中医特色外治方案治疗Wagner2～4级糖尿病足溃疡临床观察
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摘要
目的:观察中医特色外治方案治疗Wagner2～4级糖尿病足溃疡的临床疗效。方法:将符合纳入标准的90例糖尿病足溃疡患者随机分为试验组和对照组,各45例。在内科治疗基础上,试验组采用中医特色外治方案治疗,对照组采用常规外科治疗方案治疗,观察两种治疗方案的临床疗效。结果:试验组总有效率为88.89%(40/45),治愈率55.56%(25/45);对照组总有效率为77.78%(35/45),治愈率为35.56%(16/45),两组总有效率比较差异具有统计学意义(Z=-2.210,P=0.027)。试验组截肢率为2.22%(1/45),对照组截肢率为17.78%(8/45),两组比较差异具有统计学意义(P<0.05);治疗后试验组脓液量、脓液色、肉芽颜色、周围皮温、疼痛感及创面面积积分均显著优于对照组(P<0.05)。结论:中医特色外治方案治疗Wagner2～4级糖尿病足溃疡临床疗效显著,能有效降低后期截肢风险,具有一定社会经济效益,适宜在临床推广应用。
Objective: To observe the clinical effect of treating diabetic foot ulcer with characteristic external therapy of traditional Chinese medicine. Methods: Ninety patients with diabetic foot ulcer who met the inclusion criteria were randomly divided into the experimental group and the control group, 45 cases in each group. On the basis of the same medicine treatment,the experimental group was treated with the characteristic external therapy scheme of traditional Chinese medicine, while the control group was treated with the conventional surgical management. The clinical efficacy of characteristic external therapy of traditional Chinese medicine and conventional surgical management was compared. Results: The total effective rate and cure rate of the experimental group was 88.89%(40/45) and 55.56%(25/45). The total effective rate and cure rate of the control group was 77.78%(35/45) and 35.56%(16/45). There was a statistical difference between the two groups(Z=-2.210, P=0.027). The amputation rate of the experimental group and the control group was 2.22%(1/45) and 17.78%(8/45) separately. There was a statistical difference between the two groups(P<0.05). After treatment, there were statistical differences in pus amount and color,granulation color, skin temperature, pain and wound area scores between the experimental group and the control group(P<0.05).Conclusion: The clinical treatment of Wagner2～4 diabetic foot ulcer with characteristic external therapy scheme of traditional Chinese medicine is significant, which can effectively reduce the risk of amputation, has certain social economic benefits, and it is suitable for clinical application.
Objective: To observe the clinical effect of treating diabetic foot ulcer with characteristic external therapy of traditional Chinese medicine. Methods: Ninety patients with diabetic foot ulcer who met the inclusion criteria were randomly divided into the experimental group and the control group, 45 cases in each group. On the basis of the same medicine treatment,the experimental group was treated with the characteristic external therapy scheme of traditional Chinese medicine, while the control group was treated with the conventional surgical management. The clinical efficacy of characteristic external therapy of traditional Chinese medicine and conventional surgical management was compared. Results: The total effective rate and cure rate of the experimental group was 88.89%(40/45) and 55.56%(25/45). The total effective rate and cure rate of the control group was 77.78%(35/45) and 35.56%(16/45). There was a statistical difference between the two groups(Z=-2.210, P=0.027). The amputation rate of the experimental group and the control group was 2.22%(1/45) and 17.78%(8/45) separately. There was a statistical difference between the two groups(P<0.05). After treatment, there were statistical differences in pus amount and color,granulation color, skin temperature, pain and wound area scores between the experimental group and the control group(P<0.05).Conclusion: The clinical treatment of Wagner2～4 diabetic foot ulcer with characteristic external therapy scheme of traditional Chinese medicine is significant, which can effectively reduce the risk of amputation, has certain social economic benefits, and it is suitable for clinical application.
