贝前列素钠片联合当归黄芪汤对糖尿病足溃疡患者创面愈合、血管新生及氧化应激的影响

Effects of Beraprost Sodium Tablets Combined with Danggui Huangqi Decoction(当归黄芪汤)on Wound Healing,Angiogenesis and Oxidative Stress in Diabetic Foot Ulcer Patients

目的探讨贝前列素钠片联合当归黄芪汤对糖尿病足溃疡(Diabetes foot ulcer, DFU)患者创面愈合、血管新生及氧化应激的作用,为临床治疗糖尿病足溃疡提供理论依据。方法选取2019年10月—2022年10月收入医院的90例糖尿病足溃疡患者随机分为治疗组与对照组,治疗组采用贝前列素钠片联合当归黄芪汤治疗,对照组单纯应用贝前列素钠片口服,每次40μg, 3次/d,连续治疗30 d。通过对比创面面积、局部疼痛程度情况、足背血流动力学指标[足背血管内径、血流流速]、血管生成因子[血管生成因子(Vascular endothelial growth factor, VEGF)、血小板衍生生长因子(Platelet derived growth factor, PDGF)、内皮抑素(Endostatin, ES)]表达、氧化应激检测指标[晚期蛋白氧化产物(Advanced oxidation protein products, AOPP)、超氧化物歧化酶(Superoxide dismutase, SOD)、丙二醛(Malondialdehyde, MDA)]分析两组临床疗效以及不良反应发生率。结果经治疗后,治疗组总有效率(88.89%,40/45)高于对照组(71.11%,32/45)(P<0.05);治疗组溃疡创面小于对照组(P<0.05);治疗组视觉模拟评分法(Visual analogue scale, VAS)评分低于对照组(P<0.05);治疗组足背血管内径及血流流速均高于对照组(P<0.05);治疗组VEGF、PDGF含量显著高于对照组,ES含量显著低于对照组(P<0.05);治疗组AOPP及MDA含量显著低于对照组,SOD含量显著高于对照组(P<0.05);治疗组不良反应发生率显著低于对照组(P<0.05)。结论贝前列素钠片联合当归黄芪汤可显著提高糖尿病足溃疡患者的疗效,促进创面愈合、血管新生,抑制氧化应激反应,减轻患者痛苦,对改善患者生活质量具有重要作用。

Objective To discuss the effects of Beraprost Sodium Tablets combined with Danggui Huangqi Decoction(当归黄芪汤)on wound healing,angiogenesis and oxidative stress in diabetic foot ulcer(DFU)patients.Methods Ninety patients with DFU in the hospital from October 2019 to October 2022 were randomly classified into two groups.The treatment group received Beraprost Sodium Tablets combined with Danggui Huangqi Decoction,while the control group administered Beraprost Sodium Tablets orally once with the dose of 40μg,3 times a day for 30 d.Wound area,local pain degree,hemodynamic indexes of dorsal artery[blood vessel diameter,blood flow velocity],expression of pro-angiogenic growth factors[vascular endothelial growth factor(VEGF),platelet-derived growth factor(PDGF),endostatin(ES)],oxidative stress detection indexes[advanced oxidation protein products(AOPP),superoxide dismutase(SOD),malondialdehyde(MDA)],clinical efficacy and incidence rate of adverse reactions were analyzed in both groups.Results The total efficacy rate was(88.89%,40/45)in the treatment group,which was higher than(71.11%,32/45)in the control group with statistical difference(P<0.05).The wound area of the treatment group was smaller than that of the control group(P<0.05).The treatment group scored lower on visual analogue scale(VAS)than the control group(P<0.05).The treatment group had higher expressions of VEGF and PDGF,and lower expression of ES than the control group with statistical difference(P<0.05).The levels of AOPP and MDA were lower and SOD levels were higher in the treatment group than those in the control group(P<0.05).The adverse reaction rate of the treatment group was lower than that of the control group(P<0.05).Conclusion Application of Beraprost Sodium Tablets combined with Danggui Huangqi Decoction in the treatment of DFU can effectively promote the wound recovery and angiogenesis,alleviate the pain,attenuate the oxidative stress and improve the quality of life in patients.