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糖尿病足术后应用茵陈蒿汤加减治疗的临床疗效

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[目的]探讨糖尿病足术后应用茵陈蒿汤加减治疗的临床疗效.[方法]回顾性分析2023年1月至12月在本院行手术治疗的95例糖尿病足患者的临床资料,依据治疗方法的不同分为对照组(n=47,常规治疗)和观察组(n=48,常规治疗+茵陈蒿汤加减治疗).比较两组临床疗效、术后恢复情况(卧床时间、下床时间、肛门排气时间、住院时间)、创面改善情况(创面面积及深度、肉芽组织生长程度、创面愈合时间)及不良反应发生情况,并统计两组治疗前后的症候积分、血清炎症因子[C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-5(IL-5)]、血糖[空腹血糖(FPG)、糖化血红蛋白(HbA1c)]、血液流变学指标[血沉(ESR)、纤维蛋白原(Fib)、血浆黏度(PV)]水平.[结果]观察组总有效率为93.75%,显著高于对照组的78.72%(P<0.05).与对照组比较,观察组术后恢复时间更短(P<0.05).治疗后,两组创面面积及深度均减少,且观察组减少更为明显(P<0.05);观察组肉芽组织生长程度大于对照组,创面愈合时间短于对照组(P<0.05).治疗后,两组中医证候积分、FPG、HbA1c、CRP、TNF-α、ESR、Fib、PV水平均降低,且观察组低于对照组(P<0.05);IL-4、IL-5水平均升高,且观察组高于对照组(P<0.05).两组患者均未见明显不良反应.[结论]茵陈蒿汤加减可促进糖尿病足患者术后恢复及创面修复,控制血糖水平,缓解症状,减轻炎症反应,改善血液流变学,提高疗效,且不会增加不良反应的发生.
Clinical Effect of Yinchenhao Decoction on Postoperative Diabetes Foot
[Objective]To investigate the clinical efficacy of Yinchenhao Decoction in the treatment of diabetes foot after operation.[Methods]The clinical data of 95 patients with diabetes foot who underwent surgical treat-ment in our hospital from January to December 2023 were retrospectively analyzed.According to the different treatment methods,they were divided into the control group(n=47,conventional treatment)and the observa-tion group(n=48,conventional treatment+Yinchenhao Decoction modified treatment).We compared the clini-cal efficacy,postoperative recovery(bed rest time,bed rest time,anal exhaust time,hospital stay),wound im-provement(wound area and depth,granulation tissue growth degree,wound healing time),and incidence of ad-verse reactions between two groups,and the symptom scores and serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interleukin-5(IL-5)],blood glucose[fasting blood glucose(FPG),glycated hemoglobin(HbA1c)]and the levels of hemorheological indicators[erythrocyte sedimen-tation rate(ESR),fibrinogen(Fib),and plasma viscosity(PV)]before and after treatment were statistically ana-lyzed for both groups.[Results]The total effective rate of the observation group was 93.75%,significantly higher than the control group's 78.72%(P<0.05).Compared with the control group,the observation group had a shor-ter postoperative recovery time(P<0.05).After treatment,the wound area and depth of both groups decreased,and the observation group showed a more significant decrease(P<0.05);The growth degree of granulation tis-sue in the observation group was greater than that in the control group,and the wound healing time was shorter than that in the control group(P<0.05).After treatment,the levels of the symptom scores FPG,HbA1c,CRP,TNF-α,ESR,Fib,and PV for both groups were all reduced,and the observation group was lower than the control group(P<0.05);The levels of IL-4 and IL-5 both increased,and the observation group was higher than the control group(P<0.05).Both groups of patients showed no significant adverse reactions.[Conclusion]Yinchenhao Decoction can promote postoperative recovery and wound repair of diabetes foot,control blood sugar level,relieve symptoms,alleviate inflammatory reaction,improve hemorheology,improve efficacy,and will not increase the incidence of adverse reactions.

Diabetic Foot/SUDiabetic Foot/ZYTreatment Outcome

彭林峰、王御震、赵志国、邢鹏超、徐洪涛、许仲佳

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上海市中西医结合医院脉管二科,上海 200082

糖尿病足/外科学 糖尿病足/中医药疗法 治疗结果

2024

医学临床研究
湖南省医学会

医学临床研究

影响因子:0.595
ISSN:1671-7171
年,卷(期):2024.41(5)