承气散外敷治疗湿热毒盛证糖尿病足溃疡患者对溃疡面积、疼痛程度及预后影响观察  

Influence of External Application of Chengqi Powder(承气散)on Ulcer Area,Pain Degree and Prognosis in Patients with Diabetic Foot Ulcer of Dampness-heat Toxin Excessiveness Syndrome

作　　者：周敏杰 蔡文怡 尹凌峰[1] 周颖 张亚旭 曹烨民[1] 方豫东[1] 徐磊[1] ZHOU Minjie;CAI Wenyi;YIN Lingfeng;ZHOU Ying;ZHANG Yaxu;CAO Yemin;FANG Yudong;XU Lei(Shanghai TCM-Integrated Hospital,Shanghai 200090,China)

机构地区：[1]上海市中西医结合医院,上海200090

出　　处：《辽宁中医药大学学报》2025年第3期216-220,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：上海市虹口区卫生健康委员会中医药科研课题(HKQGYQY-ZYY-2022-22);上海市虹口区卫生健康委员会中医药科研重大课题(HKZYY-2024-01);虹口区第二轮“国医强优”三年行动计划(2022—2024年)立项项目(HKGYQYXM-2022-07)。

摘　　要：目的探究承气散外敷治疗湿热毒盛证糖尿病足溃疡疗效及对患者溃疡面积、疼痛程度及预后的影响。方法按照随机数字表法将上海市中西医结合医院脉管科2022年4月—2023年4月收治的126例湿热毒盛证糖尿病足溃疡患者纳为研究对象,分为常规组与中医组,每组各63例。两组患者入院后均给予降血糖、清创换药等常规治疗,中医组在常规治疗基础上给予承气散外敷治疗,两组治疗均为1次/d,持续治疗4周。比较两组患者中医疗效、中医症状积分、溃疡面积、数字等级评定量表(numerical rating scale,NRS)评分、血清炎症指标[白细胞(white blood cell,WBC)、降钙素(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)]水平、药物不良反应及半年内复发率。结果中医组总有效率显著高于常规组(P<0.05);与治疗前比较,治疗后两组患者中医症状积分显著下降(P<0.05),且中医组显著低于常规组(P<0.05);与治疗前比较,治疗第1~4周两组患者溃疡面积及NRS评分均逐渐下降(P<0.05),组内不同时间点比较差异具有统计学意义(P<0.05),且中医组治疗4周内各时间段的溃疡面积及NRS评分均显著低于常规组(P<0.05);与治疗前比较,治疗后两组患者血清炎症指标(WBC、PCT、CRP)水平显著下降(P<0.05),且中医组显著低于常规组(P<0.05);两组患者未见明显不良反应;中医组复发率(2例,6.35%)与常规组(5例,19.05%)比较差异无统计学意义(χ2=1.361,P=0.243)。结论承气散外敷辅助常规治疗可有效改善湿热毒盛证糖尿病足溃疡患者临床症状,缓解疼痛情况,抑制炎症反应,安全性高,值得推广。Objective To explore the efficacy of external application of Chengqi Powder(承气散)on diabetic foot ulcer of dampness-heat toxin excessiveness syndrome and its influence on ulcer area,pain degree and prognosis.Methods 126 patients with diabetic foot ulcer of dampness-heat toxin excessiveness syndrome in department of vascular surgery of Shanghai TCM-integrated hospital were included in the study from April 2020 to April 2023.All patients were divided into routine group and traditional Chinese medicine group by means of the random number table method,with 63 cases in each group.After admission,both groups were given routine treatments such as blood glucose reduction,debridement and dressing change and vaseline gauze external application,and the traditional Chinese medicine group was given external application of Chengqi Powder on the basis of routine treatments.Both groups were treated once a day for 4 weeks.The TCM efficacy,TCM symptoms scores,ulcer area,numerical rating scale(NRS)score and serum inflammatory indicators[white blood cell(WBC),procalcitonin(PCT),C-reactive protein(CRP)]levels,adverse drug reactions and recurrence rate within six months were compared between the two groups.Results The effective rate in traditional Chinese medicine group was significantly higher than that in routine group(P<0.05).After treatment,the TCM symptoms scores were significantly decreased in both groups compared with before treatment(P<0.05),and the traditional Chinese medicine group had significantly lower scores(P<0.05).On the 1st to the 4th week of treatment,the ulcer area and NRS score in the two groups were reduced gradually compared with before treatment(P<0.05),and there were significant differences at different time points within the groups(P<0.05),and the ulcer area and NRS score in traditional Chinese medicine group on the 1st to the 4th week of treatment were significantly lower than those in routine group(P<0.05).After treatment,the levels of serum inflammatory indicators(WBC,PCT,CRP)in both groups were declin

关 键 词：承气散 湿热毒盛证 糖尿病足溃疡 糖尿病 

分 类 号：R255.4[医药卫生—中医内科学] R587.2[医药卫生—中医学]