中药清法对糖尿病足患者微循环障碍的疗效分析  

Effectiveness of TCM clearing method for patients with diabetic foot and microcirculation dysfunction

作　　者：赵普庆[1] 杨沁彤[2] 李藜[3] 董斌斌[4] 孙丽霞[5] 洪流 

机构地区：[1]上海市中西医结合医院内科,上海200082 [2]上海市中西医结合医院脉管科,上海200082 [3]上海市黄浦区中心医院内科,上海200002 [4]复旦大学附属华山医院北院,上海201907 [5]上海市中西医结合医院护理部,上海200082 [6]上海市黄浦区疾病控制中心,上海200023

出　　处：《同济大学学报（医学版）》2015年第4期96-100,共5页Journal of Tongji University(Medical Science)

基　　金：上海市中西医结合医院科研课题计划资助(2012-02-05)

摘　　要：目的探讨中药清法治疗糖尿病足患者微量白蛋白尿对微循环障碍疗效。方法 200例糖尿病足患者随机分为中西医治疗组和西医对照组,各100例。两组均采用相同的基础治疗。中西医治疗组予中药清法,药物组成:穿心莲、蚤休、垂盆草、川乌、三七、冰片,100 ml/袋,每次1袋,2次/d;西医对照组予西洛他唑100 mg,1次/d,口服,且均行血生化、微量白蛋白尿及血液流变学的检测,比较治疗前后二组的变化。结果用药前,两组患者的年龄、体质量、身高、BM I、收缩压、舒张压、TC、HDL-C、LDL-C、TG、BUN、Cr、UA、FPG、2 h PG、M A、全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、血细胞比容、红细胞聚集指数和纤维蛋白原差异均无统计学意义(P>0.05)。治疗后,两组患者的TC、TG、UA、FPG、M A、全血黏度低切、全血黏度中切、全血黏度高切、血浆黏度、血细胞比容、红细胞聚集指数和纤维蛋白原差异有统计学意义(P<0.05),HD L-C、L D L-C、B U N、C r、2 h PG差异无统计学意义(P>0.05)。此外,依据"脱疽"诊治疗效标准和糖尿病足坏疽疗效判定标准比较中西医治疗组与西医对照组的治疗结果,疗效差异有统计学意义(P<0.01)。结论中药清法通过治疗糖尿病足患者微量白蛋白尿和血液流变学,进而改善患者微循环障碍,促进伤口愈合,是值得推广的一种方法。[ Abstract ] Objective To investigate the effectiveness of TCM clearing method （Qingfa） in treatment of patients with diabetic foot and microcirculation dysfunction. Methods Two hundred patients with diabetic foot were randomly divided into combined traditional Chinese and Western medicine treatment group （ group A, n = 100） and Western medicine control group （group B, n = 100）. All patients received basic treatment, in addition, patients in group A received Chinese medicine Qingfa, which was made up of Andrographis Paniculata, Rhizoma Paridis, Sedum Sarmentosum Bunge, Radix Aconiti, Panax Notoginseng, Cinnamomum Cam Phora, while patients in group B received cilostazol 100mg q. d. Blood biochemical parameters, microalbuminuria （MA） and hemorheology were tested and compared before and after treatment in two groups. Results Three were no significant differences in age, weight, height, body mass index （BMI）, systolic blood pressure, diastolic blood pressure, total cholesterol （TC）, high density lipoprotein cholesterol （ HDL-C）, low density lipoprotein cholesterol （ LDL-C）, triglyceride （TG）, blood urea nitrogen （BUN）, creatinine （Cr）, uric acid （UA）, fasting plasma glucose （FPG）, 2 - h plasma glucose （2hl~）, microalbuminuria （MA）, whole blood viscosity at low shear, whole blood viscosity in cutting, whole blood viscosity in high shear, plasma viscosity, hematocrit, erythrocyte aggregation and fibrinogen before treatment between two groups （P 〉 0. 05 ）. There were significant differences in TC, TG, UA, FPG, MA, whole blood viscosity at low shear, in cutting and in high shear, plasma viscosity, hematocrit, erythrocyte aggregation and fibrinogen after treatment between two groups （P 〈0.05）; while there were no significant differences in HDL-C, LDL-C, BUN, Cr, UA, 2hPG between two groups （P 〉 0. 05 ）. According to diagnosis and therapy efficacy criteria of ＂loss gangrene＂, the efficacy of diabetic foot was significant different between two

关 键 词：糖尿病足 中药清法 微循环障碍 疗效 

分 类 号：R587.1[医药卫生—内分泌]