Therapeutic Efficacy of Modified Danggui Sini Decoction in Treatment of Diabetic Foot and Its Impact on Hemorheology
Objective To observe the curative effect of Modified Danggui Sini Decoction in the treatment of dia-betes foot(DF)and the improvement of hemorheology.Method A total of 82 patients with DF admitted to the First Affili-ated Hospital of Heilongjiang University of Chinese Medicine from March 2021 to March 2023 were randomly divided into two groups:the control group(41 patients with DF)that received routine treatment,and the observation group(41 patients with DF)that received routine treatment combined with Modified Danggui Sini Decoction.After 8 weeks of treatment,the comprehensive clinical efficacy of two groups was evaluated.The traditional Chinese medicine(TCM)syndrome score and local symptom score of the wound were assessed,glucose metabolism related indicators[fasting postprandial blood glucose(FPG),2-hour postprandial blood glucose(2 h PG),glycosylated hemoglobin A1c(HbA1c)]were detected,the distal foot artery blood flow velocity and ankle brachial index(ABI)were monitored,and the hemorheological indicators[whole blood viscosity,plasma viscosity(PV)]as well as serum inflammatory factors[interleukin-1]β(IL-1 β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],vascular endothelial growth factor(VEGF)and hypoxia inducible factor-1α(HIF-1α)were detected.Results After treatment,the TCM syndrome scores of both groups of patients decreased significantly compared to before treatment,and the difference was statistically significant(P＜0.05).The observation group had lower score than the control group,with a greater reduction in scores in the observation group compared to the control group,and the difference was statistically significant(P＜0.05).After treatment,the wound area,granulation morphology,exudation,and pain scores of both groups of patients were significantly decreased compared to before treatment,and scores of the observation group were lower than the control group,with statistically significant differences(P＜0.05).After treat-ment,the FPG,2 h PG,and HbA1c of the two groups of patients decreased significantly compared to before treatment(P＜0.05).However,there was no statistically significant difference between the two groups(P＞0.05).After treatment,the average blood flow velocity of the posterior tibial artery and dorsal pedis artery and ABI in both groups of patients increased compared to before treatment(P＜0.05).Moreover,the levels of these indictors of the observation group were significantly higher than those of the control group(P＜0.05).After treatment,the whole blood high shear viscosity,whole blood low shear viscosity,and PV of both groups of patients were significantly reduced compared to before treatment,and the observa-tion group exhibited significantly lower levels than the control group(P＜0.05).After treatment,the serum levels of IL-1β,IL-6 and TNF-α in both groups were significantly lower than before treatment,and the observation group demonstra-ted significantly lower levels than the control group(P＜0.05).After treatment,the serum VEGF levels in both groups of patients increased compared to before treatment,and the observation group had significantly higher VEGF level than the control group.In contrast,HIF-1α levels decreased compared to before treatment,and the observation group had remark-ably reduced HIF-1α as compared with the control group(P＜0.05).The graded efficacy evaluation showed that the total effective rate of clinical comprehensive efficacy in the observation group was 92.86％(39/42),which was significantly higher than 76.19％(32/42)in the control group,with a statistically significant difference(P＜0.05).During the treat-ment period,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The modified prescription of Danggui Sini Decoction has a certain therapeutic effect on DF,possi-bly by regulating hemorheology,improving blood circulation,inhibiting inflammatory reaction and regulating the expression of HIF-1α and VEGF to promote the remission of the condition.
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