理中活血通脉汤治疗半阴半阳证糖尿病足截趾清创术后患者的疗效观察  

Observation of the Efficacy of Lizhong Huoxue Tongmai Decoction in Treating Pa-tients with Half-Yin and Half-Yang Syndrome Undergoing Toe Amputation and Debridement Surgery for Diabetic Foot

作　　者：尚俊良 王广宇[1] 石春红 徐旭英[1] SHANG Jun-iang;WANG Guang-yu;SHI Chun-hong;XU Xu-ying(Department of Ulcer and Vascular Surgery,Beijing Hospital of Traditional Chinese Medicine,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：《世界中西医结合杂志》2024年第7期1347-1353,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(面上项目)(82174388)。

摘　　要：目的探讨理中活血通脉汤治疗半阴半阳证糖尿病足截趾清创术后患者的临床疗效。方法选取2019年1月-2022年1月期间于首都医科大学附属北京中医医院疮疡血管外科住院治疗的半阴半阳证糖尿病足截趾清创术后的患者90例作为研究对象。按照2∶1的比例随机分为对照组30例和治疗组60例。治疗组给予理中活血通脉汤口服,对照组给予活血通脉汤口服,两组均给以常规控制基础病、清创等治疗,均外用紫色疽疮纱条换药,1个月为1个疗程,连续治疗2个月,共2个疗程。观察比较两组患者治疗前后糖尿病足截趾清创术后创面面积、创面缩小率、创面证候积分、创面证候积分减少率、实验室指标[血清C反应蛋白(C-reactive protein,CRP)、糖化血红蛋白(Glycosylated hemoglobin,HbA1c)、前白蛋白(Prealbumin,PA)和纤维蛋白原(Fibrinogen,FIB)]、胃肠功能指标(胃残余量、肠内营养达标时间和急性胃肠损伤超声检查评分的变化)及临床疗效、用药安全性。结果治疗后两组患者创面面积较治疗前减小,差异有统计学意义(P<0.05);且治疗组创面面积小于对照组,创面缩小率高于对照组,差异有统计学意义(P<0.05)。治疗后第2个疗程两组患者创面证候积分较治疗前降低,差异有统计学意义(P<0.05);且治疗组创面证候积分低于对照组,创面证候积分减少率高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CRP、HbA1c、FIB水平较治疗前降低,血清PA水平较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清CRP、HbA1c、FIB水平低于对照组,血清PA水平高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组患者胃肠功能指标胃残余量、肠内营养达标时间低于对照组,差异有统计学意义(P<0.05);治疗组患者急性胃肠损伤超声检查评分低于对照组,差异无统计学意义(P>0.05)。治疗后治疗组临床总有效率85.00%(51/60)高于对照�Objective To investigate the clinical efficacy of Lizhong Huoxue Tongmai decoction in treating patients with half-Yin and half-Yang syndrome undergoing toe amputation and debridement surgery for diabetic foot.Methods From January 2019 to January 2022,90 patients with diabetic foot in a half-Yin and half-Yang syndrome underwent toe amputation and debridement surgery and were hospitalized in the Department of Ulcer and Vascular Surgery at Beijing Hospital of Traditional Chinese Medicine were selected as the study objects.They were randomly divided into a control group(30 cases)and a treatment group(60 cases)in a 2∶1 ratio.The treatment group received oral administration of Lizhong Huoxue Tongmai decoction,while the control group received oral administration of HuoxueTongmai decoction.Both groups received conventional treatment for underlying conditions and debridement,and external application of purple wound gauze dressing for a month,for a total of two months(2 courses).The wound area,wound shrinkage rate,wound symptom score,wound symptom score reduction rate,laboratory indicators[serum C-reactive protein(CRP),glycosylated hemoglobin(HbA1c),prealbumin(PA),fibrinogen(FIB)],gastrointestinal function indicators(gastric residual volume,time to achieve enteral nutrition,and acute gastrointestinal injury ultrasonic score changes),clinical efficacy,and medication safety were observed and compared between the two groups before and after treatment.Results After treatment,the wound area in both groups was significantly reduced compared to before treatment,with a statistically significant difference(P<0.05);the wound area in the treatment group was smaller than in the control group,and the wound shrinkage rate was higher than in the control group,with a statistically significant difference(P<0.05).After the second course of treatment,wound syndrome scores in both groups decreased compared to before treatment,with a statistically significant difference(P<0.05);the treatment group had lower wound syndrome scores and a higher

关 键 词：糖尿病足截趾清创术后 半阴半阳证 胃肠功能 理中活血通脉汤 

分 类 号：R587.1[医药卫生—内分泌]