负压疗法联合生肌玉红膏对DFU患者血清Th1/Th2细胞因子及miR-155表达的影响  

Effect of Negative Pressure Therapy Combined with Jade Ointment on Serum Th1/Th2 Cells and miR-155 Expression in DFU Patients

作　　者：李珍 李文霞 区岛良 黎珊珊 吴飞 张梅 谢桃梅 谢雪花 王永研 LI Zhen;LI Wenxia;OU Daoliang(Danzhou People's Hospital,Hainan Danzhou 571700,China)

机构地区：[1]海南省儋州市人民医院内分泌代谢科,海南儋州571700

出　　处：《河北医学》2023年第10期1720-1725,共6页Hebei Medicine

基　　金：海南省卫生健康行业科研项目,(编号:22A200155)。

摘　　要：目的:探究生肌玉红膏联合负压疗法对糖尿病足(DFU)患者血清Th1、Th2细胞因子及miR-155表达的影响。方法:选取2021年6月至2022年1月我院收治的146例DFU患者为研究对象,Excel电脑随机法简单随机将患者分为联合组和对照组,各73例。患者均给予常规清创和基础治疗,均采取负压创面疗法,对照组患者给予藻酸钙敷料进行治疗,联合组患者给予减味生肌玉红膏进行治疗,总疗程均为8周。比较两组疗效,治疗前及治疗1周、2周、4周和8周的DFU肉芽组织中miR-155相对表达量及血清Th1相关细胞因子、Th2相关细胞因子,记录治疗前后血常规、肝肾功能指标。结果:观察组患者的治疗有效率(91.78%,67/73例)高于对照组(79.45%,58/73例),组间具有差异(P<0.05)。治疗方法、时间及二者的交互作用对miR-155相对表达量的影响均有统计学意义(P<0.05)。随着时间的推移,两组患者的miR-155相对表达量均降低,且与对照组患者相比,观察组患者的水平降低趋势更明显。治疗前患者的Th1和Th2相关因子进行组间t检验无统计学差异(P>0.05),经过治疗,8周后患者的各项因子水平显著改善,TNF-α、IL-2、IFN-γ均降低,IL-4、IL-5、IL-10均升高,且与对照组相比,观察组治疗前后差值更大(P<0.05)。治疗前两组的WBC、RBC、PLT水平比较均无统计学差异(P>0.05);经过治疗,患者的WBC水平显著降低,且观察组治疗前后差值大于对照组,差异有统计学意义(P<0.05),但治疗前及治疗后两组RBC、PLT水平组间比较,差异均无统计学意义(P>0.05)。治疗前及治疗后两组肝肾功能指标比较无统计学差异(P>0.05)。结论:对糖尿病足患者采用生肌玉红膏联合负压疗法可以显著改善患者的血清Th1/Th2细胞因子及miR-155表达水平,提高患者的治疗效果。Objective:To explore the effect of negative pressure therapy combined with jade ointment on serum expression of Th 1,Th 2 cells and miR-155 in patients with diabetic foot(DFU).Methods:A total of 146 DFU patients admitted to our hospital from June 2021 to January 2022 were selected and grouped by Excel computerized randomized simply random method into a combination group and a control group,with 73 patients in each group.The patients were given conventional debridement and basic treatment,with negative pressure wound therapy,the control group was treated with calcium alginate dressing,and the combined group was treated with reduced muscle Yuhong ointment for treatment.The total course of treatment was 8 weeks.The efficacy of the two groups,the relative expression of miR-155 and serum Th1-related cytokines Th2-related cytokines in DFU granulation tissues before treatment and at 1,2,4,and 8 weeks of treatment were compared,and blood and liver and renal function indexes were recorded before and after treatment.Results:The observation group had a higher response rate(91.78%,67/73)than the control group(79.45%,58/73),with differences between groups(P<0.05).The effect of treatment,time and interaction on the relative expression of miR-155 was significant(P<0.05).The relative expression of miR-155 decreased in both groups over time and showed a stronger trend in the observation group compared to the control group.There was no statistically significant difference in the patients'Th1-and Th2-related factors before treatment by in-tergroup t-test(P>0.05),and after treatment,the patients'levels of the factors improved significantly after 8 weeks,with a decrease in TNF-α,IL-2,and IFN-γ,and an increase in IL-4,IL-5,and IL-10,and the difference between pre-and post-treatment was greater in the Observation Group compared with the Control Group(P<0.05).There was no statistical difference in the comparison of WBC,RBC and PLT levels be-tween the two groups before treatment(P>0.05);after treatment,the patients'WBC levels were sign

关 键 词：糖尿病足 负压疗法 生肌玉红膏 TH1/TH2细胞 MIR-155 

分 类 号：R587.2[医药卫生—内分泌]