自体富血小板凝胶联合复方多黏菌素B软膏对糖尿病足患者创面修复和炎症指标及生命质量的影响

Effects of autologous platelet rich gel combined with compound polymyxin B ointment on wound repair and inflammatory indexes and quality of life in diabetic foot patients

目的分析自体富血小板凝胶联合复方多黏菌素B软膏对糖尿病足(diabetic foot,DF)患者创面修复、炎症指标及生命质量的影响。方法选取2022年1—12月于九江市第一人民医院就诊的72例DF患者作为研究对象,按照随机数字表法分为凝胶组与联合组,每组36例。凝胶组给予自体富血小板凝胶治疗,联合组给予复方多黏菌素B软膏联合自体富血小板凝胶治疗。比较两组临床疗效、足部创面面积、炎症指标[C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factorɑ,TNF-α)]及生命质量。结果联合组治疗总有效率为94.44%,高于凝胶组的77.78%,差异有统计学意义(P<0.05)。治疗前、治疗7 d后,两组足部创面面积比较差异无统计学意义;治疗14、21、28 d后,联合组足部创面面积均小于凝胶组,差异有统计学意义(P<0.05)。治疗28 d后,两组血清CRP、TNF-α、IL-6水平均低于治疗前,且联合组低于凝胶组,差异有统计学意义(P<0.05)。治疗28 d后,两组生理功能、生理职能、躯体疼痛、一般健康状况、情感职能、精力、精神健康、社会功能评分均高于治疗前,且联合组高于凝胶组,差异有统计学意义(P<0.05)。结论自体富血小板凝胶联合复方多黏菌素B软膏治疗DF的效果确切,可促进患者足部创面修复,减轻机体炎症反应,提高生命质量。

Objective To analyze the effects of autologous platelet rich gel combined with compound polymyxin B ointment on wound repair,inflammatory indexes and quality of life in diabetic foot(DF)patients.Methods A total of 72 diabetic foot patients admitted to the First People's Hospital of Jiujiang City from January to December 2022 were selected as the study subjects,and they were divided into the gel group and the combined group,according to random number table method,with 36 cases in each group.The gel group was treated with autologous platelet rich gel,and the combined group was treated with compound polymyxin B ointment combined with autologous platelet rich gel.The clinical efficacy,food wound area,inflammatory indexes(C-reactive protein[CRP],interleukin-6[IL-6],tumor necrosis factor-α[TNF-α])and quality of life were compared between the two groups.Results The total effective rate in the combined group was 94.44%,which was higher than 77.78%in the gel group,the difference was statistically significant(P<0.05).Before treatment and after 7 d of treatment,there was no significant difference in foot wound area between the two groups;after 14,21,28 d of treatment,the foot wound area in the combined group was smaller than that in the gel group,and the differences were statistically significant(P<0.05).After 28 d of treatment,serum CRP,TNF-αand IL-6 levels of the two groups were lower than before treatment,and the combined group was lower than the gel group,the differences were statistically significant(P<0.05).After 28 d of treatment,the scores of physiological function,physiological function,physical pain,general health,emotional function,energy,mental health and social function of the two groups were higher than before treatment,and the combined group was higher than the gel group,and the differences were statistically significant(P<0.05).Conclusion Autologous platelet rich gel combined with compound polymyxin B ointment has a definite effect in the treatment of DF,which can promote foot wound repair,reduce the inflammatory response of patients and improve the quality of life of patients.