Effect of Danggui Buxue Decoction and Ermiao Powder addition and subtraction combined with vacuum sealing drainage technique on diabetic foot
ZHANG Yang1 GENG Haitao2 LIU Yuanwei1 ZHANG dan3 WANG Yan1 SONG Rui4 ZUO Weiwei4
1.Department of General Medicine, Qinhuangdao Military Hospital, Hebei Province, Qinhuangdao 066000, China;
2.Department of Pain, Qinhuangdao Third Hospital, Hebei Province, Qinhuangdao 066000, China;
3.the First Department of Radiotherapy, Qinhuangdao First Hospital, Hebei Province, Qinhuangdao 066000, China;
4.Department of Respiratory, Qinhuangdao Military Hospital, Hebei Province, Qinhuangdao 066000, China
Abstract:Objective To explore the effect of Danggui Buxue Decoction combined with Ermiao Powder addition and subtraction combined with vacuum sealing drainage (VSD) technique on diabetic foot (DF). Methods From September 2017 to October 2019, 80 patients with DF from Qinhuangdao Military Hospital in Hebei Province were selected as the research subjects, the patients were divided into observation group and control group by random number table method, 40 cases in each group. Both groups were given basic treatment + debridement and dressing change. Based on this, the control group was given VSD technology, and the observation group was given Danggui Buxue Decoction and Ermiao Powder addition and subtraction combined with VSD technology. The clinical efficacy, symptom improvement (skin temperature, foot pain, bipedal ankle brachial index [ABI]), inflammatory indicators (procalcitonin [PCT], C-reactive protein [CRP]) and serum insulin-like growth factor-1 (IGF-1), pigment epithelium-derived factor (PEDF) levels were compared between the two groups before and after treatment. Results The total effective rate of the observation group was higher than that of the control group (P < 0.05); after treatment, the skin temperature of the two groups was higher than before, and the pain score of the affected foot was lower than before (P < 0.05), the skin temperature and ABI index of the observation group after treatment were higher than the control group, and the pain score of the affected foot was lower than the control group (P < 0.05); after treatment, the levels of CRP, PCT and PEDF in both groups were lower than before treatment, and the levels of IGF-1 were higher than before treatment (P < 0.05); after treatment, the levels of CRP, PCT and PEDF in the observation group were lower than those in the control group, and the levels of IGF-1 were higher than those in the control group (P < 0.05). Conclusion Danggui Buxue Decoction and Ermiao Powder addition and subtraction combined with VSD technology for the first time in the treatment of DF, the effect is definite, can effectively improve clinical symptoms, shorten wound healing time, reduce inflammatory levels, and adjust serum levels of PEDF and IGF-1.
[1] 李丹,陈龙菊.中医药治疗糖尿病足的研究进展[J].中国中医基础医学杂志,2018,24(6):867-870.
[2] Bravo-Molina A,Linares-Palomino JP,Vera-Arroyo B,et al. Inter-observer agreement of the Wagner,University of Texas and PEDIS classification systems for the diabetic foot syndrome [J]. Foot Ankle Surg,2018,24(1):60-64.
[3] 彭闵,周秋红,许景灿,等.多学科团队诊疗模式在糖尿病足诊治中应用的进展[J].中国普通外科杂志,2017,26(12):1609-1617.
[4] 李丽华,叶斐,付先利,等.糖尿病足截肢患者血清Nε-羧甲基赖氨酸与胫前动脉斑块内钙化的关系[J].中华心血管病杂志,2017,45(11):958-962.
[5] 曹烨民,赵诚,赵满忱.糖尿病足高危人群的中医药治疗[J].中华糖尿病杂志,2018,10(7):500-502.
[6] 郑洁,祝友鹏,李恭驰,等.细菌和基质金属蛋白酶-9及基质金属蛋白酶抑制剂-1对糖尿病足创面愈合影响的研究进展[J].感染、炎症、修复,2018,19(3):177-180.
[7] 李高申,郭梅珍,牛美兰,等.活血生肌汤联合干细胞移植干预糖尿病足作用的临床研究[J].中国中医基础医学杂志,2018,24(6):798-802.
