负压封闭引流联合“清筋疽散”冲洗治疗糖尿病足溃疡临床研究  

VSD Combined with Clearing Tendon Gangrene Powder in Treatment of Diabetic Foot Ulcer

作　　者：陈德清[1] 朱丹平[1] 邱子津[2] 熊恩平[1] 廖颖[1] 张诗音[1] 刘芳[1] 李勇[1] 吴雨晨[1] 付利[1] 左国庆[1] 

机构地区：[1]重庆市中医院,重庆400011 [2]重庆医药高等专科学校医学美容教研室,重庆401331

出　　处：《中华中医药学刊》2017年第6期1513-1516,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：重庆市卫生和计生委科技项目(ZY20150230);重庆市中医院院内培育项目(2014-02-39)

摘　　要：目的:观察负压封闭引流联合"清筋疽散"冲洗治疗糖尿病足溃疡临床疗效。方法:收集糖尿病足溃疡患者72例,随机将其分为两组,对照组35例予单纯负压封闭引流组,观察组37例予负压封闭引流联合"清筋疽散"冲洗治疗,连续治疗4周。比较两组患者创面愈合率、细菌清除率、肉芽组织覆盖率、肉芽组织生长厚度及引流组织中相关因子类胰岛素一号增长因子(IGF-1)、表皮生长因子(EGF)、肿瘤坏死因子α(TNF-α)、一氧化氮(nitricoxide,NO)含量变化,并评价两种疗法的临床疗效。结果:治疗4周后,与对照组比较,观察组患者溃疡创面处肉芽组织覆盖率、肉芽组织生长厚度、细菌清除率及创面愈合率均显著升高(P<0.05),引流组织中相关因子IGF-1、EGF及NO的含量显著升高(P<0.05),TNF-α的含量显著降低(P<0.05);且观察组的总有效率显著升高,差异有统计学意义(P<0.05)。结论:VSD联合"清筋疽散"冲洗治疗糖尿病病足溃疡可有效促进肉芽组织生长及溃疡组织创面的修复、减轻创面感染几率及炎性反应,从整体上提高创面愈合率,临床效果较优,该疗法可以在临床上进行推广。Objective： To observe the effect of vacuum sealing drainage combined with Clearing Tendon Gangrene Powder in the treatment of diabetic foot ulcer. Methods： A total of 72 cases of diabetic foot ulcer patients were randomly divided into 2 groups. Thirty-five cases in the control group were treated with vacuum sealing drainage group and the observation group＇s 37 cases were treated with closed negative pressure drainage combined Clearing Tendon Gangrene Powder,continuous treatment for 4 weeks. Compare 2 groups＇ wound healing rate,bacterial clearance rate,granulation tissue coverage,granulation tissue growth and related factors of drainage tissue insulin like growth factor 1 thickness（ IGF-1）,epidermal growth factor（ EGF）,tumor necrosis factor alpha（ TNF-alpha） and nitric oxide（ nitricoxide,NO） content changes,clinical curative effect and evaluate two kinds of therapy. Results： After 4 weeks of treatment,compared with control group,the observation group＇s ulcer wound granulation tissue coverage,the growth of granulation tissue thickness,bacterial clearance rate and wound healing rate were significantly increased（ P〈0. 05）. The contents of IGF-1,EGF and related factors in the organization NO drainage increased significantly（ P〈0. 05）. The content of TNF-alpha was significantly decreased（ P〈0. 05） and the total effective rate of observation group was significantly increased. The difference was statistically significant（ P〈0. 05）. Conclusion： VSD combined with Clearing Tendon Gangrene Powder in treatment of diabetic foot ulcer can effectively promote the growth of granulation tissue and ulcer repair,wound and reduce the probability of inflammatory reaction and wound infection,improve the wound healing rate,with better clinical effect. The treatment can be carried out in clinical practice.

关 键 词：糖尿病病足 VSD 清筋疽散 冲洗治疗 联合疗法 临床研究 

分 类 号：R587.2[医药卫生—内分泌]