封闭负压引流术联合解毒生肌法对糖尿病足患者溃疡创面血管新生及炎症因子Lp-PLA2、IL-18的影响  

Effects of Vacuum Sealing Drainage and Detoxification and Regenerating Muscle Methods on Inflammatory Factor Lp-PLA2 and IL-18,Angiogenesis in Ulcer Wound in Patients with Diabetic Foot

作　　者：吴霞[1] 张分 张建民 汲翔 WU Xia;ZHANG Fen;ZHANG Jianmin;JI Xiang(Pukou District Hospital of TCM,Nanjing 211800,China;Nanjing Yimin Hospital;Ma'anshan Central Hospital)

机构地区：[1]南京市浦口区中医院,江苏南京211800 [2]南京一民医院 [3]马鞍山市中心医院

出　　处：《西部中医药》2022年第10期100-103,共4页Western Journal of Traditional Chinese Medicine

基　　金：江苏省卫生科研项目(ZK520197)。

摘　　要：目的:探讨解毒生肌法联合封闭负压引流术对糖尿病足患者溃疡创面血管新生及炎症因子脂蛋白相关磷脂酶A2(lipoprotein associated phospholipaseA2,Lp-PLA2)、白细胞介素18(interleukin 18,IL-18)的影响。方法:选取糖尿病足患者120例,按随机数表法分为观察组和对照组,每组60例。对照组采用常规糖尿病足治疗方案,观察组在上述基础上增加解毒生肌法联合封闭负压引流术进行治疗,两组均治疗12周。比较两组治疗前后血管内皮生长因子(vascular endothlial growth factor,VEGF)、内皮抑素(endostatin,ES)、碱性成纤维生长因子(basic fibroblast growth factor,bFGF)、Lp-PLA2、IL-18水平,创面愈合情况,中医证候评分并评价临床疗效和安全性。结果:治疗后两组VEGF、bFGF水平均高于治疗前(P<0.05),且观察组治疗后高于对照组(P<0.05);ES、Lp-PLA2、IL-18水平,创面面积均低于本组治疗前,且观察组治疗后低于对照组(P<0.05);观察组创面缩小率高于对照组(P<0.05)。观察组治疗总有效率[91.67%(55/60)]高于对照组[80.00%(48/60)](P<0.05);两组治疗安全性比较差异无统计学意义(P>0.05)。结论:解毒生肌法联合封闭负压引流术可以改善患者溃疡创面血管生长指标,降低血清炎症因子水平,对促进创面愈合具有积极作用。Objective:To discuss detoxification and regenerating muscle method and vacuum sealing drainage(VSD)on angiogenesis in ulcer wound,inflammatory factor Lp-PLA2 and IL-18 in patients with diabetic foot.Methods:All 120 patients were selected and divided into the observation group and the control group according to random number table method,60 cases in each group.The control group applied conventional thera peutic regimen of diabetic foot,and the observation group was treated by detoxification and regenerating muscle method and VSD based on conventional therapy,both groups were treated for 12 weeks.To compare the levels of VEGF,ES,bFGF,Lp-PLA2 and IL-18 before and after treatment,wound healing conditions,TCM syndrome integrals between both groups,to assess clincial effects and the safety.Results:After the treatment,the levels of VEGF and bFGF in both groups were higher than these before treating(P<0.05),and the observation group was higher than the control group after the treatment(P<0.05);the levels of ES,Lp-PLA2 and IL-18,wound size were lower than these before the treatment within the same group,and the observation group was lower than the control group after the treatment(P<0.05);the observation group was higher than the control group in wound reduction rate(P<0.05).Total effective rate of the observation group was[91.67%(55/60)],higher than[80.00%(48/60)]of the control group(P<0.05);the difference had no statistical meaning between both groups in therapeutic safety(P>0.05).Conclusion:Detoxification and regenerating muscle method together with VSD could improve vascular growth index of ulcer wound,lower serum levels of inflammatory factors,and it has a positive effect on promoting wound healing.

关 键 词：糖尿病足 解毒生肌法 封闭负压引流术 血管生长 炎症因子 

分 类 号：R578.2[医药卫生—消化系统]