[8] Hingorani A,LaMuraglia GM,Henke P,et al. The management of diabetic foot:A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine [J]. J Vasc Surg,2016,63(2 Suppl):3S-21S.
[9] 国家中医药管理局医政司.中医病证诊断疗效标准[M].北京:中国中医药出版社,2017:143.
[10] Imran M,Hussain MB,Baig M. A Randomized,Controlled Clinical Trial of Honey-Impregnated Dressing for Treating Diabetic Foot Ulcer [J]. J Coll Physicians Surg Pak,2015,25(10):721-725.
[11] 李丹,陈龙菊.中医药治疗糖尿病足的研究进展[J].中国中医基础医学杂志,2018,24(6):867-870.
[12] 杨元庆,李思,张智龙,等.针刺对2型糖尿病足大鼠血管内皮因子的影响[J].中华中医药杂志,2018,33(6):2332-2335.
[13] 周珍,艾望,张莹雯.当归补血汤对糖尿病大鼠肝脏、骨骼肌细胞膜上GLUT4的影响[J].中华中医药学刊,2018, 36(11):2795-2798.
[14] 帅瑜,张思泉,沈鑫,等.当归补血汤对糖尿病大鼠肾组织内质网IRE1α-JNK通路的抑制作用[J].中华中医药学刊,2018,36(6):1372-1375.
[15] Hadavand F,Amouzegar A,Amid H.Pro-Calcitonin,Erythrocyte Sedimentation Rate and C-reactive Protein in Predicting Diabetic Foot Ulcer Characteristics;a Cross Sectional Study [J]. Arch Acad Emerg Med,2019,7(1):37.
[16] 谢翠松,骆宁,谭艳飞.硫辛酸对糖尿病足Wagner 2、3级患者氧化应激与炎症反应的影响[J].中国现代医学杂志,2019,29(20):69-73.
[17] 乃若旋.胫骨横向骨搬移治疗糖尿病足的临床疗效及对糖代谢、C肽及炎症指标水平的影响[D].南宁:广西医科大学,2019.
[18] 李超,赵金峰,张言涛,等.血清降钙素原和C-反应蛋白与白细胞计数对糖尿病足感染严重程度判定及预后评估的价值[J].中国慢性病预防与控制,2019,27(1):48-51.
[19] 崔国胜,曾剑玉,张婧,等.神经生长因子对2型糖尿病小鼠骨髓基质细胞体外成骨能力的影响[J].中华口腔医学杂志,2018,53(2):97-102.
[20] 王中京,邓艾平,李居怡,等.细胞因子与糖尿病足血管发生的相关性研究[J].国际内分泌代谢杂志,2019,39(2):120-123.
[21] 王强.持续性封闭负压引流治疗对糖尿病足患者血清IGF1、NO水平的影响[J].国际检验医学杂志,2018,39(1):63-66.
[22] 李骥,梁志强,曹烨民.中医药膳对糖尿病足溃疡合并低蛋白血症影响的临床研究[J].上海中医药杂志,2018, 52(8):40-43.
[23] 钟泉.清创-VSD-植皮/皮瓣修复的序贯模式在糖尿病足溃疡治疗中的应用[J].数理医药学杂志,2018,31(7):1078-1079.
[24] 徐靖波,王瑞瑞.封闭负压引流技术联合皮瓣移植术对糖尿病足溃疡的应用[J].黑龙江医药科学,2019,42(2):91-92.
[25] 李月姗,孙永,王华.糖尿病足溃疡创面感染患者MMP-2、TIMP-2、Smad3蛋白表达状况及其诊断价值分析[J].临床和实验医学杂志,2020,19(3):289-292.
[26] 李丹,陈龙菊.糖尿病足神经病变动物模型研究进展[J].中国实验动物学报,2018,26(1):128-132.
[27] 雒否乐,胡文华,曾晓芳.糖尿病胃轻瘫胃排空状态与肾功能水平的关系研究[J].现代消化及介入诊疗,2018, 23(6):706-709.
[28] 邓春艳,赵伟,韩琪臻.基于“虚、瘀”致毒理论浅析当归补血汤加味治疗糖尿病足验案[J].中国民族民间医药,2019,28(22):105-107.