阴阳合愈汤联合生长因子凝胶治疗糖尿病足湿性溃疡患者的效果观察

Effect observation of Yinyang Heyu decoction combined with growth factor gel in the treatment of patients with diabetic foot wet ulcer

目的:探讨阴阳合愈汤联合生长因子凝胶(Growth Factor Gel,GFG)治疗糖尿病足湿性溃疡患者的效果。方法:选择于2019年1月―2021年12月医院收治的糖尿病足湿性溃疡患者90例作为研究对象,随机数字表法分为三组,各30例,A组采取常规换药治疗,B组采取GFG治疗,C组在B组基础上给予阴阳合愈汤治疗,测定治疗前后患者的β-连环蛋白(β-catenin)、糖原合酶激酶-3β(Glycogen Synthase Kinase-3β,GSK-3β)、含半胱氨酸的天冬氨酸蛋白水解酶-3(Cysteine-containing Aspartate Proteolytic Enzyme 3,Caspase-3)、B细胞淋巴瘤-2基因相关X蛋白(B-cell Lymphoma-2Associated X protein,Bax)凋亡基因表达量,测定血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)、胰岛素样生长因子-1(Insulin-like Growth Factor-1,IGF-1)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)细胞生长因子含量,测量并计算溃疡面积和深度。结果:治疗后,C组β-catenin显著高于A组和B组,GSK-3β、Caspase 3、BAX显著低于A组和B组,B组各指标显著优于A组(P <0.05)。治疗后,C组VEGF、IGF-1显著高于A组和B组,TNF-α、IL-6显著低于A组和B组,B组各指标显著优于A组(P <0.05)。治疗后,C组溃疡面积及深度显著低于A组和B组,B组各指标显著优于A组(P <0.05)。结论:针对糖尿病足湿性溃疡患者采取阴阳合愈汤联合GFG治疗可恢复凋亡基因表达量及细胞因子含量,抑制创面炎症反应,促进创面的修复,修复溃疡皮肤,治疗效果好,值得推广。

Objective:To investigate the effects of Yinyang Heyu decoction(阴阳合愈汤)combined with growth factor gel(GFG)in the treatment of patients with diabetic foot wet ulcer.Methods:A total of 90 patients with diabetic foot wet ulcers from January 2019 to December 2021 were selected as study subjects,and were randomly divided into three groups,with 30 patients in each group,group A was treated by routine dressing change,group B was treated with GFG,and group C was treated with Yinyang Heyu decoction on the basis of the treatment in group B.The expression levels of apoptotic genesβ-catenin,glycogen synthase kinase-3β(GSK-3β),caspase-3 and Bcl-2 associated X protein(Bax)were measured before and after treatment.The contents of vascular endothelial growth factor(VEGF),insulin-like growth factor 1(IGF-1),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured,and the ulcer area and depth were calculated.Results:After treatment,β-catenin in group C was significantly higher than that in group A and group B,GSK-3β,caspase-3 and BAX were significantly lower than those in group A and group B,and the indexes in group B were significantly better than those in group A(P<0.05).After treatment,VEGF and IGF-1 in group C were significantly higher than those in groups A and B,TNF-αand IL-6 were significantly lower than those in groups A and B,and the indexes in group B were significantly better than those in group A(P<0.05).After treatment,the ulcer area and depth in group C were significantly lower than those in groups A and B,and the indexes in group B were significantly better than those in group A(P<0.05).Conclusion:For patients with diabetic foot wet ulcer,Yinyang Heyu decoction combined with GFG can restore apoptotic gene expression and cytokine content,inhibit wound inflammation,promote wound repair,and repair ulcer skin,and the therapeutic effect is good,which is worthy of promotion.