中药浴联合足底穴位按摩对糖尿病足患者局部组织中bFGF的影响分析
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摘要
目的探讨中药浴联合足底穴位按摩对糖尿病足患者局部组织中bFGF的影响分析。方法选取80例糖尿病足患者作为研究对象,按照随机数字表的方法分为观察组和对照组,各40例。对照组患者予以常规的饮食和降血糖治疗,观察组患者在此基础上加以中药浴联合足底穴位按摩治疗,分别对2组患者的临床疗效、中医症状分级量化表、英国糖尿病足部神经筛查量表积分及踝肱指数进行客观比较,同时观察2组患者治疗前后的局部组织中血清碱性成纤维细胞生长因子(bFGF)。结果经比较,观察组与对照组的临床总有效率分别为92.50%和72.50%,差异具有统计学意义(P <0.05);治疗前,2组患者的中医症状评分、足部神经筛查及踝肱指数差异不具有统计学意义(P> 0.05)。治疗后,观察组患者的中医症状评分、足部神经筛查及踝肱指数改善水平更显著于对照组,与治疗前和对照组比较差异显著(P <0.05),而对照组患者治疗前后的中医症状评分比较差异明显(P <0.05),但足部神经筛查及踝肱指数改善治疗前后比较不具有统计学意义(P> 0.05);此外,观察组患者治疗后的局部组织中bFGF表达水平与治疗前及对照组比较差异显著(P <0.05)。结论中药浴联合足底穴位按摩治疗糖尿病足患者的临床疗效确切,有助于提高足部神经传导功能,改善局部炎症水平,故具推广优势。
Objective To explore the effect of Chinese medicine bath combined with plantar acupoint massage on b FGF in local tissues of diabetic foot patients. Methods 80 cases of diabetic footwere selected as research subjects.The patients were divided into the observation group(n = 40) and the control group(n = 40). The patients in the control group were treated with regular diet and hypoglycemic treatment, and the observation group was treated with traditional Chinese medicine bath combined with foot acupoint massage therapy. The clinical effects, the TCM symptom grading scale, the British diabetic foot nerve screening scale integral and the ankle brachial index were compared. Meanwhile, basic fibroblast growth factor(bFGF) in the local tissues of two groups before and after treatment were observed. Results The total clinical effective rate of the observation group and the control group was 92.50% and 72.50%, respectively, and the difference was significant(P <0.05). Before the treatment, the TCM symptom score, the foot nerve screening and the ankle brachial index of the two groups were not significant(P >0.05). After treatment, the TCM symptom score, foot nerve screening and the improvement of ankle brachial index were more significant in the control group than in the control group(P<0.05), while in the control group, there were significant differences in TCM symptom scores before and after treatment(P <0.05). But there was no significant difference between the foot nerve screening and the improvement of the ankle brachial index before and after treatment(P >0.05). In addition, the level of bFGF expression in the local tissues of the observation group was significantly different from that before treatment and in the control group(P <0.05). Conclusion Traditional Chinese medicine bath combined with foot point massage is effective in the treatment of diabetic foot. It is helpful to improve the nerve conduction function of foot and improve the level of local inflammation, so it has the advantage of popularization.
Objective To explore the effect of Chinese medicine bath combined with plantar acupoint massage on b FGF in local tissues of diabetic foot patients. Methods 80 cases of diabetic footwere selected as research subjects.The patients were divided into the observation group(n = 40) and the control group(n = 40). The patients in the control group were treated with regular diet and hypoglycemic treatment, and the observation group was treated with traditional Chinese medicine bath combined with foot acupoint massage therapy. The clinical effects, the TCM symptom grading scale, the British diabetic foot nerve screening scale integral and the ankle brachial index were compared. Meanwhile, basic fibroblast growth factor(bFGF) in the local tissues of two groups before and after treatment were observed. Results The total clinical effective rate of the observation group and the control group was 92.50% and 72.50%, respectively, and the difference was significant(P <0.05). Before the treatment, the TCM symptom score, the foot nerve screening and the ankle brachial index of the two groups were not significant(P >0.05). After treatment, the TCM symptom score, foot nerve screening and the improvement of ankle brachial index were more significant in the control group than in the control group(P<0.05), while in the control group, there were significant differences in TCM symptom scores before and after treatment(P <0.05). But there was no significant difference between the foot nerve screening and the improvement of the ankle brachial index before and after treatment(P >0.05). In addition, the level of bFGF expression in the local tissues of the observation group was significantly different from that before treatment and in the control group(P <0.05). Conclusion Traditional Chinese medicine bath combined with foot point massage is effective in the treatment of diabetic foot. It is helpful to improve the nerve conduction function of foot and improve the level of local inflammation, so it has the advantage of popularization.
引文
[1]王自辉,王晓媛,张雅兰,等.清热解毒活血通络法治疗糖尿病足的研究[J].中国中西医结合杂志,2013,33(4):480-483.
[2]张净,薛耀明.2型糖尿病踝肱指数异常相关危险因素分析及对糖尿病足的预测价值[J].中华内科杂志,2013,52(11):951-955.
[3]张敏,赵志芳,朱月珍,等.蚕食清创法联合立奇膏外敷治疗糖尿病足的临床研究[J].解放军护理杂志,2013,30(15):43-44.
[4]LAVERY L A,ARMSTRONG D G,WALKER S C.Healing rates of diabetic foot ulcers associated with midfoot fracture due to Charcot’s arthropathy[J].Diabet Med,2015,14(1):46-49.
