Foot

目的探究高压氧联合硫辛酸治疗糖尿病足的临床疗效。方法选取2020年5月至2022年5月河南省人民医院豫东分院收治的92例糖尿病足患者作为研究对象,按照不同治疗方法将其分为观察组(32例)、对照组(30例)和空白组(30例)。观察组患者在常规治疗的基础上行高压氧联合硫辛酸治疗,对照组患者在常规治疗的基础上单纯行硫辛酸治疗,空白组患者单纯行常规治疗,对比观察3组患者临床疗效、血糖相关指标及血管功能相关因子水平与踝肱指数。结果治疗4周后,3组患者临床疗效对比,观察组明显优于空白组(Z=-2.429,P=0.015),而观察组与对照组以及对照组与空白组间无明显差异(Z=-1.415、-1.299,P=0.157、0.194)。治疗4周后,3组患者空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbAlc)水平对比,观察组均明显低于空白组(q=6.574、6.162、6.339,P均<0.001),而观察组与对照组以及对照组与空白组间无明显差异(FBG:q=3.310、3.213,P=0.055、0.065;2 h PBG:q=2.840、3.270,P=0.116、0.059;HbAlc:q=3.230、3.059,P=0.063、0.083);3组患者血清内皮素(ET)水平对比,观察组明显低于对照组与空白组(q=3.443、6.630,P=0.044、P<0.001),而对照组与空白组间无明显差异(q=3.137,P=0.074);3组患者血清降钙素基因相关肽(CGRP)、血管内皮生长因子(VEGF)水平对比,观察组均明显高于对照组与空白组(CGRP:q=3.491、6.883,P=0.041、P<0.001;VEGF:q=3.467、6.636,P=0.042、P<0.001),而对照组与空白组间无明显差异(q=3.339、2.851,P=0.053、0.114)。治疗4周后,3组患者踝肱指数对比,观察组明显高于对照组与空白组(q=3.947、7.330,P=0.018、P<0.001),而对照组与空白组间无明显差异(q=3.330,P=0.054)。结论高压氧联合硫辛酸治疗糖尿病足,有助于控制血糖水平、改善血管内皮功能及下肢血管病变程度,提高治疗效果,临床推广价值较高。

Objective To study the therapeutic effect of hyperbaric oxygen combined with thioctic acid in treating diabetic foot.Methods 92 patients with diabetic foot admitted to Yudong Branch of Henan Provincial People’s Hospital between May 2020 and May 2022 were enrolled and divided into study group(n=32),control group(n=30)and blank group(n=30)based on different treatments they received.Patients in the blank group only received conventional systemic treatments,whereas on the basis of conventional systemic treatments,patients in the study group were treated with hyperbaric oxygen combined with thioctic acid,and patients in the control group were treated with thioctic acid alone.Clinical efficacy,blood glucose-related indicators,the levels of vascular function-related factors and ankle-brachial index were compared between the three groups.Results After 4 weeks of treatment,the comparison among the three groups in terms of clinical efficacy showed that the study group was obviously superior to the blank group(Z=-2429,P=0015),while there was no significant difference between the study group and the control group,and between the control group and the blank group(Z=-1415 and-1299,P=0157 and 0194).After 4 weeks of treatment,the comparison among the three groups in terms of the levels of fasting blood glucose(FBG),2-hour postprandial blood glucose(2 h PBG)and glycosylated hemoglobin(HbAlc)showed that the levels in the study group were obviously lower than those in the blank group(q=6574,6162 and 6339,all P<0001),while there was no significant difference between the study group and the control group,and between the control group and the blank group(FBG:q=3310 and 3213,P=0055 and 0065;2 h PBG:q=2840 and 3270,P=0116 and 0059;HbAlc:q=3230 and 3059,P=0063 and 0083);the comparison among the three groups in terms of the level of serum endothelin(ET)showed that the level in the study group was significantly lower than that in the control group and the blank group(q=3443 and 6630,P=0044,P<0001),while there was no significant difference between the control group and the blank group(q=3137,P=0074);the comparison among the three groups in terms of the level of serum calcitonin gene-related peptide(CGRP)and vascular endothelial growth factor(VEGF)showed that the levels in the study group were both significantly higher than those in the control group and the blank group(CGRP:q=3491 and 6883,P=0041,P<0001;VEGF:q=3467 and 6636,P=0042,P<0001),while there was no significant difference between the control group and the blank group(q=3339 and 2851,P=0053 and 0114).After 4 weeks of treatment,the ankle-brachial index of patients in the study group was significantly higher than that in the control group and the blank group(q=3947 and 7330,P=0018,P<0001),but there was no significant difference between the control group and the blank group(q=3330,P=0054).Conclusion Hyperbaric oxygen combined with thioctic acid in treating diabetic foot can help control blood glucose level,ameliorate vascular endothelial function and the degree of lower extremity vascular disease,and improve curative effect,showing high value of clinical promotion.