自拟中药汤剂联合湿润烧伤膏对Wagner 3~4级糖尿病足患者创面组织中VEGF、bFGF表达的影响  

Influence of Hospital-made Chinese Herb Decoction Combined with MEBO on the Expression of VEGF and bFGF in Wound Tissues of Patients with Wagner Grade 3-4 Diabetic Foot

作　　者：张志伟 冯志海 Zhang Zhiwei;Feng Zhihai(Internal Medicine Department 4 of Xuchang No.5 People’s Hospital,Xuchang City,Henan 461000,China)

机构地区：[1]许昌市第五人民医院内四科,河南许昌461000

出　　处：《中国烧伤创疡杂志》2020年第5期327-330,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：河南省首批青苗人才培养项目[豫中医科教(2018)16号]。

摘　　要：目的研究自拟中药汤剂熏洗联合湿润烧伤膏外涂对Wagner 3~4级糖尿病足患者创面组织中血管内皮生长因子(vascular endothelial growth factor,VEGF)及碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)表达的影响。方法选取2017年4月至2019年4月许昌市第五人民医院收治的150例Wagner3~4级糖尿病足患者作为研究对象,并按照随机数表法将其随机分为研究组(75例)与对照组(75例),其中对照组患者采用湿润烧伤膏外涂治疗局部创面,研究组患者在对照组治疗的基础上联合应用自拟中药汤剂熏洗,对比两组患者创面愈合时间及创面组织中VEGF、bFGF表达水平的变化情况。结果研究组患者创面愈合时间为(48.9±22.4) d,明显短于对照组患者的创面愈合时间(67.4±18.2) d (t=5.551,P=0.000);治疗第7、14天,两组患者创面组织中VEGF、bFGF表达水平均呈上升趋势(VEGF:F=54.160、22.660,P均=0.000;bFGF:F=58.180、40.570,P均=0.000),但研究组均显著高于对照组(VEGF:t=5.003、2.957,P均=0.000、0.004;bFGF:t=4.718、2.455,P=0.000、0.015)。结论自拟中药汤剂熏洗联合湿润烧伤膏外涂可促进Wagner 3~4级糖尿病足创面愈合,除中医药的清热燥湿、活血化瘀、祛腐生肌等辨证论治作用外,上调创面组织中VEGF、bFGF的表达水平也可能是其主要作用机制。Objective To investigate the influence of the combination of the fumigation and washing with a hospital-made Chinese herb decoction and the external application of MEBO on the expression of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in wound tissues of patients with Wagner grade 3-4 diabetic foot.Methods One hundred and fifty patients with Wagner grade 3-4 diabetic foot admitted into Xuchang No.5 People’s Hospital between April 2017 and A pril 2019 were selected as study subjects to be divided into a study group(75 patients)and a control group(75 patients)according to the random number table.The local wounds in the control group were managed with the external application of MEBO,while the local wounds in the study group,besides the treatment in the control group,were also given the fumigation and washing with a hospital-made Chinese herb decoction.The wound healing time,the changes of VEGF and bFGF expression in wound tissues were compared between the two groups.Results In the study group the wound healing time was(48.9±22.4)d,obviously shorter than(67.4±18.2)d in the control group(t=5.551,P=0.000).On day 7 and 14 of treatment,the expression levels of VEGF and bFGF in wound tissues were all increased in the two groups(VEGF:F=54.160 and 22.660,both P=0.000;bFGF:F=58.180 and 40.570,both P=0.000),but the increased levels in the study group were markedly higher than that in the control group(VEGF:t=5.003 and 2.957,P=0.000 and 0.004;bFGF:t=4.718 and 2.455,P=0.000 and 0.015).Conclusion The treatment protocol of fumigation and washing with a hospital-made Chinese herb decoction combined with the external application of MEBO can promote the wound healing of Wagner grade 3-4 diabetic foot,of which the main action of mechanism may be the up-regulated expression of VEGF and bFGF in wound tissues,in addition to the dialectical treatment effects of traditional Chinese medicine such as clearing off heat and drying dampness,promoting blood circulation to remove blood stasis,removing slou

关 键 词：自拟中药汤剂 湿润烧伤膏 糖尿病足 血管内皮生长因子 碱性成纤维细胞生长因子 

分 类 号：R587.2[医药卫生—内分泌]