四妙勇安汤合仙方活命饮联合拔腐祛瘀方与生肌散分期外敷治疗湿热内蕴型糖尿病足(脱疽)78例临床观察  

Clinical Observation of Treating Damp Type of Diabetic Foot 78 Cases with Simiao Tang Xian Fang Huo Ming Yin combined together to pull rot Stasis and Shengjisan staging topical

作　　者：李智[1] 李国信[2] 赵婷婷[3] 

机构地区：[1]辽宁中医药大学第二临床学院 [2]辽宁中医药大学附属第二医院外科 [3]沈阳师范大学门诊部,沈阳110034

出　　处：《实用中医内科杂志》2015年第1期31-33,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察四妙勇安汤合仙方活命饮联合拔腐祛瘀方与生肌散分期外敷治疗湿热内蕴型糖尿病足（脱疽）疗效。[方法]使用前瞻性设计方法,对78例住院患者使用四妙勇安汤合仙方活命饮（玄参30g,金银花20g,当归30g,黄柏51g,苍术15g,天花粉20g,丹皮、赤芍各15g,白芷10g,贝母、防风各6g,赤芍10g,皂角刺、穿山甲、天花粉、乳香、没药各6g,陈皮10g,甘草15g）,1剂/d,水煎200m L,早晚口服。初期,拔腐祛瘀方（生川乌、防风、川红花、当归尾、荆芥、细辛、川断、独活、羌活、吴茱萸、艾叶、伸筋草、乳香、没药、大血藤）,研磨成粉,过150目筛,各取等量混匀,香油调和,根据患足红肿范围敷药,敷药范围应超过红肿范围2cm,厚度约1.0-1.5mm,1次/d;后期,生肌散,滑石、冰片、朱砂、黄柏、白蔹,研磨成粉,过200目筛,各取等量混匀,用法同上,1次/d。连续治疗4周为1疗程。观测临床症状、局部症状体征积分、理化检查指标、不良反应。治疗1疗程,判定疗效。[结果]痊愈57例,显效11例,有效3例,无效6例,总有效率92.30%。局部症状体征积分、血流变指标均有降低（P〈0.01）。临床疗效与糖尿病足分级呈负相关关系（P〈0.05）。[结论]四妙勇安汤合仙方活命饮联合拔腐祛瘀方与生肌散分期外敷治疗湿热内蕴型糖尿病足（脱疽）,疗效满意,无副作用,值得推广。[Objective] To observe Simiao Tang Xian Fang Huo Ming Yin combined together to pull rot Stasis and Shengjisan staging topical treatment of diabetic foot damp type effect. [Method] Using a prospective design methods,78 cases of hospitalized patients with Simiao decoction and Xian Fang Huo Ming Yin（Scrophulariaceae 30 g,honeysuckle 20 g,angelica 30 g,Treats 51 g,herb 15 g,TCS 20 g,Dan,red peony root 15 g Angelica 10 g,Fritillaria,wind 6g,red peony root 10 g,herb 6g,pangolin 6g,TCS 6g,frankincense 6g,myrrh 6g,dried tangerine peel 10 g,licorice 15g）,1 a / d,decoction 200 m L,sooner or later orally. Initially,pulling rotten Stasis（Chuan Wu,wind,Sichuan safflower,Angelica tail,Nepeta,Asarum,Sichuan off,independent living,Notopterygium,Evodia,leaves,lycopodii,frankincense,myrrh,Sargentodoxa）,ground into powder,over 150 mesh sieve,and the same amount from each mix,sesame oil reconcile,treated according to the scope of the affected foot swelling,redness dressing range should exceed the scope of 2cm,thickness of about 1.0 - 1.5mm,1 times / d; late Shengjisan,talc,borneol,cinnabar,Cork,Ampelopsis,ground into powder,over 200 mesh sieve,mix equal amounts from each usage ibid.,1 times / d. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms,signs and symptoms of local integration,physical and chemical examination indicators of adverse reactions. A course of treatment to determine efficacy. [Results] cured 57 cases,11 cases markedly effective in 3 cases,6 cases,the total efficiency of 92.30%. Local symptom score,blood indicators were lower（P〈0.01）. Clinical efficacy and diabetic foot grade was negatively correlated（P〈0.05）. [Conclusion] Simiao Tang Xian Fang Huo Ming Yin combined together to pull rot Stasis and Shengjisan staging topical treatment of diabetic foot damp type,results were satisfactory,no side effects,it is worth promoting.

关 键 词：糖尿病足 脱疽 湿热内蕴 四妙勇安汤合仙方活命饮 拔腐祛瘀方 生肌散 局部症状体征积分 理化检查指标 中医药治疗 前瞻性设计 

分 类 号：R289.5[医药卫生—方剂学]