摘要
目的探讨通络疽愈方内服联合活血止痛洗剂对糖尿病足溃疡(DFU)患者创面愈合程度、内皮生长因子及纤维蛋白原水平变化影响。方法选择医院2017年1月—2018年10月期间收治85例DFU患者作为本次研究对象,通过随机数字表随机分为中药干预组和对照组。对照组42例患者在介入治疗后给予低分子肝素钙5000 IU皮下注射3 d,前列地尔10μg静脉滴注,和西洛他唑口服100 mg/次,2次/d。中药干预组43例患者在对照组治疗的基础上给予通络疽愈方内服联合活血止痛洗剂治疗。两组均在治疗4周后评价临床效果,并比较炎症因子、血管内皮功能、生长因子及纤维蛋白原水平。结果中药干预组总有效率为88.37%,对照组总有效率为76.19%,中药干预组临床疗效优于对照组(P<0.05);两组创面深度、中医证候积分均显著下降(P<0.05),与对照组比较,治疗2、4周时,中药干预组创面深度、中医证候积分降低作用显著(P<0.05);中药干预组治疗2、4周创面愈合率均高于对照组(P<0.05);两组WBC、NE%、CRP、纤维蛋白原含量均有显著降低(P<0.05),与对照组比较,治疗2、4周时,中药干预组WBC、NE%、CRP、纤维蛋白原降低作用显著(P<0.05);两组血清IL-1含量在治疗2周时升高,治疗4周时降低,中药干预组在治疗2、4周时IL-1水平均显著低于对照组(P<0.05);两组VEGF、EGF、b FGF均有显著升高(P<0.05),与对照组比较,治疗2、4周时,中药干预组VEGF、EGF、b FGF升高作用显著(P<0.05);两组NO显著升高(P<0.05),ET、TXB2显著降低(P<0.05),与对照组比较,治疗2、4周时,中药干预组NO升高作用显著(P<0.05),ET、TXB2降低作用显著(P<0.05)。结论通络疽愈方内服联合活血止痛洗剂治疗DFU患者能够显著缓解症状,促进创面愈合,可能与抑制WBC、NE%、CRP、IL-1及纤维蛋白原水平,促进VEGF、EGF、b FGF等生长因子,改善血管内皮功能有关。
Objective To explore the effect of Tongluo Juyu Decoction combined with Huoxue Zhitong Lotion on wound healing,endothelial growth factor and fibrinogen level in diabetic foot ulcer(DFU)patients.Methods 85 patients with DFU admitted to the hospital from January 2017 to October 2018 were selected as the subjects of this study.They were randomly divided into Chinese medicine intervention group and control group through the random number table.42 patients in the control group were given low molecular weight heparin calcium 5000 IU subcutaneously for 3 days,alprostadil 10μg intravenous drip,and cilostazol 100 mg/time,twice a day.On the basis of the treatment in the control group,the intervention group was treated with Tongluo Juyu Decoction and Huoxue Zhitong Lotion.The clinical effects of the two groups were evaluated after 4 weeks of treatment,and the levels of inflammatory factors,vascular endothelial function,growth factors and fibrinogen were compared.Results The total effective rate was 88.37%in the intervention group and 76.19%in the control group;The wound depth and TCM syndrome score of the two groups decreased significantly(P<0.05),compared with the control group,the depth of wound and TCM syndrome score in the TCM intervention group decreased significantly(P<0.05).The wound healing rate of the TCM intervention group was higher than that of the control group(P<0.05);Compared with the control group,WBC,NE%,CRP and fibrinogen decreased significantly(P<0.05);The level of IL-1 in the two groups increased at the 2 nd week of treatment and decreased at the 4 th week of treatment.The level of IL-1 in the intervention group was significantly lower than that in the control group at the 2 nd and 4 th week of treatment(P<0.05).VEGF,EGF and b FGF were significantly increased in the two groups(P<0.05),and the effect of TCM intervention group is more significant(P<0.05).NO was significantly increased in the two groups(P<0.05),ET and TXB2 were significantly decreased in two groups(P<0.05),and NO in the intervention group was higher than that in the control group(P<0.05),ET and TXB2 were lower than that in the control group(P<0.05).Conclusion Tongluo Juyu Decoction combined with Huoxue Zhitong Lotion can significantly alleviate symptoms and promote wound healing in DFU patients,which may be related to the inhibition of WBC,NE%,CRP,IL-1 and fibrinogen levels,the promotion of VEGF,EGF,b FGF and other growth factors,and the improvement of vascular endothelial function.
作者
李恒
寇谦
周小茜
LI Heng;KOU Qian;ZHOU Xiaoqian(Ninth Hospital of Xi'an,Xi'an 710054,Shaanxi,China)
出处
《辽宁中医药大学学报》
CAS
2020年第8期85-89,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
陕西省科学重点研发计划(2018SF-8856)
作者简介
李恒(1974-),女,河北定兴人,副主任医师,学士,研究方向:中医内科;通讯作者:周小茜(1974-),女,上海人,副主任医师,学士,研究方向:创面,瘢痕临床治疗。
