目的 观察生肌玉红膏联合参芪降糖胶囊对糖尿病足(Diabetic foot.DF)患者血糖控制及创面愈合的影响.方法 选取2021年12月—2022年12月期间河南省平顶山市中医医院收治的DF患者86例为研究对象,采用随机数字表法分为对照组和观察组,每组各43例.对照组采取常规治疗,观察组在对照组基础上予以生肌玉红膏联合参芪降糖胶囊,均治疗1个月.观察比较两组患者血糖控制水平,创面愈合情况,患肢足背动脉血流速度及踝肱指数,血清血管内皮生长因子(Vascular endothelial growth factor,VEGF)、丙二醛(Malondialdehyde,MDA)及超氧化物歧化酶(Superoxide dismutase,SOD)水平及中医证候积分.结果 治疗后两组患者FPG、2 h PG及HbA1c水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组FPG、2 h PG及HbA1c水平均明显低于对照组,差异有统计学意义(P＜0.05).治疗后观察组患者创面面积缩小率、肉芽组织覆盖率、细菌清除率均明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者患肢足背动脉血流速度及ABI指数均较治疗前升高,差异有统计学意义(P＜0.05);且观察组患肢足背动脉血流速度明显高于对照组,差异有统计学意义(P＜0.05).治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P＜0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P＜0.05).治疗后两组患者血清VEGF、SOD水平均较治疗前升高,MDA水平均较治疗前降低,差异有统计学意义(P＜0.05);且观察组VEGF、SOD水平均明显高于对照组,MDA水平明显低于对照组,差异有统计学意义(P＜0.05).结论 生肌玉红膏联合参芪降糖胶囊治疗DF效果显著,能有效控制患者血糖水平,改善创面血运,抑制创面细菌繁殖,促进创面肉芽生长,加速坏死组织脱落,减轻氧化应激反应,促进创面愈合,减轻临床症状,其作用机制可能与该方案能有效调节创面组织VEGF表达、促进血管新生有关.
Effect of Shengji Yuhong Ointment Combined with Shenqi Jiangtang Capsules on Blood Glucose Control and Wound Healing in Patients with Diabetic Foot
Objective To observe the effect of Shengji Yuhong Ointment combined with Shenqi Jiangtang Cap-sules on blood glucose control and wound healing in patients with diabetic foot(DF).Methods A total of 86 DF patients treated at Pingdingshan Traditional Chinese Medicine Hospital from December 2021 to December 2022 were enrolled and randomly divided into a control group and an observation group according to a random number table,with 43 patients in each group.The control group received conventional treatment,while the observation group received Shengji Yuhong Oint-ment combined with Shenqi Jiangtang Capsules in addition to the conventional treatment.Both groups were treated for one month.The blood glucose control level,wound healing status,dorsalis pedis artery blood flow velocity,ankle-brachial in-dex(ABI),serum levels of vascular endothelial growth factor(VEGF),malondialdehyde(MDA),superoxide dismutase(SOD),and traditional Chinese medicine(TCM)syndrome scores were compared between the two groups.Results After treatment,both groups showed significant reductions in fasting plasma glucose(FPG),2-hour postprandial glucose(2 h PG),and HbA1c levels compared to those before treatment(P＜0.05),with the observation group showing significantly lower levels than the control group(P＜0.05).After treatment,the observation group showed a significantly higher wound area reduction rate,granulation tissue coverage rate,and bacterial clearance rate than the control group(P＜0.05).After treatment,both groups showed a significant increase in the dorsalis pedis artery blood flow velocity and ABI compared to those before treatment(P＜0.05),with the observation group showing higher dovsalis pedis artery blood flow velocity than the control group(P＜0.05).After treatment,both groups showed a significant reduction in TCM syndrome scores com-pared to those before treatment(P＜0.05),with the observation group showing significantly lower TCM syndrome scores than the control group(P＜0.05).After treatment,serum VEGF and SOD levels were significantly increased,and MDA levels were significantly decreased in both groups compared to those before treatment(P＜0.05),with the observation group showing significantly higher VEGF and SOD levels and significantly lower MDA levels than the control group(P＜0.05).Conclusion Shengji Yuhong Ointment combined with Shenqi Jiangtang Capsules is an effective treatment for DF,which can effectively control blood glucose levels,improve blood circulation in the wound area,inhibit bacterial prolifera-tion,promote granulation tissue growth,accelerate necrotic tissue shedding,reduce oxidative stress,promote wound healing,and relieve clinical symptoms.The mechanism of action may be related to the effective regulation of VEGF expression in the wound tissue,promoting angiogenesis.
万方数据
维普
