通经活络洗剂治疗糖尿病足临床观察  

Clinical Observation on Tongjing Huoli Lotion in Treatment of Diabetic Foot

作　　者：刘欣[1,2] 王斐 LIU Xin;WANG Fei(The Affiliated Hospital to Qingdao University,Qingdao Shandong China 266000;Traditional Chinese Medicine Hospital of Pingyi County,Pingyi Shandong China 273300)

机构地区：[1]青岛大学附属医院,山东青岛266000 [2]平邑县中医医院,山东平邑273300

出　　处：《中医学报》2018年第8期1415-1418,共4页Acta Chinese Medicine

基　　金：山东省卫生厅科技计划项目(201605112B)

摘　　要：目的:观察通经活络洗剂治疗糖尿病足(diabetic foot,DF)脾肾阳虚、经脉不通证的临床疗效,以及对血清中环氧合酶-2(cyclooxygenase-2,COX-2)和单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)水平的影响。方法:将80例DF患者按随机数字表法分为对照组和治疗组,每组40例。对照组:采用常规西药治疗,如糖尿病健康教育,合理饮食,降血压、血脂,胰岛素治疗,改善微循环,营养神经,并对患足行清创、换药及抗感染等治疗。治疗组在对照组治疗基础上加用自拟通经活络洗剂足浴治疗,药物组成:艾叶20 g,制草乌15 g,川芎20 g,附子10 g,干姜15 g,桂枝10 g,红花10 g,青风藤20 g,忍冬藤30 g,细辛10 g,桑枝20 g,伸筋草20 g,苏木10 g,透骨草20 g,威灵仙20 g。将以上药物用清水浸泡45 min,常规水煮取汁4 000 m L,将药液置于木桶中,先将患足置于木桶两缘上熏洗,待药液温度降至约40℃,再将患者足及下肢浸泡于药液中,每次30 min,每天2次。两组患者均连续治疗4周。观察两组患者脾肾阳虚、经脉不通证症状评分、创面愈合时间、住院天数、踝肱指数(ankle brachial index,ABI)和临床疗效情况。检测两组患者血清中COX-2和MCP-1水平。结果:治疗后,治疗组脾肾阳虚、经脉不通证的症状评分明显低于对照组,差异有统计学意义(P<0.01)。治疗组患者的创面愈合时间和住院天数均明显少于对照组,差异均有统计学意义(P<0.01)。治疗后,治疗组患者的ABI明显高于对照组,差异有统计学意义(P<0.01)。治疗组患者有效率为85.0%显著高于对照组62.5%,差异有统计学意义(P<0.05)。治疗后,治疗组血清中COX-2和MCP-1水平均显著低于对照组,差异均有统计学意义(P<0.01)。结论:在常规西医治疗基础上加用通经活络洗剂治疗DF脾肾阳虚、经脉不通证疗效显著,且能下调患者体内的COX-2和MCP-1水平。Objective： To observe the clinical efficacy of Tongjing Huoli lotion in treatment of diabetic foot（ DF） with blocked meridian symptom due to Spleen and Kidney Yang Deficiency Syndrome and the effect on cyclooxygenase-2（ COX-2） in serum and monocyte chemotactic protein-1（ MCP-1） levels. Methods： 80 cases of DF patients were divided into control group and treatment group according to the random number table,with 40 cases in each group. Control group： conventional western medicine treatment,such as diabetes health education,a reasonable diet,lower blood pressure,blood lipids,insulin treatment,improvement of microcirculation,nutrition nerves,and debridement,dressing and anti-infective treatment. The treatment group was treated with a self-made meridian lotion,namely,Tongjing Huoli lotion,in addition to that of the the control group. Drug composition： Artemisiae argyi 20 g,Systemic turf 15 g,Chuanxiong 20 g,Aconite 10 g,Dried ginger 15 g,Cassia twig 10 g,Safflower 10 g,Blue wind cane 20 g,Honeysuckle 30 g,Asarum 10 g,Mulberry 20 g,Lycopersicon esculenta 20 g,Su wood 10 g,Speranskia 20 g,Clematis 20 g. The above drugs were soaked with water for 45 min,and conventional boiled drug juice was made and 4000 m L of the liquid put was placed in a cask. The affected foot was first placed on both sides of the cask for fumigation. After the temperature of the liquid was lowered to about 40 ℃,patient＇s foot and lower limbs were soaked in the liquid,for 30 minutes each time,twice a day. Both groups of patients were treated for 4 weeks. The symptoms of Spleen and Kidney Yang Deficiency Syndrome,wound healing time,length of hospital stay,ankle brachial index（ ABI） and clinical efficacy were observed in both groups. Both serum levels of COX-2 and MCP-1 were measured. Results： After treatment,the symptom index scores of Spleen and Kidney Yang Deficiency in the treatment group were significantly lower than those in the control group（ P〈0. 01）. The wound healing time and length of hospital stay in th

关 键 词：糖尿病足 脾肾阳虚、经脉不通证 通经活络洗剂 中医药疗法 中西医结合 

分 类 号：R259[医药卫生—中西医结合]