四妙勇安汤加味灌洗联合负压封闭引流治疗湿热毒盛型糖尿病足伴感染的临床观察  

Clinical efficacy of modified Simiao Yongan Decoction combined with vacuum sealing drainage for diabetic foot infections of damp heat toxin

作　　者：刘皓[1] 李树森[1] 吴广迎 冯军 姚书格 刘俞辛 LIU Hao;LI Shusen;WU Guangying;FENG Jun;YAO Shuge;LIU Yuxin(Department of Interventional Vascular Surgery,he Second Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000;Department of Traditional Chinese Medicine,the Second Affiliated Hospital of Xingtai Medical College,Xingtai,Hebei 054000)

机构地区：[1]邢台医学高等专科学校附属二院介入血管外科,河北邢台054000 [2]邢台医学高等专科学校附属二院中医科,河北邢台054000

出　　处：《河北中医》2023年第1期52-55,60,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：2021邢台市市级科技计划自筹经费项目(编号:2021ZC170)。

摘　　要：目的观察四妙勇安汤加味灌洗联合负压封闭引流治疗湿热毒盛型糖尿病足伴感染的临床疗效。方法将60例湿热毒盛型糖尿病足伴感染患者按照随机数字表法分为2组,在均予常规治疗基础上,对照组30例予0.9%氯化钠注射液灌洗联合负压封闭引流治疗,治疗组30例予四妙勇安汤加味灌洗联合负压封闭引流治疗。比较2组治疗1、2周后创面细菌感染转阴情况,比较2组治疗前及治疗1、2周后C反应蛋白(CRP)水平变化情况,比较2组治疗前及治疗2周后经皮氧分压水平变化情况,统计2组治疗4周创面愈合疗效情况。结果治疗组治疗1周转阴率70%(21/30),治疗2周转阴率90%(27/30),对照组分别为60%(18/30)、70%(21/30),治疗组治疗1、2周创面细菌感染转阴率均高于对照组(P<0.05)。与本组治疗前比较,2组治疗1、2周CRP水平均降低(P<0.05),且治疗组治疗1、2周CRP水平均低于对照组治疗同期水平(P<0.05)。与本组治疗前比较,2组治疗2周经皮氧分压均升高(P<0.05),且治疗组治疗2周经皮氧分压水平高于对照组治疗同期(P<0.05)。治疗组创面愈合总有效率93.3%(28/30),对照组创面愈合总有效率80.0%(24/30),治疗组总有效率高于对照组(P<0.05)。结论四妙勇安汤加味灌洗联合负压封闭引流治疗湿热毒盛型糖尿病足伴感染疗效确切,具有明显的抑菌、抗炎作用,并可通过改善局部微循环,提高经皮氧分压,从而促进创面愈合。Objective To observe the clinical efficacy of modified Simiao Yongan Decoction combined with vacuum sealing drainage(VSD)for Diabetic foot infections(DFIs)of damp heat toxin.Methods Totally 60 DFIs patients(damp heat toxin)were randomly assigned into the treatment group(n=30)and the control group(n=30),in addition to conventional therapy,the control group received lavage with 0.9%sodium chloride injection combined with VSD,and the treatment group received lavage of modified Simiao Yongan Decoction combined with VSD.After 1 and 2 weeks of treatment,the aim was to compare negative rate of bacterial infection in wound,C-reactive protein(CRP),percutaneous oxygen partial pressure.The wound healing rate on week 4 were recorded.Results The negative rate on weeks 1 and 2 in the treatment group were higher than those in the control group 70%[21/30]vs 60%[18/30],90%[27/30]vs 70%[21/30],[P<0.05],respectively).On weeks 1,2,CRP in the both groups was decreased(P<0.05),which was decreased in the treatment group compared with the concurrent control group(P<0.05).percutaneous oxygen partial pressure on week 2 in the both groups was increased(P<0.05),which was higher in the treatment group than in the concurrent control group(P<0.05).The overall effective rate of wound healing was 93.3%(28/30)in the treatment group,higher than that of 80.0%(24/30)in the control group(P<0.05).Conclusion For DFIs patients(damp heat toxin),lavage with modified Simiao Yongan Decoction combined with VSD has definite curative effect,which can promote wound healing by improving local microcirculation and increasing percutaneous oxygen partial pressure,and with obvious antibacterial and anti-inflammatory effects.

关 键 词：糖尿病足 感染 负压伤口疗法 四妙勇安汤 中西医结合疗法 

分 类 号：R255.4[医药卫生—中医内科学] R587.29[医药卫生—中医学]