黄连解毒汤治疗湿热毒盛证糖尿病足感染患者临床疗效评价
Clinical effect of Huanglian Jiedu decoction on treatment of patients with damp-heat toxic-excess diabetic foot infection
籍胤玺 1徐娜 1金毅 1林玉玲 1刘琳 1李曾一 1窦润鹏 1马圆圆 1程省 1曾俊风1
作者信息
- 1. 南阳市中心医院内分泌科,河南南阳 473000
- 折叠
摘要
目的 探讨黄连解毒汤对湿热毒盛证糖尿病足感染患者血清细胞因子水平及创面愈合情况的影响.方法 采用随机数字表法将2020年8月—2023年4月在南阳市中心医院接受治疗的152例湿热毒盛证糖尿病足感染患者分为A组和B组,每组例数均为76例.A组患者采用常规方式进行治疗,在A组患者治疗的基础上,B组患者采用黄连解毒汤进行治疗,两组均持续治疗4周.比较两组治疗4周后的临床疗效,创面愈合情况,治疗前、治疗4周后的中医证候积分、足背动脉血流动力学、疼痛评分及血清细胞因子水平.结果 B组治疗4周后的总有效率高于A组(90.79％vs.76.32％,P＜0.05);与治疗前比较,两组治疗4周后的创面面积均缩小,且与A组比较,B组更小(P＜0.05);两组各症状中医证候积分、数字分级法(NRS)评分、血清二胺氧化酶(DAO)、细胞间黏附分子-1(ICAM-1)、白细胞介素(IL)-1、IL-6水平均降低,且与A组比较,B组更低(P＜0.05);足背动脉血管内径及血流量均增大,且与A组比较,B组均更大(P＜0.05);与A组比较,B组治疗4周后的新生肉芽组织覆盖面积更大,新生肉芽组织覆盖率更高(P＜0.05).结论 黄连解毒汤能够有效缓解湿热毒盛证糖尿病足感染患者相关症状,促进患者创面愈合,改善患者足背动脉血流动力学,并有效减轻患者疼痛感及炎症反应,进一步改善患者肠壁通透性,进而提高治疗效果.
Abstract
OBJECTIVE To investigate the effect of Huanglian Jiedu decoction on serum level of cytokine and wound healing in patients with damp-heat toxic-excessive diabetic foot infection.METHODS A total of 152 diabetic foot infection patients with damp-heat toxicity syndrome admitted to Nanyang Central Hospital from Aug 2020 to Apr 2023 were divided into the group A and group B by random number table method,with 76 cases in each group.Pa-tients in the group A were treated with conventional methods.Patients in the group B were treated with Huanglian Jiedu decoction on the basis of conventional methods.Both groups were treated for four weeks.The clinical efficacy and wound healing after four weeks of treatment,the score of traditional Chinese medicine syndrome,blood flow dynamics,score of pain and level of serum cytokine before and after treatment were compared between the two groups.RESULTS The total effective rate in the group B after four weeks of treatment was higher than that in the group A(90.79％vs.76.32％,P＜0.05).Compared with before treatment,the wound area in both groups de-creased after 4 weeks of treatment,and compared with the group A,that in the group B was smaller(P＜0.05).The scores of traditional Chinese medicine syndromes,numerical grading system(NRS),levels of serum diamine oxidase(DAO),intercellular adhesion molecule-1(ICAM-1),interleukin-1(IL-1),and IL-6 decreased in both groups,and compared with the group A,the group B was lower(P＜0.05).The diameter and blood flow in the dorsal foot artery increased,and compared with the group A,the diameter in the group B had was larger(P＜0.05).Compared with the group A,coverage area of newly formed granulation tissue in the group B was larger and coverage rate of newly formed granulation tissue was higher after 4 weeks of treatment(P＜0.05).CONCLUSION Huanglian Jiedu decoction could effectively relieve the symptoms of diabetic foot infection in pa-tients with dampness-heat toxic-excess syndrome,promote wound healing,improve the hemodynamics of pa-tients'dorsalis foot,effectively reduce the pain and inflammatory response of patients,and further improve the permeability of patients'intestinal wall,thus improving the therapeutic effect.
关键词
糖尿病足/感染/湿热毒盛证/黄连解毒汤/血清细胞因子/中医证候积分/足背血流动力学/疼痛评分Key words
Diabetic foot/Infection/Syndrome of dampness-heat toxicity/Huanglian Jiedu decoction/Serum cy-tokine/Score of traditional Chinese medicine syndrome/Dorsalis foot hemodynamics/Score of pain引用本文复制引用
基金项目
河南省卫生健康委项目(SBGJ202103108)
出版年
2024
NETL
NSTL
万方数据