四妙勇安汤联合自粘性软聚硅酮有边型泡沫敷料对Wagner 1—2级糖尿病足肢端血流动力学、EGF及血清FGF21、CTRP9的影响  

Effects of Simiao Yong’an Decoction Combined with Self-Adhesive Soft Silicone Rimmed Foam Dressing on Acrohemodynamics,EGF,Serum FGF21 and CTRP9 in Wagner Grade 1 to 2 Diabetic Feet

作　　者：吕继宏 张效科 段玉红 王黎 苏红霞 巩雪莹 LYU Jihong;ZHANG Xiaoke;DUAN Yuhong;WANG Li;SU Hongxia;GONG Xueying(The Second Dept.of Endocrinology,Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院内分泌二科,陕西咸阳712000

出　　处：《中国医院用药评价与分析》2024年第8期915-918,922,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金资助项目(No.81774304);陕西省自然科学基础研究计划项目(No.2022JM-494)。

摘　　要：目的:观察四妙勇安汤联合自粘性软聚硅酮有边型泡沫敷料对Wagner 1—2级糖尿病足肢端血流动力学、表皮生长因子(EGF)及血清成纤维细胞生长因子-21(FGF21)、C1q肿瘤坏死因子相关蛋白9(CTRP9)的影响。方法:选择2020年2月至2023年6月该院收治的Wagner 1—2级糖尿病足患者102例,分组方式为随机数字表法。对照组51例患者给予自粘性软聚硅酮有边型泡沫敷料治疗,观察组51例患者给予四妙勇安汤联合自粘性软聚硅酮有边型泡沫敷料治疗。比较两组患者的临床疗效,治疗前后测量患者的创面面积、病灶处皮肤温度,检测足背部经皮氧分压,记录视觉模拟评分(VAS),检测患者足背动脉血流速度、血管内径,测量足背部微血管基础血流灌注量,检测血清EGF、淀粉样蛋白A(SAA)、FGF-21、CTRP9和脂蛋白相关磷脂酶A2(Lp-PLA2)水平。结果:观察组患者的总有效率为96.08%(49/51),高于对照组的80.39%(41/51),差异有统计学意义(P<0.05)。治疗后,观察组患者的VAS评分低于对照组,创面面积小于对照组,皮肤温度、经皮氧分压高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者足背动脉血流速度较对照组快,血管内径、微血管基础血流灌注量较对照组大,FGF21水平较对照组降低,CTRP9、EGF水平较对照组升高,SAA、Lp-PLA2水平较对照组降低,差异均有统计学意义(P<0.05)。结论:四妙勇安汤联合自粘性软聚硅酮有边型泡沫敷料治疗Wagner 1—2级糖尿病足患者,可抑制机体炎症,提升EGF水平,调节FGF-21、CTRP9水平,改善肢端动脉血流动力学及微血管循环,促进创面愈合,缓解创面疼痛,提升皮肤温度、经皮氧分压,提高临床疗效。OBJECTIVE:To observe the effects of Simiao Yong’an Decoction combined with self-adhesive soft silicone edged-type foam dressing on the end-hemodynamics,epidermal growth factor(EGF),serum fibroblast growth factor-21(FGF21)and C1q tumor necrosis factor-associated protein 9(CTRP9)of Wagner Grade 1-2 diabetic feet.METHODS:A total of 102 patients with Wanger grade 1 to 2 diabetic feet admitted into the hospital from Feb.2020 to Jun.2023 were grouping via random number table method.Fifty-one cases in the control group was given self-adhesive soft silicone rimmed foam dressing,51 cases in the observation group received Simiao Yong’an decoction combined with self-adhesive soft silicone rimmed foam dressing.Clinical efficacy were compared between two groups,the patients’wound area and skin temperature at the lesion were measured,transcutaneous oxygen partial pressure at the dorsum of foot was detected,the visual analog scores(VAS)were recorded,the patients’arterial flow velocity and intravascular diameter at the dorsum of foot were detected,the microvascular basal perfusion volume at the dorsum of foot was measured,EGF,amyloid A(SAA),FGF-21,CTRP9 and lipoprotein-associated phospholipase A2(Lp-PLA2)levels were detected.RESULTS:The total effective rate of the observation group was 96.08%(49/51),higher than 80.39%(41/51)of the control group,with statistically significant difference(P<0.05).After treatment,the VAS was lower,the wound area was smaller,the skin temperature and transcutaneous oxygen partial pressure were higher in the observation group than those in the control group,with statistically significant differences(P<0.05).After treatment,the arterial flow velocity and intravascular diameter at the dorsum of foot was faster,the intravascular diameter and microvascular basal perfusion volume at the dorsum of foot were larger,the FGF21 level was lower,the CTRP9 level and EGF content were higher,the SAA and Lp-PLA2 contents were lower in the observation group than those in the control group,with statistically sig

关 键 词：四妙勇安汤 自粘性软聚硅酮有边型泡沫敷料 Wagner 1—2级糖尿病足 炎症 表皮生长因子 肢端动脉血流动力学 微血管循环 

分 类 号：R932[医药卫生—生药学]