引文
[1]Zhang P,Lu J,Jing Y,et al.Global epidemiology of diabetic foot ulceration:a systematic review and meta-analysis.Ann Med,2017,49(2):106-116
[2]郑月宏,刘端.糖尿病足血管病变的外科治疗.中华糖尿病杂志,2016,8(7):388-391
[3]国际糖尿病足工作组.糖尿病足国际临床指南.北京:人民军医出版社,2004:2
[4]Leila Y.Literature review on the management of diabetic foot ulcer.World Journal of Diabetes,2015,6(1):37-53
[5]王娟,张如峰,李进龙.奚九一教授诊治糖尿病足经验.陕西中医,2007,28(3):320-321
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版).中国实用内科杂志,2018,38(4):292-344
[7]奚九一,赵兆琳,吴伟达,等.对糖尿病足诊治的几点新看法.中国实用外科杂志,1998(9):53-55
[8]中国糖尿病足细胞与介入治疗技术联盟.糖尿病足介入综合诊治临床指南.4版.中国介入影像与治疗学,2018,15(1):3-12
[9]柳国斌,奚九一,张磊,等.一种治疗糖尿病足的外用中药软膏制剂,ZL201010186284.X:2011-11-30
[10]李云平,矫浩然,王刚,等.关于糖尿病足溃疡中医证候疗效评价体系探讨.天津中医药,2012,29(3):251-253
[11]郑筱萸.中药新药临床研究指导原则.北京:中国医药科技出版社,2002:85-86
[12]Prabhu Dayal Sinwar.The diabetic foot management-recent advance.International Journal of Surgery,2015,15(2):27-30
[13]Pinelopi Grigoropoulou,Ioanna Eleftheriadou,Edward B Jude,et al.Diabetic foot infections:an update in diagnosis and management.Curr Diab Rep,2017,17(1).DOI 10.1007/s11892-017-0831-1
[14]国际糖尿病足工作组.糖尿病足国际临床指南.北京:人民军医出版社,2003:5
[15]王琦威,曹雯,刘凯,等.中西医结合治疗糖尿病足疗效的Meta分析.中华中医药学刊,2017,35(1):112-114
[16]赵炳瑞,韩大为.糖尿病足中医外治法治疗进展.世界最新医学信息文摘,2018,18(98):139-140
[17]贾湘隆,徐旭英.回阳生肌膏治疗糖尿病足阴证疮面述要.中华中医药杂志,2019,34(1):267-269
[18]金真,林明欣,林燕玲,等.运用中医外治三联模式治疗0级糖尿病足40例临床观察.中华中医药杂志,2013,28(2):443-446
[19]柳国斌,张磊,闫少庆,等.清筋术治疗糖尿病足疗效观察.上海中医药大学学报,2009,23(6):22-24
[20]牛东霞,李西林,夏晶,等.紫朱软膏质量标准研究.中国中医药信息杂志,2014,21(6):95-97
[21]韦婧,刘萍.黄芪提取物作用于巨噬细胞的研究进展.时珍国医国药,2018,29(7):1710-1712
[22]毛跟年,郭倩,瞿建波,等.阿胶化学成分及药理作用研究进展.动物医学进展,2010,31(11):83-85
[23]张宪发.龙血竭对糖尿病大鼠烫伤创面修复作用的实验研究.南宁:广西医科大学,2012
[24]陈改英,林默君.TRPM8与血管张力的调控.国际心血管病杂志,2013,40(3):151-154
[25]谭巧珠,刘志滔,李岑,等.朱砂外用制剂促进创面愈合的研究进展.华西药学杂志,2017,32(4):442-446
[26]李蒙娜,闫言,王宝玺.紫草素促进皮肤伤口愈合机制研究进展.中医药学报,2018,46(2):124-128
[2]郑月宏,刘端.糖尿病足血管病变的外科治疗.中华糖尿病杂志,2016,8(7):388-391
[3]国际糖尿病足工作组.糖尿病足国际临床指南.北京:人民军医出版社,2004:2
[4]Leila Y.Literature review on the management of diabetic foot ulcer.World Journal of Diabetes,2015,6(1):37-53
[5]王娟,张如峰,李进龙.奚九一教授诊治糖尿病足经验.陕西中医,2007,28(3):320-321
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版).中国实用内科杂志,2018,38(4):292-344
[7]奚九一,赵兆琳,吴伟达,等.对糖尿病足诊治的几点新看法.中国实用外科杂志,1998(9):53-55
[8]中国糖尿病足细胞与介入治疗技术联盟.糖尿病足介入综合诊治临床指南.4版.中国介入影像与治疗学,2018,15(1):3-12
[9]柳国斌,奚九一,张磊,等.一种治疗糖尿病足的外用中药软膏制剂,ZL201010186284.X:2011-11-30
[10]李云平,矫浩然,王刚,等.关于糖尿病足溃疡中医证候疗效评价体系探讨.天津中医药,2012,29(3):251-253
[11]郑筱萸.中药新药临床研究指导原则.北京:中国医药科技出版社,2002:85-86
[12]Prabhu Dayal Sinwar.The diabetic foot management-recent advance.International Journal of Surgery,2015,15(2):27-30
[13]Pinelopi Grigoropoulou,Ioanna Eleftheriadou,Edward B Jude,et al.Diabetic foot infections:an update in diagnosis and management.Curr Diab Rep,2017,17(1).DOI 10.1007/s11892-017-0831-1
[14]国际糖尿病足工作组.糖尿病足国际临床指南.北京:人民军医出版社,2003:5
[15]王琦威,曹雯,刘凯,等.中西医结合治疗糖尿病足疗效的Meta分析.中华中医药学刊,2017,35(1):112-114
[16]赵炳瑞,韩大为.糖尿病足中医外治法治疗进展.世界最新医学信息文摘,2018,18(98):139-140
[17]贾湘隆,徐旭英.回阳生肌膏治疗糖尿病足阴证疮面述要.中华中医药杂志,2019,34(1):267-269
[18]金真,林明欣,林燕玲,等.运用中医外治三联模式治疗0级糖尿病足40例临床观察.中华中医药杂志,2013,28(2):443-446
[19]柳国斌,张磊,闫少庆,等.清筋术治疗糖尿病足疗效观察.上海中医药大学学报,2009,23(6):22-24
[20]牛东霞,李西林,夏晶,等.紫朱软膏质量标准研究.中国中医药信息杂志,2014,21(6):95-97
[21]韦婧,刘萍.黄芪提取物作用于巨噬细胞的研究进展.时珍国医国药,2018,29(7):1710-1712
[22]毛跟年,郭倩,瞿建波,等.阿胶化学成分及药理作用研究进展.动物医学进展,2010,31(11):83-85
[23]张宪发.龙血竭对糖尿病大鼠烫伤创面修复作用的实验研究.南宁:广西医科大学,2012
[24]陈改英,林默君.TRPM8与血管张力的调控.国际心血管病杂志,2013,40(3):151-154
[25]谭巧珠,刘志滔,李岑,等.朱砂外用制剂促进创面愈合的研究进展.华西药学杂志,2017,32(4):442-446
[26]李蒙娜,闫言,王宝玺.紫草素促进皮肤伤口愈合机制研究进展.中医药学报,2018,46(2):124-128