甘草油加味治疗糖尿病足游离皮片植皮术后创面的临床观察  

Clinical observation of supplemented licorice oil therapy in the treatment of postoperative wounds after free skin grafting of diabetic foot

作　　者：尚俊良 朱艳萍[1] 石春红 徐旭英[1] SHANG Junliang;ZHU Yanping;SHI Chunhong;XU Xuying(Department of Ulcerative Vascular Surgery,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院疮疡血管外科,北京100010

出　　处：《现代中医临床》2024年第3期1-6,20,共7页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金面上项目(No.82174388)。

摘　　要：目的 评价甘草油加味治疗糖尿病足游离皮片植皮术后创面的临床疗效。方法 选择糖尿病足游离皮片植皮术后患者60例,按照2∶1随机分为治疗组(甘草油加味)40例和对照组(甘草油)20例。糖尿病足患者根据病情需要行清创或截趾术后,在局部创面床条件基本具备的条件下行游离皮片植皮术,2组分别于植皮术后第3天以单层甘草油加味纱条、甘草油纱条覆盖,再以无菌干纱布稍加压包扎,每日换药一次,1个月为1个疗程,连续治疗2个月,共2个疗程。观察2组临床疗效、创面面积、创周(主症:疼痛积分,次症:皮色、肿胀、温度)积分、患者血清C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、纤维蛋白原(fibrinogen,FIB)水平和患者创面基质金属蛋白酶(MMPs)MMP-2、MMP-9浓度。结果 治疗后,2组创面面积均较治疗前缩小,治疗组缩小更显著,差异均有统计学意义(P<0.05)。治疗后,2组创周兼症积分、主症积分和创周总积分均较治疗前降低,治疗组较对照组降低更显著,差异有统计学意义(P<0.05)。治疗后2组患者血清CRP、FIB水平均较治疗前降低,治疗组降低更明显,差异有统计学意义(P<0.05);治疗后2组患者血清ESR水平差异无统计学意义(P>0.05)。治疗后2组患者创面MMP-2、MMP-9浓度水平均较治疗前降低,治疗组降低更明显,差异有统计学意义(P<0.05)。治疗组总有效率为92.5%(37/40),对照组总有效率为85.0%(17/20),治疗组总有效率优于对照组(P<0.05)。结论 甘草油加味对糖尿病足游离皮片植皮术后创面的修复具有良好的临床疗效。Objective To evaluate the clinical efficacy of supplemented licorice oil therapy in the treatment of postoperative wounds after free skin grafting of diabetic foot.Methods A total of 60 patients after free skin grafting for diabetic foot(DF) were randomly divided into a treatment group(supplemented licorice oil therapy group,n=40) and a control group(licorice oil therapy group,n = 20) in a 2∶1 ratio.The patients underwent debridement or toe amputation as needed,followed by free skin grafting under conditions of adequate local wound bed preparation.The two groups received treatment with single-layer gauze strips soaked with supplemented licorice oil and regular licorice oil,respectively,on the third postoperative day,followed by covering with sterile dry gauze.Dressing changes were performed daily.Each course of treatment lasted for one month,with a total of two consecutive courses.Clinical efficacy,wound size,wound score(main symptom:pain score;secondary symptoms including skin color,swelling,and temperature),serum levels of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),fibrinogen(FIB),and wound matrix metalloproteinases(MMPs) MMP-2 and MMP-9 concentrations were observed.Results After treatment,both groups showed a reduction in wound size compared to before treatment,with a more significant reduction observed in the treatment group(P < 0.05).After treatment,both groups showed a decrease in wound score compared to before treatment,with a more significant decrease observed in the treatment group(P < 0.05).After treatment,both groups showed a decrease in serum CRP and FIB levels compared to before treatment,with a more significant decrease observed in the treatment group(P < 0.05).There were no significant differences in serum ESR levels between the two groups after treatment(P > 0.05).After treatment,both groups showed a decrease in wound MMP-2 and MMP-9 concentrations compared to before treatment,with a more significant decrease observed in the treatment group(P < 0.05).The total effective rate of

关 键 词：糖尿病足 游离皮片植皮术糖尿病足植皮术后 创面 甘草油加味 临床观察 

分 类 号：R269[医药卫生—中西医结合]