依帕司他胶囊联合银锌霜对糖尿病足溃疡患者创面愈合及踝肱指数的影响

Effect of Epalrestat Capsules Combined with Silver Zinc Cream on Wound Healing and Ankle Brachial Index in Patients with Diabetic Foot Ulcer

目的:观察依帕司他胶囊联合银锌霜治疗糖尿病足溃疡(DFU)的疗效。方法:选择2020年6月~2023年6月某院收治的86例DFU患者作为研究对象,采用随机数字表法分为对照组和观察组,每组43例。两组均参照《中国2型糖尿病防治指南》(2013年版)予以常规治疗,对照组在常规治疗基础上予以依帕司他胶囊,观察组在对照组治疗基础上加用银锌霜。比较两组患者创面愈合情况、下肢皮温、踝肱指数、下肢疼痛程度、下肢血管功能[收缩期峰值血流速度(PSV)、内膜中层厚度(IMT)、血管弹性程度]、内皮抑素、碱性成纤维生长因子(bFGF)、血管内皮生长因子(VEGF)、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)]。结果:治疗后,两组患者下肢皮温、下肢疼痛程度、IMT、内皮抑素、CRP、TNF-α、IL-1β均低于治疗前(P<0.05),且观察组各指标水平低于对照组(P<0.05)。治疗后,两组患者踝肱指数、PSV、血管弹性程度、bFGF、VEGF均高于治疗前(P<0.05),且观察组高于对照组(P<0.05)。观察组的创面愈合时间短于对照组(P<0.05),创面愈合率高于对照组(P<0.05)。结论:依帕司他胶囊联合银锌霜可提高DFU患者的创面愈合率,缩短创面愈合时间,改善下肢皮温、踝肱指数、下肢血管功能,缓解下肢疼痛程度,可能与调节内皮抑素、bFGF、VEGF及炎症因子等的表达水平有关。

Objective:To observe the efficacy of epalrestat capsules combined with silver zinc cream in the treatment of diabetic foot ulcer(DFU).Methods:Eighty-six patients with DFU admitted to a hospital during June 2020 to June 2023 were divided into control group and observation group by a random number table method with 43 cases in each group.In addition to the standard of care given according to China Prevention and Treatment Guidelines of Type 2 Diabetes Mellitus(2013 edition),the control group was treated with epalrestat capsules on the basis of coventional treatment,and the observation group added silver zinc cream to the treatment of the control group.Wound healing,lower limb skin temperature,ankle-brachial index,lower limb pain,lower limb vascular function[peak systolic blood flow velocity(PSV),intima-media thickness(IMT),vascular elasticity],endostatin,basic fibroblast growth factor(bFGF),vascular endothelial growth factor(VEGF),inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)]were compared between the two groups.Results:After treatment,the levels of skin temperature of lower extremities,pain of lower extremities,IMT,endostatin,CRP,TNF-α,IL-1βin both groups were lower than those before treatment(P<0.05),and lower in the observation group than in the control group(P<0.05).After treatment,the ankle-brachial index,PSV,vascular elasticity,bFGF and VEGF in both groups were higher than those before treatment(P<0.05),and were higher in the observation group than in the control group(P<0.05).The time to wound healing of the observation group was shorter than that of the control group(P<0.05),and the wound healing rate was higher than that of the control group(P<0.05).Conclusion:Epalrestat capsules combined with silver zinc cream can improve the wound healing rate,shorten the time to wound healing,and improve the skin temperature,ankle-brachial index,vascular function of lower extremity and alleviation of lower extremity pain in DFU patients,which may be related to the regulation of endostatin,bFGF,VEGF and inflammatory factors.