清热解毒活血通络法治疗糖尿病足的研究  

Treatment of Diabetic Foot by Clearing Heat, Detoxification, Activating Blood, and Dredging Collaterals Method

作　　者：王自辉[1] 王晓媛[1] 张雅兰[1] 赵玲 李红霞[3] 

机构地区：[1]河北医科大学第二医院中医外科,石家庄050000 [2]河北省鹿泉市人民医院内科,河北050200 [3]河北以岭医院康复科,石家庄050091

出　　处：《中国中西医结合杂志》2013年第4期480-483,共4页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨清热解毒活血通络法治疗糖尿病足的作用机制。方法将60例糖尿病足患者随机分为治疗组和对照组,每组30例,在相同基础治疗下,治疗组采用中药清解通络方口服+中药外洗+祛腐生肌药捻换药,对照组西医常规无菌换药治疗。3个月为1个疗程,治疗前后检测患肢创面面积和碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)含量、周围血管和神经传导功能,并观察治疗效果。结果治疗组治愈15例(50.0%),显效12例,有效2例,无效1例,总有效率96.7%;对照组分别依次为9(30.0%)、6、8、7例,总有效率76.7%;治疗组总有效率优于对照组(P<0.01)。两组治疗后创面bFGF和VEGF含量均明显增高(P<0.01),且治疗组优于对照组(P<0.01);两组治疗后足背动脉血流速度、足背动脉血管内径及腓总神经传导速度均有改善(P<0.05,P<0.01),且治疗组优于对照组(P<0.01)。结论清解通络方口服与外洗相结合,配合祛腐生肌药捻换药,可以促进糖尿病足溃疡愈合,血管和神经功能改善,疗效优于西医常规治疗。Objective To study the mechanism of treating diabetic foot by clearing heat, detoxification, activating blood, and dredging collaterals method. Methods Sixty diabetic foot patients were randomly assigned to the treatment group and the control group, 30 cases in each group. On the basis of the same routine treatment, patients in the treatment group were treated by Qingjie Tongluo Recipe （QTR） plus external washing of Chinese herbs plus external dressing by herbs with removing necrosis and promoting granulation actions, while those in the control group were treated with routine aseptic external dressing. Three months was taken as one therapeutic course. The wound area and basic fibroblast growth factor （bFGF） were detected before and after treatment. The content of vascular endothelial growth factor （VEGF）, the peripheral vascular and nerve functions were also measured. The therapeutic effects were also observed. Results After treatment, in the treatment group,15 patients were cured, 12 markedly effective, 2 effective, 1 ineffective, the cure rate was 50.0% and the total effective rate was 96.7%, while in the control group, 9 cases were cured, 6 markedly effective, 8 effective, 7 ineffective, the cure rate was 30.0% and the total effective rate was 76.7%. The total effective rate was better in the treatment group than in the control group （P0.01）. The contents of bFGF and VEGF were significantly higher in the two groups after treatment （P0.01）. Besides, better results were obtained in the treatment group （P0.01）. The blood flow speed of the dorsalis pedis artery, the inner diameter of the dorsalis pedis artery, and the common peroneal nerve conduction velocity were somewhat improved （P0.05, P0.01）. Besides, better results were obtained in the treatment group （P0.01）. Conclusions QTR combined external washing plus external dressing by herbs with removing necrosis and promoting granulation actions could promote the healing of diabetic foot induced ulcers, improve the vascular and nerve

关 键 词：糖尿病足 清热解毒活血通络 祛腐生肌 碱性成纤维细胞生长因子 血管内皮生长因子 

分 类 号：R259[医药卫生—中西医结合] R269[医药卫生—中医内科学]