[5]LIPSKY,BENJAMIN A,BEREND T,et al.2012 Infectious diseases society of america clinical practice guideline;for the diagnosis and treatment of diabetic foot infections(reprinted;from clinical infectious diseases,vol 54,pg 132,2012)[J].Journal of American Podiatric Medical Association,2013,103(1):2-7.
[6]张静,张晓义,何红,等.糖尿病足危险因素分析[J].江苏医药,2013,39(7):821-823.
[7]王军,张庚扬,侯玉芬,等.糖尿病足溃疡期中医综合外治方案规范的多中心临床研究[J].现代中医临床,2013,20(2):30-31.
[8]曾庆明,刘春招.中西医诊疗糖尿病足概况[J].中医学报,2015,30(5):652-654.
[9]胡慧萍,陈明卫.糖尿病足溃疡愈合及截肢的相关因素分析[J].安徽医科大学学报,2016,51(11):1634-1637.
[10]黄新,代波,狄钾骐,等.外用中药治疗糖尿病足的文献应用分析[J].中医药信息,2014,31(3):40-43.
[11]姚佳春.中药活血通络剂足浴辅助治疗糖尿病足[J].吉林中医药,2016,36(1):50-53.
[12]王军,张学勇,马红莲,等.糖尿病足溃疡中医综合外治方案[J].天津中医药,2014,31(4):250-251.
[13]王丽颖,高天舒.补气活血中药足浴联合护理干预治疗早期糖尿病足病[J].长春中医药大学学报,2016,32(5):1036-1038.
[14]张兰蓉,魏丹蕾,周毅业,等.0级糖尿病足中医证型与凝血和免疫因子的相关性研究[J].世界中医药,2014,9(8):1017-1019.
[15]周甜,胡家才,邓巧莉,等.糖尿病足的中西医综合治疗进展[J].现代中西医结合杂志,2016,25(28):3189-3192.
[16]左文仁,付丽媛.糖尿病下肢血管病变及糖尿病足的中医治疗研究进展[J].中医药导报,2015,21(8):85-87.
[17]肖智慧,曹刚,黄强,等.糖尿病足的中医研究进展[J].中医药信息,2018,35(2):100-103.
[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[J].中华中医药杂志,2013,28(2):443-446.
[19]许华颖.中西医结合治疗糖尿病足病临床研究[J].中医学报,2015,30(1):38-39.
[20]单鹏翼,张学军,安瑞金,等.中医药治疗糖尿病足临床研究进展[J].河北医学,2013,19(10):1575-1577.
[2]张净,薛耀明.2型糖尿病踝肱指数异常相关危险因素分析及对糖尿病足的预测价值[J].中华内科杂志,2013,52(11):951-955.
[3]张敏,赵志芳,朱月珍,等.蚕食清创法联合立奇膏外敷治疗糖尿病足的临床研究[J].解放军护理杂志,2013,30(15):43-44.
[4]LAVERY L A,ARMSTRONG D G,WALKER S C.Healing rates of diabetic foot ulcers associated with midfoot fracture due to Charcot’s arthropathy[J].Diabet Med,2015,14(1):46-49.
[5]LIPSKY,BENJAMIN A,BEREND T,et al.2012 Infectious diseases society of america clinical practice guideline;for the diagnosis and treatment of diabetic foot infections(reprinted;from clinical infectious diseases,vol 54,pg 132,2012)[J].Journal of American Podiatric Medical Association,2013,103(1):2-7.
[6]张静,张晓义,何红,等.糖尿病足危险因素分析[J].江苏医药,2013,39(7):821-823.
[7]王军,张庚扬,侯玉芬,等.糖尿病足溃疡期中医综合外治方案规范的多中心临床研究[J].现代中医临床,2013,20(2):30-31.
[8]曾庆明,刘春招.中西医诊疗糖尿病足概况[J].中医学报,2015,30(5):652-654.
[9]胡慧萍,陈明卫.糖尿病足溃疡愈合及截肢的相关因素分析[J].安徽医科大学学报,2016,51(11):1634-1637.
[10]黄新,代波,狄钾骐,等.外用中药治疗糖尿病足的文献应用分析[J].中医药信息,2014,31(3):40-43.
[11]姚佳春.中药活血通络剂足浴辅助治疗糖尿病足[J].吉林中医药,2016,36(1):50-53.
[12]王军,张学勇,马红莲,等.糖尿病足溃疡中医综合外治方案[J].天津中医药,2014,31(4):250-251.
[13]王丽颖,高天舒.补气活血中药足浴联合护理干预治疗早期糖尿病足病[J].长春中医药大学学报,2016,32(5):1036-1038.
[14]张兰蓉,魏丹蕾,周毅业,等.0级糖尿病足中医证型与凝血和免疫因子的相关性研究[J].世界中医药,2014,9(8):1017-1019.
[15]周甜,胡家才,邓巧莉,等.糖尿病足的中西医综合治疗进展[J].现代中西医结合杂志,2016,25(28):3189-3192.
[16]左文仁,付丽媛.糖尿病下肢血管病变及糖尿病足的中医治疗研究进展[J].中医药导报,2015,21(8):85-87.
[17]肖智慧,曹刚,黄强,等.糖尿病足的中医研究进展[J].中医药信息,2018,35(2):100-103.
[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[J].中华中医药杂志,2013,28(2):443-446.
[19]许华颖.中西医结合治疗糖尿病足病临床研究[J].中医学报,2015,30(1):38-39.
[20]单鹏翼,张学军,安瑞金,等.中医药治疗糖尿病足临床研究进展[J].河北医学,2013,19(10):1575-1577.