活血生肌膏联合负压封闭引流技术治疗糖尿病足的临床效果研究  

Clinical study on treatment of diabetic foot with ointment for promoting blood circulation and muscle growth combined with vacuum sealing drainage

作　　者：张杰荣 陈秀香 熊时喜[1] 田晓林[1] 高方茂 林超 吴维炎 林天东[5] ZHANG Jie-rong;CHEN Xiu-xiang;XIONG Shi-xi(Department of Orthopedic Injuries,Sanya Hospital of Traditional Chinese Medicine,Sanya(572000),China)

机构地区：[1]海南省三亚市中医院骨伤一科,三亚572000 [2]广州中医药大学,广州510000 [3]海南省三亚市中医院针灸二科,三亚572000 [4]海南省澄迈县中医院,澄迈571900 [5]海南省中医院,海口570203

出　　处：《中国中西医结合外科杂志》2024年第4期511-516,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局项目(林天东全国名中医传承工作室);海南省卫生健康行业科研项目(21A200340)。

摘　　要：目的:研究活血生肌膏结合负压封闭引流技术(VSD)治疗糖尿病足的临床效果。方法:选取2020年1月—2022年1月我院收治的糖尿病足患者50例,采用随机对照评估者及受试者盲法,分为观察组和对照组各25例。对照组采用清创术后常规VSD技术,观察组在对照组基础上,创面覆盖活血生肌膏。观察两组术后创面评分、恢复状况、疼痛评分、炎症相关指标、生活质量评分的变化情况。结果:两组治疗后疼痛评分、溃疡面积和深度、新生上皮出现时间、C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和转化生长因子(TGF-β1)水平均较同组治疗前显著降低(P<0.01),溃疡愈合率、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(b-FGF)值及SF-36评分均显著升高(P<0.01)。治疗后观察组患者术后创面评分较对照组升高(P<0.05),溃疡面积和深度较对照组减少(P<0.05),新生上皮出现时间短于对照组(P<0.05),溃疡愈合率、较对照组显著升高(P<0.01);与对照组相比,观察组CRP、IL-6、TNF-α水平均显著降低(P<0.01);VEGF、b-FGF水平及SF-36评分较对照组均显著升高(P<0.01),TGF-β1水平低于对照组(P<0.05)。观察组总有效率为96.0%(24/25)高于对照组的68.0%(17/25),差异有统计学意义(P<0.05)。结论:活血生肌膏联合VSD治疗糖尿病足效果显著,无不良反应,值得临床推广应用。Objective To investigate the clinical effect of ointment for promoting blood circulation and muscle growth combined with vacuum sealing drainage(VSD)in the treatment of diabetic foot.Methods A total of 50 diabetic foot patients admitted to our hospital were selected,and the research method was randomized controlled assessor-participant blind,and 25 cases were divided into observation group and control group.The control group was treated with conventional VSD technology after debridement,and the wound surface of the observation group was covered with ointment for promoting blood circulation and muscle growth on the basis of the control group.Observe the changes in postoperative trauma scores,recovery status,pain scores,inflammation-related indexes,and quality of life evaluation of the two groups.Results Postoperative VAS score,ulcer area,ulcer depth,time to appearance of neoepithelium,CRP,IL-6,TNF-αand TGF-β1 levels were significantly lesser in both groups contrasted with those in the same group before therapy(P<0.01),and ulcer healing rate,VEGF,b-FGF levels and SF-36 scores were significantly higher(P<0.01).After therapy,the postoerative wound score of patients in the observation group was higher than that of the control group(P<0.05),the sore area and depth were reduced contrasted with that of the control group(P<0.05),the time for the appearance of neoplastic epithelium was shorter than that of the control group(P<0.05),and the rate of ulcer healing was considerably upper contrasted with that of the control group(P<0.01);the levels of CRP,IL-6,and TNF-αof the observation group were all extraordinarily diminished(P<0.01);VEGF,TGF-β1 index value and SF-36 score were substantially upper than that of the control group(P<0.01),and the diminish of b-FGF index value was more advantageously than that of the control group(P<0.05).The total effective rate of 96.0%(24/25)in the therapy group,which was superior than that of 68.0%(17/25)in the control group(P<0.05).Conclusion The effect of ointment for promoting blood c

关 键 词：活血生肌膏 负压封闭引流技术 糖尿病足 临床观察 

分 类 号：R63[医药卫生—外科学] R289[医药卫生—临床医学]